Māori and pain

Abstract

Pain is subjective and is therefore a complex and diffi cult health issue to address. In-depth understanding is required for improvements to be made in how it is managed. Research suggests that culture plays a role in pain experiences, but very little such research has been conducted in Aotearoa (New Zealand). Signifi cant health disparities exist between Mäori (the indigenous people) and Päkehä (New Zealanders of European descent), and could also exist in pain experience. We reviewed the sparse, diverse literature on Mäori and pain and found patchy, inconsistent coverage, arising perhaps from the range of methodologies used and types of pain covered, with a distinct gap around chronic pain. Although pain is a signifi cant area of Mäori health, none of the research explored the lived experience of pain from a Mäori perspective. The need for indepth research using a Kaupapa Mäori (Mäori theory) approach to address this under-researched issue is discussed.

Evaluation of Self-Management Support Functions in Apps for People With Persistent Pain: Systematic Review

“…Although meeting all these cultural aspects in an app may not be possible and would be country or region specific, there is a need for providing information tailored to cultural beliefs, considering the existing health disparities across cultures (eg, ethnic and racial minorities) in pain prevalence and access to services [55]. From the New Zealand context, providing culturally appropriate information is important to meet the needs of New Zealand Māori—Indigenous people of New Zealand—who are at high risk of reporting persistent pain [56] and experience greater health inequities than any other ethnic group in New Zealand [13,57]. It is interesting to note that none of the previous app reviews [23,24,30,31,58] have investigated the provision of culturally tailored information despite the evidence to support that cultural beliefs and practices affect individual pain experiences [59] and adherence to active self-management strategies [27].…”

Palliative care and quality of life needs and outcomes for Māori with cancer: what do we know?

“…When considering this in the context of cancer, the latter could result in a lack of understanding or exclusion of alternative or traditional therapies including rongoā (traditional Māori system of holistic healing) (Ahuriri-Driscoll et al, 2008) Lawrenson et al (2013) noted that for Māori at the palliative stage of their illness, relief of pain was the most common reason for Emergency Department attendance (Lawrenson et al, 2013). This is supported by evidence of disparities in pain experiences for Māori, in general, alongside issues with the quality of medication dispensing for older Māori (Hikaka et al, 2021;Mcgavock et al, 2012). Despite the prioritisation given to physical pain mitigation in palliative care, Māori with lung cancer are more likely to access pain medication for the first time in the 2 weeks prior to their death; in comparison, non-Māori with lung cancer are more likely than Māori to access pain medication more than 24 weeks before death (Gurney et al, 2021).…”

It’s more than just physical: Experiences of pain and pain management among Māori with cancer and their whānau.

“…For Māori with cancer, pain and its associated morbidities are not yet well understood (Gurney et al, 2021). It is argued that pain models must include a multidimensional approach, and pay attention to contextual and cultural factors so to adequately address pain in Māori (McGavock, Barnes, & McCreanor, 2012;Pitama, Huria, Beckert, & Lacey, 2011). For a number of decades, international definitions of pain have acknowledged the multi-dimensional aspects of pain (O'Neill & Fallon, 1997), and have explicitly included the impacts of biological, psychological, and social factors on pain perception (Hussain, 2022;Raja et al, 2020).…”