Understanding cultural constructions of chronic pain in Mexican -American women

Diane B Monsivais, The University of Texas School of Nursing at Houston


Background. Non-malignant chronic pain is a national health problem. Cultural constructions of chronic pain, such as expression of symptoms and decision making, may interfere with treatment. Purpose. To describe the cultural constructions of chronic pain held by Mexican-American women. Methods. This qualitative, focused ethnographic study examined the shared cultural experiences of women with non-malignant chronic pain. Field work and recruitment of participants took place in a pain management clinic and in a fibromyalgia support group over a 9 month period. In-depth, open-ended interviews lasting from 1-3 hours were held with participants. Data analysis was iterative, beginning with data collection and continuing throughout analysis. Data rigor was established through a clear audit trail and debriefing sessions with other qualitative researchers in Houston and El Paso. Findings. Fifteen Mexican-American women were interviewed. Themes were identified through qualitative thematic data analysis and categorized into 3 main areas: (1) delegitimizing experiences, (2) negotiating legitimacy for identity as a woman with chronic pain, and (3) finding legitimacy for identity as a woman with chronic pain. The main themes were viewed through Kleinman's popular and professional sectors of the local healthcare system. In the popular sector, women often felt delegitimized because they believed others would not recognize the pain as being a legitimate problem and might think they were "faking." Silence was their method of negotiating their identity as a truthful person capable of fulfilling expected roles. In the professional sector, participants openly expressed their painful symptoms, but were often unable to find effective treatment. When pain medication was prescribed, culturally-associated stigmas led women to under-use medications in order to control the negative associations with their own identity. Supportive relationships created legitimizing experiences in both the popular and professional sectors. Conclusion. Cultural constructions of chronic pain reflect influences of the legitimacy of invisible illnesses, and stigmas related to pain medication. If these ideas are not explored and addressed with patients, they may interfere with treatment.

Subject Area

Cultural anthropology|Womens studies|Nursing

Recommended Citation

Monsivais, Diane B, "Understanding cultural constructions of chronic pain in Mexican -American women" (2008). Texas Medical Center Dissertations (via ProQuest). AAI3362677.