What Do Adult Surgical Patients Speaking Primarily Cantonese, Italian, or Portuguese Really Want to Know About Pain and Pain Management?

BACKGROUND:Surgical patients consider information about pain and pain management to be highly important (Apfelbaum, 2003). At the same time, evidence indicates that members of racial and ethnic minorities are more likely to experience inadequate pain management (Green, Anderson, Baker, Campbell, Decker, Fillingim, & Todd, 2003; Mossey, 2011). AIMS:This study investigated the needs of general day surgery patients who spoke primarily Cantonese, Italian, or Portuguese at home for information about postoperative pain. DESIGN:This was a mixed methods, descriptive study. SETTING:The day surgery unit of a large, quaternary care hospital in downtown Toronto. PARTIPANTS/SUBJECTS:Inclusion criteria were day patients who were at least 18 years of age or older and spoke primariy Cantonese, Italian or Portugues at home. and were able to read and write in their primary language. METHODS:Participants who had undergone a day surgery procedure completed a telephone information needs survey in their primary language (Cantonese, Italian, Portuguese) within 72 hours after discharge. Composite mean scores were calculated for each item. Chi-squared analyses were used to probe for intergroup differences and compare with English-fluent participants from phase 1 of this study (Kastanias, Denny, Robinson, Sabo, & Snaith, 2009). RESULTS:Sixty-three participants in total completed the survey: 21% Cantonese, 41% Italian, and 38% Portuguese. The mean age of the sample was 70 years old; 89% were born outside of Canada, and 52% were male. For the combined group, the average importance rating score range for the information items was 6.2-8.9 out of a possible score of 10. All items were rated as moderate (5-6 out of 10) to high (≥7out of 10) importance. Surgical subtype, health status, and age had no effect on the importance of any information item. There were no significant differences between the three language groups on any of the information items. This lack of difference may have been a result of a lack of power due to the small sample size of the individual language groupings. Overall, the top-ranked information items were "the plan for which drugs to take and when," "what I can do if I still have pain or side effects," and "side effects I was most likely to get." CONCLUSIONS:Similar to English-fluent participants (Kastanias et al., 2009), participants who primarily spoke either Cantonese, Italian, or Portuguese at home placed moderate to high importance on all of the information items. and neither surgical subtype, health status nor age had any effect on the importance of any item. The multilingual sample in this study placed more importance than English-fluent participants on information regarding help with paying for pain medication (p = .001) and the side effects they were most likely to experience (p < .05). Due to a paucity of literature in this area, further research is warranted. Results may assist with evaluating and improving current approaches to surgical patient pain management education.