Bostick Geoff P, Norman Kathleen E, Sharma Astha, Toxopeus Renee, Irwin Grant, Dhillon Raj
Department of Physical Therapy, University of Alberta.
School of Rehabilitation Therapy, Queen's University, Kingston, Ont.
Physiother Can. 2021 Winter;73(1):19-25. doi: 10.3138/ptc-2019-0027.
Health care disparities exist for people from culturally and linguistically diverse (CALD) communities. Addressing the cultural competence of health care providers could limit these disparities. The aim of this study was to improve cultural knowledge of and humility regarding pain in a CALD community. This interpretive description qualitative study used focus group discussions (FGDs) to generate ideas about how South Asian culture could influence how health care providers manage pain. A total of 14 people with pain and of South Asian background (6 women and 8 men, aged 28-70 y) participated. Two investigators independently analyzed the data. This process involved repeatedly reading the transcripts, then manually sorting the key messages into categories. The investigators compared their categorizations and resolved differences through discussion. Next, similar categories and concepts were grouped into ideas (potential themes). These ideas, along with supporting categories and verbatim quotes, were presented to the full research team for feedback. After compiling the feedback, the ideas formed the thematic representation of the data. The data from the FGDs revealed how pain management could be culturally adapted. The FGDs generated four themes about South Asian cultural perspectives that could influence the pain management experience for people living with pain: (1) cultural and linguistic impediments to communication, (2) understanding of pain in terms of the extent to which it interferes with function and work, (3) nurturing or personal attention as a marker of good care, and (4) value attributed to traditional ideas of illness and treatment. This study demonstrates how engaging with CALD people living with pain can lead to improved cultural knowledge and humility that can form the basis for adapting pain management. Through this process, it is more likely that a meaningful and client-centred pain management plan can be developed.
来自文化和语言多样化（CALD）社区的人群存在医疗保健差异。提高医疗保健提供者的文化能力可能会减少这些差异。本研究的目的是提高CALD社区对疼痛的文化知识和谦卑态度。这项解释性描述性定性研究使用焦点小组讨论（FGD）来生成有关南亚文化如何影响医疗保健提供者管理疼痛方式的想法。共有14名有疼痛问题且具有南亚背景的人（6名女性和8名男性，年龄在28 - 70岁之间）参与。两名研究人员独立分析数据。这个过程包括反复阅读转录本，然后手动将关键信息分类。研究人员比较他们的分类并通过讨论解决差异。接下来，将相似的类别和概念归为想法（潜在主题）。这些想法以及支持类别和逐字引用被呈现给整个研究团队以获取反馈。汇总反馈后，这些想法形成了数据的主题呈现。FGD的数据揭示了疼痛管理如何进行文化调适。FGD产生了四个关于南亚文化观点的主题，这些主题可能会影响疼痛患者的疼痛管理体验：（1）沟通中的文化和语言障碍；（2）从疼痛对功能和工作的干扰程度来理解疼痛；（3）将关怀或个人关注视为优质护理的标志；（4）对传统疾病和治疗观念的重视。本研究表明，与患有疼痛的CALD人群互动如何能够提高文化知识和谦卑态度，从而为调适疼痛管理奠定基础。通过这个过程，更有可能制定出有意义且以患者为中心的疼痛管理计划。
