Cancer-related pain and nonmalignant pain is a health concern for the Native American people of Montana and Wyoming because reservations are geographically remote from health specialists, alternative approaches to health care delivery are necessary Telehealth is currently being used to bring specialized health care to under-served Americans throughout the United States. Native American reservations are a prime location for telemedicine interventions because of the specialized resources on the reservations and the long distance needed to travel to access specialized health care. Little research is available on the use of telehealth with the Native American population. Even less is available on the pain experience in Native Americans. A person's response to pain is influenced by his or her past experience with pain, the duration and intensity of the pain, and their culture. Culture is an especially important consideration in the Native American population. Current pain assessment instruments do not take the Native American culture and language barriers into consideration. Adequate pain management and alternative methods of health care delivery in the Native American population have not been well researched. Therefore, the overall goal of this study is to evaluate the adaptation of a standardized pain assessment questionnaire as well as the acceptance of telemedicine as a means of delivery for pain management treatment in the Crow Native American population.
Specific aims this study will address include. 1) Evaluation of the adaptability of the Brief Pain Inventory for use with a Native American population, and 2) Evaluation of the feasibility of nursing management of chronic pain using telehealth technology with a Native American population. The Brief Pain Inventory will first be adapted in culturally sensitive English. This translation will be refined and preliminary testing conducted. Expert-patient agreement will be established and intra-item correlation performed. There will be 10 Crow patients with complaints of pain over 3 months in duration. Each participant will have one face-to-face consultation with the Advanced Practice Nurse pain expert There will be three consultations over telehealth Telehealth will be considered an acceptable mechanism of pain management delivery if Crow participants' pain scores decrease over the course of the study and they score 4 or above on the Acceptance of Telehealth Questionnaire. Results of this study provide the basis for tool development and alternative methods of health care delivery in a medically under-served Crow population.
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