The lived experiences of chronic pain among immigrant Indian-Canadian women: A phenomenological analysis

Abstract

Background: Chronic pain is a growing public health concern affecting 1.5 million people in Canada. In particular, it is a concern among the expanding immigrant population, because immigrant groups report higher pain intensity than non-immigrants. In 2011, the Indian population became the largest visible minority group and continues to be the fastest growing. Though the prevalence of chronic pain among Canadian Indians is unknown, research has found a higher prevalence among Indian women than men in India, Malaysia, Singapore, and the United Kingdom, with women reporting more severe pain. An understanding of how pain is experienced by this particular group is therefore important for providing culturally sensitive care. Aims: This study explores the lived experiences of chronic pain among immigrant Indian women in Canada. Methods: Thirteen immigrant Indian women participated in one-on-one interviews exploring daily experiences of chronic pain. Results: Using thematic analysis informed by van Manen's phenomenology of practice, four themes emerged: (1) the body in pain, (2) pain in the context of lived and felt space, (3) pain and relationships, and (4) pain and time. Women revealed that their experiences were shaped by gender roles and expectations enforced through culture. Specifically, a dual gender role was identified after immigration, in which women had to balance traditional household responsibilities of family labor and care alongside employment outside the home, exacerbating pain. Conclusions: This research uncovers the multifaceted nature of chronic pain and identifies factors within the sociocultural context that may place particular groups of women at greater risk of living with pain. RÉSUMÉ Contexte: La douleur chronique est un problème de santé publique croissant qui touche 1,5 million de personnes au Canada. Elle est particulièrement préoccupante au sein de la population immigrante en expansion, car les groupes d'immigrants signalent une intensité de douleur plus élevée que les non-immigrants. En 2011, la population indienne est devenue le plus grand groupe de minorités visibles et continue d'être celui qui connaît la croissance la plus rapide. Bien que la prévalence de la douleur chronique chez les Indo-Canadiens soit inconnue, des études ont montré que la prévalence de cette maladie chez les femmes indiennes était supérieure à celle des hommes en Inde, en Malaisie, à Singapour et au Royaume-Uni, les femmes faisant état de douleurs plus intenses. Une compréhension de la manière dont la douleur est ressentie par ce groupe particulier est donc importante pour fournir des soins adaptés à la culture. Objectifs: Cette étude se penche sur les expériences de douleur chronique vécues par les immigrantes indiennes au Canada. Méthodes: Treize immigrantes indiennes ont participé à des entretiens individuels portant sur leurs expériences de douleur chronique quotidiennes. Résultats: Grâce à une analyse thématique fondée sur la phénoménologie de la pratique de van Manen, quatre thèmes ont émergé : (1) le corps do...

Qualitative research and pain: Current controversies and future directions

“…14,28 We illustrate the point of transferability of qualitative findings using two articles in the Special Issue. 28,29 Using a qualitative descriptive methodology, Dale et al 28 interviewed recently discharged patients about their procedural oral pain experiences while mechanically ventilated in the intensive care unit (ICU). Using an object elicitation approach, the authors found that patients recalled significant pain and distress related to oral care in the ICU but that, because of ventilation, were unable to self-report this pain.…”

“…The findings from this study are transferrable to the growing literature on the development of pain education frameworks in various disciplines such as medicine, nursing, and dentistry. [30][31][32] Similarly, Mustafa et al 29 explored the lived experience of chronic pain in immigrant Indian-Canadian women using a phenomenological design. The authors found that immigrant Indian-Canadian women's experiences of pain are influenced by several unique sociocultural factors (e.g., gender roles, work burden, lack of social support), which in turn impact pain expression, openness to treatment, and the consequences of pain on the family.…”

“… 34 By example, Tabeefar et al 35 used thematic saturation as a construct to guide sampling adequacy in their study of community pharmacists’ experiences with chronic pain, which was guided by the principles of grounded theory. Conversely, and in line with phenomenological inquiry, the studies by Dagg et al, 27 Mustafa et al, 29 and Woodgate et al 16 focused on obtaining rich personal accounts and describing the similarities and differences in experiences across participants. A one-size-fits-all approach to evaluating qualitative studies, as is often done by non-qualitative experts, disregards the core epistemological and ontological underpinnings of the various qualitative designs.…”

“…This carefully curated collection includes high-quality, cutting-edge empirical qualitative studies in pain that highlight theoretical and methodological advancements in the field. The studies included in this Special Issue employ a range of qualitative methodologies, including grounded theory, 35 phenomenology, 16 , 27 , 29 qualitative description, 28 and arts-based approaches. 15 , 17 The collection of studies also demonstrates the array of methods of data collection possible in qualitative research, including both traditional (e.g., one-on-one interviews 27 , 29 , 35 ) and novel (e.g., photovoice, 16 object elicitation, 28 social media posts 15 ) methods.…”

“…The studies included in this Special Issue employ a range of qualitative methodologies, including grounded theory, 35 phenomenology, 16 , 27 , 29 qualitative description, 28 and arts-based approaches. 15 , 17 The collection of studies also demonstrates the array of methods of data collection possible in qualitative research, including both traditional (e.g., one-on-one interviews 27 , 29 , 35 ) and novel (e.g., photovoice, 16 object elicitation, 28 social media posts 15 ) methods. Finally, the Special Issue articles illustrate the capacity of qualitative research to capture the meaning and experience of pain in diverse populations, including children with anxiety, 16 critically ill patients, 28 pharmacists working with individuals with chronic pain, 35 immigrant women, 29 parents of children who have undergone surgery, 27 individuals with heart disease, 17 and those with various forms of chronic pain.…”