Department of General Practice, School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia.
Patient Educ Couns. 2022 May;105(5):1152-1169. doi: 10.1016/j.pec.2021.08.021. Epub 2021 Aug 27.
Many studies investigating the management of chronic pain often exclude participation of people from refugee and immigrant backgrounds. This review seeks to understand and evaluate the effectiveness of interventions for chronic pain management when applied in the context of refugee and immigrant populations.
A systematic review was undertaken using six databases and the PICO search strategy. Included studies were published in English, comprised of patients over 18 years of age and excluded cancer-related chronic pain.
Twenty-one papers met the inclusion criteria: 13 cohort studies and eight randomised control trials. The majority of interventions involved multidisciplinary or psychological interventions, with the remaining studies based on education, exercise therapy or culturally adapted information. Studies integrating multidisciplinary care to manage chronic pain showed more consistent improvements in pain intensity and function than other unimodal interventions.
Multidisciplinary interventions reduce pain intensity, improve functional impairment, and alleviate other psychosocial symptoms exhibited chronic pain patients from refugee or immigrant backgrounds. Additional well-designed, large-scale studies are needed to decisively estimate the effectiveness of culturally adapted, multidisciplinary intervention programs over time.
Clinical practice may benefit from adapting interventions to better support the management of chronic pain in refugee and immigrant populations.
许多研究调查慢性疼痛的管理往往排除了难民和移民背景的人的参与。本综述旨在了解和评估在难民和移民人群背景下应用慢性疼痛管理干预措施的有效性。
使用六个数据库和 PICO 搜索策略进行了系统评价。纳入的研究发表于英文期刊，包含 18 岁以上的患者，排除了与癌症相关的慢性疼痛。
21 篇论文符合纳入标准：13 项队列研究和 8 项随机对照试验。大多数干预措施涉及多学科或心理干预，其余研究基于教育、运动疗法或文化适应性信息。整合多学科护理以管理慢性疼痛的研究显示，疼痛强度和功能的改善比其他单一模式干预更为一致。
多学科干预措施可减轻慢性疼痛患者的疼痛强度，改善功能障碍，并缓解其他心理社会症状。需要更多设计良好、大规模的研究来确定随着时间的推移，文化适应性的多学科干预计划的有效性。
临床实践可能受益于调整干预措施，以更好地支持难民和移民人群中慢性疼痛的管理。
