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Cultural background influences the expression of pain severity and, therefore, quality of life. This article addresses the reliability of one assessment tool for use with the minority population.
Pain among older adults is a significant and growing problem. It has been estimated that the older adult population experiences twice as much pain as the younger population (Ferrell & Ferrell, 1991). Approximately 25% to 50% of community dwelling older adults and as much as 45% to 80% of the older adult population in long-term care experience chronic pain problems (American Geriatrics Society [AGS], 1998). By 2020, more than 20% of the older adult population will be 65 or older, and the cohort is becoming more racially, ethnically, and culturally diverse (Heller, Oras, & Durney-Crowley, 2000).
By 2030, the Administration on Aging (2001) projects that ethnic minorities will represent 24% of citizens age 65 and older. The rapid increase in the numbers and diversity of the older adult population is contributing to the demand for health care resources that are equitable and accessible. Research indicates inadequate assessment and undertreatment (Bernabei et al., 1998; Ferrell, Ferrell, & Osterweil, 1990; Morrison Sc Siu, 2000; Sengstaken Si King, 1993) result in impairments that impact the older adult's quality of life (Ferrell & Ferrell, 1990; Lavsky-Shulan et al., 1985; Moss, Lawton, & Ghcksman, 1991; Weiner, Peterson, Oc Keefe, 1998). Thus, issues related to assessing and managing pain in older adults, especially minority older adults, will continue to be a priority.
Accurate assessment of pain and adequate treatment across all ages and ethnic groups has been recommended by key policy, professional, and regulatory agencies, including the Agency for Health Care Policy and Research (AHCPR) (1992, 1994), the AGS (1998), the American Pain Society (1999), and the Joint Commission on Accreditation at Healthcare Organizations QCAHO, 1999). Cultural background has been identified as an important factor influencing pain behavior and expression (Keefe, Jacobs, & UnderwoodGordon, 1997; McGuire, 1992). Two prominent issues related to the problem of assessment of pain in minority older adults exist. First, there is a need for valid and reliable assessment tools for use with different cultural and ethnic groups. Although empirical psychometric evaluation of pain assessment tools for use with older adults is growing, data addressing appropriate tools and...