Exploring thoughts about pain and pain management: Interviews with South Asian community members in the UK

Burton, Amy; Hissey, Laura; Milgate, Sarah

doi:10.1002/msc.1400

Cited by 7 publications

(7 citation statements)

References 44 publications

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“…This is an important issue for healthcare professionals to consider and discuss with patients. These findings align with other research into the importance of privacy, masculinity and alternative therapies in healthcare for patients from South Asian communities [ 21 , 38 ].…”

Section: Discussionsupporting

confidence: 89%

Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford: a qualitative interview study

Clarke

Crooks²,

Bennett

et al. 2023

BMC Palliat Care

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Background Pain is a significant problem for many people with advanced disease or a serious illness. Culture and ethnicity can affect the experience and management of pain. However, there is limited research in South Asian communities in the UK on their experiences of pain. The aim of this study is to explore the experiences and attitudes of patients and family carers from South Asian communities about pain and its management within advanced disease or serious illness. Methods Qualitative thematic analysis based on descriptive phenomenology (Sundler et al. 2019). Qualitative semi-structured interviews with patients or family carers from South Asian communities (N = 15). Interviews were recorded, transcribed and analysed using an inductive approach. Public and Patient Involvement representatives from British South Asian communities were consulted for guidance. Results There were five key themes from the interviews: The importance of communication about pain with healthcare professionals; Concerns about taking pain medication; Personal resilience, privacy and self-management; Gender, culture and pain; Home pain management as struggle and frustration. Conclusion To improve pain management for people from South Asian communities with advanced disease or a serious illness, there are a number of important issues for healthcare professionals from palliative and primary care services to address. These include: greater awareness around people’s fears and concerns about pain medication; their potential use of alternative pain management strategies; and cultural issues such as resilience, privacy, dignity and gender roles. Effective communication between doctors, patients and family members could be improved by using a ‘cultural humility’ model; providing clear and accessible pain medication information; understanding and taking account of people with both low, and medium levels, of English language proficiency; and improving patient trust. Additionally, improvements to out of hours services could improve pain management for all patients managing their pain at home.

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Section: Discussionsupporting

confidence: 89%

Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford: a qualitative interview study

Clarke

Crooks²,

Bennett

et al. 2023

BMC Palliat Care

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“…While this could represent an actual difference in the rate of migraine, other data suggest that it could be cultural influence on the reporting of symptoms and attitudes toward pharmacologic treatment. 29,30 For example, small qualitative studies in the United States and United Kingdom have found that providers perceive that South Asians under-report pain and can be reluctant to accept pharmacologic treatments. 29,30 Due to the demographics of Philadelphia, the number of Asian patients in our sample is relatively small and heterogeneous, and future studies should explore this finding.…”

Section: Discussionmentioning

confidence: 99%

“…An unexpected finding in this analysis was the lower odds of specific diagnosis and treatment in Asian patients. While this could represent an actual difference in the rate of migraine, other data suggest that it could be cultural influence on the reporting of symptoms and attitudes toward pharmacologic treatment 29,30 . For example, small qualitative studies in the United States and United Kingdom have found that providers perceive that South Asians under‐report pain and can be reluctant to accept pharmacologic treatments 29,30 .…”

Section: Discussionmentioning

confidence: 99%

“…29,30 For example, small qualitative studies in the United States and United Kingdom have found that providers perceive that South Asians under-report pain and can be reluctant to accept pharmacologic treatments. 29,30 Due to the demographics of Philadelphia, the number of Asian patients in our sample is relatively small and heterogeneous, and future studies should explore this finding.…”

Section: Discussionmentioning

confidence: 99%

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Patient headache questionnaires can improve headache diagnosis and treatment in children

