School of Physiotherapy, University of Otago, New Zealand.
Department of Physiotherapy, Liverpool Hospital, Liverpool, New South Wales, Australia; School of Science and Health, Western Sydney University, Campbell Town, New South Wales, Australia.
Physiotherapy. 2020 Jun;107:292-305. doi: 10.1016/j.physio.2019.08.002. Epub 2019 Aug 9.
People with persistent pain from culturally and linguistically diverse (CALD) communities experience significant health inequities.
To synthesise the sociocultural factors influencing pain management between CALD patients with persistent pain and physiotherapists treating CALD patients.
Major electronic databases MEDLINE, AMED, Scopus, Web of Science, PsycINFO and Google Scholar were searched until July 2018.
Studies were included if they explored clinical interactions between physiotherapists and patients with persistent pain from diverse ethnocultural backgrounds.
The methodological quality of qualitative and quantitative studies were assessed using the Critical Appraisal Skills Programme (CASP) Checklist and Mixed Methods Appraisal Tool (MMAT) respectively.
A thematic synthesis approach was used to extract the common themes.
Sixteen articles from 16 studies were included. Eleven studies were qualitative and five studies were quantitative. Ten explored patients' perspectives, four explored physiotherapists' perspectives, and two explored both. Key factors included: (a) language competence; (b) active vs passive coping strategies; (c) gendered influences; (d) cultural-spiritual beliefs, illness perceptions and expression of pain; (e) treatment satisfaction and; (f) barriers to access.
Discordant perspectives on causation, pain management approaches, and patient autonomy in management are evident between CALD patients and physiotherapists. Such discordance potentially create stress in the therapeutic alliance and undermines the efficacy of pain management interventions. To mitigate such barriers, it is crucial to foster cultural competence in physiotherapy and equip physiotherapists with opportunities to maximise their sociocultural awareness, knowledge and skill practising physiotherapy in cultural plural societies.
来自文化和语言多样化（CALD）社区的持续性疼痛患者经历着严重的健康不平等。
综合分析影响文化和语言多样化的持续性疼痛患者的社会文化因素和治疗这些患者的物理治疗师。
直到 2018 年 7 月，主要电子数据库 MEDLINE、AMED、Scopus、Web of Science、PsycINFO 和 Google Scholar 都进行了搜索。
如果研究探索了来自不同族裔背景的物理治疗师和持续性疼痛患者之间的临床互动，则将其纳入研究。
使用批判性评估技能计划（CASP）清单和混合方法评估工具（MMAT）分别评估定性和定量研究的方法学质量。
使用主题综合方法提取共同主题。
从 16 项研究中纳入了 16 篇文章。11 项研究为定性研究，5 项研究为定量研究。其中 10 项探讨了患者的观点，4 项探讨了物理治疗师的观点，还有 2 项探讨了两者。关键因素包括：（a）语言能力；（b）积极与消极应对策略；（c）性别影响；（d）文化-精神信仰、疾病观念和疼痛表达；（e）治疗满意度；（f）获得治疗的障碍。
在病因、疼痛管理方法以及患者在管理中的自主权方面，文化和语言多样化患者和物理治疗师的观点明显不一致。这种不一致性可能会在治疗联盟中造成压力，并削弱疼痛管理干预的效果。为了减轻这些障碍，在物理治疗中培养文化能力并为物理治疗师提供机会，使其能够最大限度地提高他们在文化多元化社会中的社会文化意识、知识和技能，这一点至关重要。
