Background. Pain is the most commonly reported symptom in primary care and is estimated to affect over 110 million people in the United States. Increased pain severity and occurrence and inadequate treatment of pain is linked to being a minority, healthcare access, socioeconomic status, age and gender. Outcomes of pain include costs, healthcare utilization, functional changes, and quality of life. Gaps in knowledge exist regarding the American Indian (AI) chronic non-malignant pain experience, management and outcomes. Objective. The purpose of this research is to describe Northern New Mexico (NNM) AIs chronic pain experience, intervention strategies, and outcomes. Methods. This study utilized a qualitative descriptive (QD) design, with in-depth, one-on-one interviews with semi-structured interview questions. A sample of 14 Native Americans were interviewed for this study. A questionnaire was used to collect demographic data. Domain, taxonomic and content analyses were utilized to gain a highly nuanced description of the research topic. Results. The participants provided rich qualitative data regarding chronic pain experience, management strategies and outcomes. Frequent pain experiences included the body as a confining entity, body awareness, unpredictability of pain, and psychological outcomes. AIs in the study utilize a variety of biomedical, professional and self-care interventions. Outcomes discussed were functional status, costs, healthcare utilization, and quality of life. Outcomes. The goal of this research is increased understanding of the chronic pain experience through the perspective of those experiencing it. Findings will be submitted to the University of Arizona dissertation library, disseminated across relevant peer-reviewed journals focused on pain and pain management, and presented to appropriate groups and organizations.

Chronic pain is a significant public health problem. A large portion of those with chronic pain have had their acute postsurgical pain transition into a chronic postsurgical pain state. The mechanisms contributing to pediatric persistent postsurgical pain is not well understood; however, there is empirical support in the adult literature to suggest that psychosocial factors play a significant role in the maintenance and exacerbation of post-surgical pain. Recent research by our group found high pain prevalence rates up to 5-years post-surgery among children undergoing spinal fusion surgery, particularly among those reporting poor pre-surgical mental health. The current study aims to extend this research by exploring psycho-social functioning and pain among children (10-21 years) who underwent major orthopedic surgery and their parents (n=21 dyads; data collection is ongoing). Measures administered 1-3 years post-surgery included pain ratings, the Bath Adolescent Pain Questionnaire (Child; Parental Impact), Fear of Pain Questionnaire, Functional Disability Inventory, and the Adult Responses to Child Symptoms. Preliminary results found that 52% of patients reported pain in the moderate-severe range in the past 6 months. Additionally, increased child pain was associated with greater child-reported functional disability (p<.01), pain-specific anxiety (p<.01), and fear of pain (p<.05), as well as worse overall emotional functioning (p<.05). Parents of children with increased pain reported worse parental strain (e.g., "found my relationship with my child difficult," p<.05). Identifying correlates of poor long-term outcomes in children with postsurgical pain may prevent the development of chronic pain into adulthood. With recent economic costs of adult chronic pain estimated to be between $560-$635 billion per year research on the role of persistent pain in children is of upmost importance in order to positively impact pre-surgical preparation, postsurgical care, and in potentially preventing disabling pain into adulthood for a population at considerable risk. This investigation was supported by the Boston Children's Hospital Career Development Fellowship Award (CS).