The Intersections of Chronic Noncancer Pain: Culturally Diverse Perspectives on Disease Burden

Abstract

Health care providers must consider how the intersectionality of social identities related to ethnoculture, social class, migration status, and gender can factor into the creation and maintenance of chronic pain disparities. A greater, more thoughtful incorporation of intersectionality in chronic pain research and clinical practice will ensure that pain management approaches are designed and applied in a way that reflects the social context of affected communities and individuals from those communities.

Recognising ethnocultural diversity in chronic pain assessment: validation of the Pictorial Representation of Illness and Self Measure (PRISM) for use with culturally diverse communities

“…This study utilised a paper version of the PRISM+ [11], laminated to allow disks to be moved and positioned easily by patients. The original paper version was selected over electronic versions as our experience with CALD communities in South West Sydney Local Health District (SWSLHD) indicated high rates of social disadvantage and limited familiarity with technology in health [30]. Further, the paper versions allowed for translations to be readily printed and taken home by participants for repeat testing.…”

“…For the PRISM+, the additional disks selected were informed by research involving Assyrian, Arabic and Vietnamese communities from SWSLHD [6, 30], and previous use of the PRISM+ in chronic pain settings [12]. Previous qualitative research findings from each CALD community emphasised the importance of family, fulfilling traditional occupational roles, social relationships, and spirituality, on the experience of pain and construction of ethnocultural identity [6].…”

The relationship between patients’ income and education and their access to pharmacological chronic pain management: A scoping review

“… 4 , 5 Given that chronic pain is a complex and multidimensional experience whose assessment, study, and management are influenced by a variety of biopsychosocial contexts, 6 it is not surprising that a variety of studies have found that patients’ socioeconomic status (SES) can affect their experiences, treatments, and health outcomes. 7–9 Patients’ chronic pain experiences have been shown to be affected by factors such as their gender, ethnicity, social class, income, education, and the neighborhood in which they reside. 7 , 9–11 The Canadian Pain Task Force 12 agrees that such factors play a role in explaining the inconsistent and inequitable experience of pain and access to pain care in Canada.…”

“… 7–9 Patients’ chronic pain experiences have been shown to be affected by factors such as their gender, ethnicity, social class, income, education, and the neighborhood in which they reside. 7 , 9–11 The Canadian Pain Task Force 12 agrees that such factors play a role in explaining the inconsistent and inequitable experience of pain and access to pain care in Canada. Therefore, among the six recommendations that the Canadian Pain Task Force has suggested to the Canadian federal government to improve the prevention and management of chronic pain are those specifically related to improving both equitable access to pain care and ensuring “equitable approaches for populations disproportionately impacted by pain.” 12 (p1)…”

The sustainability of evidence-based pain management practices in aged care

“…Such pain behaviours may include, facial expressions, vocalisations, changes in body positioning (limping, posturing or guarding), changes in normal behaviour (withdrawal from socialisation), or changes in physiological signs (sweating, pallor) (Achterberg et al, 2013).These behaviours may be indicators to an observer, of the presence of pain and the only way that a person with dementia, other neurological or sensory deficits, can communicate with others that something is wrong (Keefe et al, 2011). However, these behaviours may also be altered or absent in people with persistent pain, or people from different social or CALD backgrounds (Brady, Veljanova, & Chipchase, 2019;Dansie & Turk, 2013; South East Melbourne Medicare Local [SEMML], 2015).…”