The lens model: assessment of cancer pain in a Chinese context

Obtaining a result closest to patients' reports about pain is crucial in pain management. The literature in the West supports the view that there are cultural differences in perception, interpretation, and expression of pain. However, there has been minimal review in Chinese communities. Therefore, the concepts of cancer pain among Chinese patients with cancer were explored by data source triangulation. There were 33 informants: 18 adult Chinese patients with cancer who were in pain, 7 physicians, and 8 nurses. The interview dialogue was transcribed into written Chinese, followed by coding and categorization. There were no predetermined themes for categorization. The dialogue was coded according to the contextual meaning. The nature and number of categories depended entirely on the coding. Five dimensions were identified: functional, pharmacologic, pain belief and meanings, psychosocial, and emotional. With reference to the five dimensions, a lens model was constructed to explain the cancer pain experience in a Chinese context. In the lens model, two lenses were used to illustrate the relations of the dimensions and cancer pain experience in the Chinese context. The pain experience was named as total pain intensity. The functional, pharmacologic, psychosocial, and emotional dimensions were the independent variables. The pain beliefs and meanings dimension was the mediating variable, and the dependent variable was the total pain intensity in the assessment of cancer pain.