Ethnicity and the pain experience

Abstract

The first objective of this investigation was to examine interethnic differences and similarities in the reported pain experience of Black, Irish, Italian, Jewish and Puerto Rican facial pain patients. Responses, attitudes and descriptions were found to be relatively similar after controlling for most variables shown by previous studies to influence reported pain experience. These variables include symptom history, signs elicited on physical, radiographic and laboratory examination, as well as social, cultural and psychological data. A thirty-five item scale was employed to measure patients' pain experience. Using analysis of variance and covariance, no significant interethnic differences were found for twenty-three (65.7%) of the items. The majority of the twelve items for which interethnic differences were found concerned the patients' emotionality (stoicism vs expressiveness) in response to pain, and interference in daily functioning attributed to pain. The pain experiences reported by the Black, Italian and Jewish patients were found most similar as measured by the twelve items. Irish and Puerto Rican patients appeared relatively distinct from the other groups as well as from each other. The second objective of this study was to identify particular variables that influence intraethnic variation in the pain experience. These were determined by multiple regression analysis of two summary indices previously derived by factor analysis of the thirty-five items. The specific variables which were most influential differed according to ethnicity, as follows: degree of medical acculturation for Black patients; degree of social assimilation for Irish patients; duration of pain for Italian patients; and level of psychological distress for Jewish and Puerto Rican patients. Thus, it appears that, in our study population, interethnic homogeneity is present for most aspects of the pain experience, while intraethnic heterogeneity exists for factors that may influence that experience. That is, the five ethnic groups were generally found to be similar in their reported responses to pain. Yet, each group was quite different with regard to factors which influence the responses.