Re Tania Simona, Bragazzi Nicola Luigi, Siri Anna, Cisneros Puebla César, Friese Susanne, Simões Mário, Candau Joël, Khabbache Hicham
UNESCO Chair "Health Anthropology, Biosphere and Healing Systems", Genoa, Italy.
Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy.
J Pain Res. 2017 Jun 6;10:1383-1390. doi: 10.2147/JPR.S115449. eCollection 2017.
Chronic pain represents a common public health concern worldwide. It is a complex phenomenon, owing to the interaction of different factors, including biological, physiological, psychological, environmental, and social variables. Some groups, such as women and immigrants, are particularly vulnerable. However, little is known about how Chinese women in Italy live with and face chronic pain. The present study aimed at filling this knowledge gap by examining the burden of chronic pain in Chinese immigrants in Italy in terms of acculturation processes, perceived control over disease, social networks, and coping strategies. A qualitative approach was used, performing a thematic field analysis. We interviewed 82 Chinese women from different Italian towns (Genoa, Milan, Turin, Bologna, Florence, and Prato) in depth. The sense of belonging to the host culture was strong in our sample. However, this did not simply reflect or translate into a linear engagement with medical systems, as health care pathways were more complex and dual (both Chinese and Western). Chinese women who felt deeply rooted in the Italian environment did not discontinue the use of traditional Chinese medicine. Chronic pain extensively and adversely affected daily life, particularly interfering with work. Coping strategies were mainly adaptive behaviors, being problem focused or maladaptive, relying upon "cope and avoid" mechanisms. Chinese women preferred to use traditional Chinese remedies rather than conventional medicine, while using the Italian system in emergencies. Perceived control over chronic pain was usually external. Finally, Chinese women with chronic pain benefit from social networks and support, which were mainly composed of Chinese peers. In conclusion, our findings underline the tremendous burden of chronic pain affecting all aspects of Chinese women's lives. Health care workers and providers should be aware of the complexity of chronic pain Therefore, a holistic approach, involving different stakeholders, should be adopted when managing chronic pain and approaching immigrant patients.
慢性疼痛是全球范围内普遍关注的公共卫生问题。它是一种复杂的现象，归因于不同因素的相互作用，包括生物、生理、心理、环境和社会变量。一些群体，如女性和移民，尤其脆弱。然而，对于在意大利的中国女性如何面对和忍受慢性疼痛知之甚少。本研究旨在通过从文化适应过程、对疾病的感知控制、社会网络和应对策略等方面考察意大利华裔移民的慢性疼痛负担，来填补这一知识空白。我们采用定性研究方法，进行了主题领域分析。我们深入采访了来自意大利不同城镇（热那亚、米兰、都灵、博洛尼亚、佛罗伦萨和普拉托）的82名中国女性。在我们的样本中，对东道国文化的归属感很强。然而，这并没有简单地反映或转化为与医疗系统的线性接触，因为医疗保健途径更为复杂和具有双重性（包括中医和西医）。深深扎根于意大利环境的中国女性并未停止使用传统中药。慢性疼痛广泛且严重地影响日常生活，尤其干扰工作。应对策略主要是适应性行为，以问题为导向或适应不良，依赖于“应对和回避”机制。中国女性在紧急情况下使用意大利医疗系统的同时，更倾向于使用传统中药。对慢性疼痛的感知控制通常是外部的。最后，患有慢性疼痛的中国女性受益于主要由中国同龄人组成的社会网络和支持。总之，我们的研究结果强调了慢性疼痛对中国女性生活各方面造成的巨大负担。医护人员和提供者应意识到慢性疼痛的复杂性。因此，在管理慢性疼痛和接待移民患者时，应采取一种涉及不同利益相关者的整体方法。
