Bernardes Christina Maresch, Houkamau Kushla, Lin Ivan, Taylor Marayah, Birch Stephen, Claus Andrew, Bryant Matthew, Meuter Renata, Isua Jermaine, Gray Paul, Kluver Joseph P, Jones Corey, Ekberg Stuart, Pratt Gregory
Aboriginal and Torres Strait Islander Health Research Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Western Australian Center for Rural Health, University of Western Australia, Geraldton, WA, Australia.
Front Pain Res (Lausanne). 2022 Dec 6;3:1041968. doi: 10.3389/fpain.2022.1041968. eCollection 2022.
Pain management requires a multidisciplinary approach and a collaborative relationship between patient-provider in which communication is crucial. This study examines the communication experiences of Aboriginal and Torres Strait Islander patients and Aboriginal and Torres Strait Islander Hospital Liaison Officers (ATSIHLOs), to improve understanding of how pain is managed in and through patient-health professional communication.
This qualitative study involved a purposive sample of patients attending three persistent pain clinics and ATSIHLOs working in two hospitals in Queensland, Australia. Focus groups and in-depth interviews explored the communication experiences of patients managing pain and ATSIHLOs supporting patients with pain. This study adopted a descriptive phenomenological methodology, as described by Colaizzi (1978). Relevant statements (patient and ATSIHLOs quotes) about the phenomenon were extracted from the transcripts to formulate meanings. The formulated meanings were subsequently sorted into thematic clusters and then integrated into themes. The themes were then incorporated into a concise description of the phenomenon of communication within pain management. Findings were validated by participants.
A total of 21 Aboriginal and Torres Strait Islander participants were involved in this study. Exploration of the communication experiences of patients and ATSIHLOs revealed overlapping themes of important barriers to and enablers of communication that affected access to care while managing pain. Acknowledging historical and cultural factors were particularly important to build trust between patients and health professionals. Some patients reported feeling stigmatized for identifying as Aboriginal and Torres Strait Islander, while others were reluctant to disclose their background for fear of not having the same opportunity for treatment. Differences in the expression of pain and the difficulty to use standard pain measurement scales were identified. Communication was described as more than the content delivered, it is visual and emotional expressed through body language, voice intonation, language and the speed of the conversation.
Communication can significantly affect access to pain management services. Aboriginal and Torres Strait Islander patients highlighted the burden of emotional pain caused by historical factors, negative stereotypes and the fear of discrimination. Pain management services and their health professionals need to acknowledge how these factors impact patients trust and care.
疼痛管理需要多学科方法以及患者与医护人员之间的协作关系，其中沟通至关重要。本研究考察了原住民和托雷斯海峡岛民患者以及原住民和托雷斯海峡岛民医院联络官（ATSIHLOs）的沟通经历，以增进对在患者与医护人员沟通中如何管理疼痛的理解。
这项定性研究采用了目的性抽样，选取了在澳大利亚昆士兰州三家持续性疼痛诊所就诊的患者以及在两家医院工作的ATSIHLOs。焦点小组和深度访谈探讨了管理疼痛的患者以及支持疼痛患者的ATSIHLOs的沟通经历。本研究采用了科莱齐（1978年）描述的描述性现象学方法。从记录中提取有关该现象的相关陈述（患者和ATSIHLOs的引述）以形成意义。随后将形成的意义分类为主题集群，然后整合为主题。然后将这些主题纳入对疼痛管理中沟通现象的简要描述。研究结果由参与者进行了验证。
共有21名原住民和托雷斯海峡岛民参与了本研究。对患者和ATSIHLOs沟通经历的探索揭示了影响疼痛管理期间获得护理的沟通的重要障碍和促进因素的重叠主题。承认历史和文化因素对于建立患者与医护人员之间的信任尤为重要。一些患者报告称，因自己是原住民和托雷斯海峡岛民而感到受辱，而另一些患者则因担心没有同等的治疗机会而不愿透露自己的背景。确定了疼痛表达的差异以及使用标准疼痛测量量表的困难。沟通被描述为不仅仅是所传达的内容，它还通过肢体语言、语调、语言和谈话速度以视觉和情感方式表达。
沟通会显著影响获得疼痛管理服务的机会。原住民和托雷斯海峡岛民患者强调了历史因素、负面刻板印象和对歧视的恐惧所造成的情感痛苦负担。疼痛管理服务及其医护人员需要认识到这些因素如何影响患者的信任和护理。
