While it is well documented that culture affects patients’ pain related beliefs and behaviours, little is known about how culture impacts Chinese cancer patients’ pain management. The objective of this systematic review was to describe pain management needs and perspectives of cancer patients from Chinese backgrounds and to identify barriers and facilitators affecting their pain management and outcomes.
This systematic review was undertaking by adhering to PRISMA and Joanna Briggs Institution's methods. CINAHL, MEDLINE, PsyINFO, Cochrane Library and China Academic Journals were searched for peer reviewed articles published in English or Chinese between 1990-2015. Risk of bias within studies was assessed by two independent reviewers using Joanna Briggs Institution's appraisal tools. Popay’s narrative method was adopted to guide data analysis and synthesis.
Of 3904 identified records, 23 articles met the inclusion criteria which provided primary data involving 6110 Chinese adult cancer patients. Suboptimal analgesics use, delays in receiving treatment, reluctance to report pain and/or poor adherence to prescribed analgesics contributed to patients’ inadequate pain control. A range of patient, family, health professional and healthcare system related barriers were reported which included: ‘fatalism’, ‘desire to be good’, low ‘pain control belief’, ‘pain endurance’ and ‘negative effect beliefs’, ‘fear of addiction’, ‘concerns about analgesic adverse effects’, ‘disease progression’, ‘poor communication’, ‘limited access to analgesics and/or after hour pain services’.
Findings from this review inform the development of optimal educational interventions to improve cancer pain management outcomes for patients from Chinese backgrounds. Future studies on patients’ pain assessment and non-pharmacological intervention related experiences are required to inform multidisciplinary and biopsychosocial approaches for culturally appropriate pain control. Cultural influences on Chinese migrants’ cancer pain management are yet to be explored.