FACTORS WHICH MODIFY THE PERCEPTION OF PAIN: SOCIAL DIFFICULTIES AND CULTURAL FACTORS
Patients with cancer do not exist in social isolation; usually they have family and friends as well as social and financial responsibilities. Cancer frequently has devastating effects on these relationships, leading to a range of social problems which are likely to worsen as the disease progresses.
Social difficulties are likely to aggravate pain; their successful resolution may greatly improve it.
• Unaddressed social problems can lead to unrelieved pain.
Cultural factors-Different cultures vary greatly in their attitude to disease, pain and death, ranging from stoic acceptance to severe anxiety and depression. There is also variation between different groups in their attitude to the philosophy of palliative care and particularly to the open discussion of the diagnosis and prognosis. Lack of respect for an individual's cultural background or culturally insensitive management are likely to cause or aggravate other problems, including pain. Language barriers, which make communication about pain and its treatment difficult, can exacerbate pain.
• Culturally appropriate management and the circumvention of language barriers may lessen pain.
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