Access Type

Open Access Dissertation

Date of Award

January 2010

Degree Type


Degree Name




First Advisor

Dr. April Hazard Vallerand


Background: Inadequate chronic pain control has far-reaching implications including costs for missed time at work; utilization of health care resources and reduced quality of life. People at highest risk for inadequate pain control include indigent adults and minorities. Newman's theory health as expanding consciousness views the chronic pain experience as a life pattern within health. Qualitatively examining chronic pain from participants' perspectives may improve chronic pain care.

Purpose: The purpose of this study was to examine the experiences of chronic pain as described by African American indigent adults attending an urban, primary care clinic.

Methods: 13- participants (7 men and 6 women). Inclusion criteria: registered patients at the clinic, spoke English, no sign of cognitive impairment, self-identified as African American, denied current illicit drug use and experiencing moderate to severe chronic pain for more than three months. Focused ethnography, two to three face-to-face interviews and two to three photovoice sessions. Photovoice provides marginalized individuals with a medium to showcase their experiences with chronic pain, and captures with images, the pain experience that is not easily explained through quantitative measures.

Findings: Five themes and numerous subthemes inductively emerged from participants' words and pictures. Participants described how time seemed to slow down as they were `Waiting on Pain'; they discussed the items they used and activities they performed as they were `Coping with Chronic Pain' and they described the `Challenges with Chronic Pain' such as convincing others of the intensity of pain. Participants also discussed how they were `Negotiating Pain in a Vulnerable Environment' and described their experiences with living in chaotic environments, yet with all of these difficulties, they were `Sharing Wisdom about Chronic Pain' with others outside of the present study.

Conclusion: This study is significant because it opens new horizons for discussing chronic pain with African American indigent adults and from participants' perspectives discusses how to provide patient-centered pain care.

Included in

Nursing Commons