Szperka,

Witzman,

Ostapenko

et al. 2023

Headache

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ObjectiveTo examine trends in diagnosis of headache and migraine in a large pediatric neurology cohort, and test whether an electronic health record (EHR)‐integrated headache questionnaire can increase specificity of diagnosis and likelihood of prescribing migraine treatment.BackgroundUnder‐diagnosis of migraine contributes to the burden of disease. As we founded our Pediatric Headache Program in 2013, we recognized that the proportion of patients with headache who were given a diagnosis of migraine was much lower than expected.MethodsWe developed a patient headache questionnaire, initially on paper (2013–2014), then in an electronic database (2014–2016), and finally integrated into our electronic health record (pilot: 2016, full: May 2017). We compared diagnoses and prescribed treatments for new patients who were given a headache diagnosis, looking at trends in the proportion of patients given specific diagnoses (migraine, etc.) versus the non‐specific diagnosis, “headache.” Next, we conducted a prospective cohort study to test for association between provider use of the form and the presence of a specific diagnosis, then for an association between specific diagnosis and prescription of migraine treatment.ResultsBetween July 2011 and December 2022 the proportion of new headache patients who were given a diagnosis of migraine increased 9.7% and non‐specific headache diagnoses decreased 21.0%. In the EHR cohort (June 2017–December 2022, n = 15,122), use of the provider form increased the rate of specific diagnosis to 87.2% (1839/2109) compared to 75.5% (5708/7560) without a patient questionnaire, nearly doubling the odds of making a specific diagnosis (odds ratio [OR] 1.90, 95% confidence interval [CI]: 1.65–2.19). Compared to those given only a non‐specific headache diagnosis who were prescribed a migraine therapy 53.7% (1766/3286) of the time, 75.3% (8914/11836) of those given a specific diagnosis received a migraine therapy, more than doubling the odds of prescription (OR 2.39, 95% CI: 2.20–2.60).ConclusionsInterventions to improve specificity of diagnosis were effective and led to increased rates of prescription of migraine treatments. These results have been sustained over several years. This headache questionnaire was adapted into the Foundation system of EpicCare, so it is broadly available as a clinical and research tool for institutions that use this EHR software.

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“…Yet ethnicity and culture were not seen as an important factors for all service users interviewed and research has reported that age and gender may more strongly influence views about pain management. 45 Acculturation is a concept related to the degree to which an individual adopts the values, beliefs and culture of their host nation. 46 This may partly explain why Service User 4, who described herself as second generation, did not find ethnicity to make a meaningful difference to her experience of the pain service.…”

Section: Discussionmentioning

confidence: 99%

Understanding ethnic minority service user experiences of being invited to and attending group pain programmes: A qualitative service evaluation

Bull

Young

Etchebarne

et al. 2022

British Journal of Pain

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Introduction Health inequalities continue to exist for individuals from an ethnic minority background who live with chronic pain. There is a growing recognition that an individual’s experience of pain is shaped by their cultural beliefs, which may influence their decisions about managing their pain. Aims This service evaluation aimed to (a) understand experiences of service users from a Black, Asian or other ethnic minority background of being invited to and attending a group pain programme in one secondary care pain rehabilitation service. (b) Provide recommendations to develop culturally grounded services to better meet the diverse needs of all service users living with chronic pain. Method Semi-structured interviews were conducted with five service users who had been offered a place on a group pain programme within the last 3 years. The interviews were recorded and transcribed verbatim. An interpretative phenomenological analysis was used to identify themes in the data. Results The analysis produced three themes (1) Pain, Ethnicity and Coping: Perceptions of pain and coping in relation to ethnicity and intersectional factors, alignment to a self-management approach. (2) Communication for Decisions: Experiences of ethnicity and culture in relation to health professional communication about group pain programmes, participants’ expectations and fears. (3) Feeling Included: Experiences of feeling included or excluded in group pain programme, relationships and empowerment during the group pain programme. Discussion The five service users shared a range of perspectives on how they felt ethnicity shaped their experience of the group pain programme. The findings suggest that adaptations to group pain programmes can make a meaningful difference for service users from ethnic minority backgrounds. 10 recommendations are suggested, including greater exploration of cultural beliefs during assessment, improving accessibility of information about the service and engaging more diverse attendees and facilitators.

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Exploring thoughts about pain and pain management: Interviews with South Asian community members in the UK

Cited by 7 publications

References 44 publications

Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford: a qualitative interview study

Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford: a qualitative interview study

Patient headache questionnaires can improve headache diagnosis and treatment in children

Understanding ethnic minority service user experiences of being invited to and attending group pain programmes: A qualitative service evaluation

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