Page 122 Complete Your CE Test Online - Click Here Barriers to the treatment of both acute and chronic pain The numerous barriers to effective treatment of pain can be patient or provider centered. Following are some barriers to effective pain management and relief (IOM, 2011): ● ● Sex: Women are more likely to report pain and seek help than men are. ● ● Race: Non-Hispanics are more likely to report pain than other groups are. Asians are the least likely. ● ● Socioeconomic: Patients with a lower income and less education report more pain. ● ● Age: Children and the elderly are more likely to be undertreated for pain. ● ● Provider biases of patients with pain: Is the patient in pain or drug seeking? Is the patient trying to get on disability? ○ ○ Inadequate appointment time to properly assess and discuss pain relief options. ○ ○ Fear of opioid addiction (both provider and patient). ○ ○ Not utilizing complementary pain management tools, such as massage and acupuncture, because of poor or no insurance coverage. Communication and education are key to overcoming barriers to the effective treatment of pain. Nurses should stay informed of the latest treatment options and recommendations, and be aware of any bias they may hold toward those experiencing pain. Communication should be frequent and thorough and should include information on treatment options, side effects, and expectations of treatment. Disparities in pain relief Disparities in pain occurrence, assessment, treatment, and outcomes exist in various vulnerable populations in the United States because of a multitude of factors (IPRCC, 2015): ● ● The individual’s willingness to report the pain. ● ● The individual’s adherence to the treatment plan. ● ● Provider bias against certain conditions: ○ ○ Women with fibromyalgia or chronic fatigue syndrome. ○ ○ Elderly residents of nursing homes. ○ ○ Minority patients with sickle cell pain. ○ ○ Those who have pain from HIV infection. These patients may feel stigmatized if the provider of care shows bias and may not seek treatment for pain relief. Racial and ethnic minorities have been reported to be undertreated for pain when compared to non-Hispanic whites (Green et al., 2003). Differences in pain treatment for racial and ethnic minorities are not specific to setting or condition. Likewise, differences are evident in various health care settings and include postoperative pain, cancer pain, noncancer pain, and chronic nonmalignant pain (Green et al., 2003). In 2015, the Interagency Pain Research Coordinating Committee set forth objectives and strategies to overcome the disparities that exist in vulnerable and underserved populations: ● ● A reduction in bias through understanding its effects and employing strategies to overcome it. ● ● An improvement to accessibility to high-quality pain relief services for those unable to access such care. ● ● Facilitation of communication between patients and health professionals. The first step in overcoming disparities in the treatment of pain is to be aware of any personal bias one may have. It is crucial to advocate for patients who may be undertreated or at risk for bias regarding pain treatment. Conclusion Pain is a universal experience, but it is highly subjective. To properly assess and manage pain, nurses must communicate thoroughly with the patient, be understanding of the various influences that make pain subjective for each individual, and be vigilant about the assessment and reassessment of pain for the patient in their care. It is important that any health care worker involved in the assessment and treatment of a patient experiencing pain stay educated on the latest guidelines and recommendations of pain management and approach all patients without bias.