POST OPERATIVE PAIN EXPERIENCES OF CENTRAL AUSTRALIAN ABORIGINAL WOMEN. WHAT DO WE UNDERSTAND?

Objective:   The aim of this study was to explore the postoperative pain experiences of Central Australian Aboriginal women and the subsequent interpretation of that pain experience by non‐Aboriginal female nurses.Design:   Qualitative study using grounded theory methodology.Setting:   Postoperative surgical setting of a Central Australian regional hospital.Subjects:   Five Aboriginal female clients who had undergone a surgical procedure, eight non‐Aboriginal female nurses and four Aboriginal female health workers employed by a Central Australian regional hospital.Results:   Aboriginal women have culturally appropriate ways of expressing and managing pain that are not well understood by non‐Aboriginal female nurses. In addition, the Aboriginal women inappropriately endow non‐Aboriginal nurses with the same powers and skills expected of healers from their culture. This phenomenon resulted in the non‐Aboriginal nurses lacking the cultural insight and the appropriate knowledge and tools required to assess and manage the postoperative pain of Central Australian Aboriginal women effectively or efficiently.Conclusions:   Non‐Aboriginal nurses have a profound knowledge deficit about the postoperative pain experiences of Central Australian Aboriginal women. This deficit is evident through the use of culturally inappropriate and unreliable pain assessment strategies and tools and the misinterpretation of traditional pain relief strategies, such as the use of pituri, rubbing and centreing. The findings of this study suggested that nurse/client interactions related to language and role interpretation were in cultural conflict. The nurses expected the Aboriginal women to adopt pain behaviours as understood from the nurses’ culture. The nurses anticipated that the client would contribute to their own care by communicating pain experiences in ways that are familiar and are believed to be universal. The Aboriginal women expected the nurses to conduct business similar to that of their own traditional tribal healers, ‘to see within’ and to ‘just know’.What is known on this subject:  The National Health and Medical Research Council claim there is a dearth in systematic studies of pain issues for Aboriginal and Torres Strait Islander people. 1 Previous studies conducted suggest that Aboriginal people do not feel pain and have an extraordinary high pain tolerance. 2,3 However, no significant studies exist in the area of pain management that address the cultural needs of Aboriginal people.What this paper adds:  Statistical evidence gathered from the informal Acute Pain Service operational within a Central Australian regional hospital, revealed that although the hospital clientele were predominately of Aboriginal descent, the service catered for a greater proportion of non‐Aboriginal people. The misconception that Aboriginal people have a high pain tolerance requiring less pain relief is outdated and erroneous, as this paper will reveal.