Institute of Applied Nursing Science, Eastern Switzerland University of Applied Sciences-Campus St Gallen, St Gallen, Switzerland
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
Med Humanit. 2023 Dec 19;49(4):700-712. doi: 10.1136/medhum-2022-012570.
Pain is one of the most neglected areas of care in sub-Saharan Africa. Access to adequate pain management is important, especially in marginalised populations, such as pastoralists. Little is known about health professionals' perceptions of pain-related care for Somali pastoralists. This study seeks to understand health professionals' perceptions of Somali pastoralists in the context of pain management in Eastern Ethiopia. Within the scope of this qualitative multicentre study, we conducted semi-structured interviews with 17 health professionals (mainly nurses) experienced in treating Somali pastoralists with pain. Data analysis was based on the coding paradigm proposed by Strauss and Corbin within Grounded Theory methodology and resulted in a conceptual model of pastoralist-specific pain management. We gave voice to pastoralists in the study design, for example, through focus group discussions conducted prior to this study. Our study is part of a larger ongoing research project involving health professionals and pastoralist communities. The perspective of pastoralists is explored in a consecutive study. 'Patient-professional relationship' was the core category we identified within the conceptual model. This category was closely linked with issues of '(mis)trust' and 'communication (barriers)'. 'Patient-related conditions' (eg, (under)-reporting of pain, care preferences and beliefs) and 'health professional-related' conditions' (eg, insufficient training, (under)exposure to local culture) had an influence on the core category. Contextual factors proved to be relevant as well, such as age and gender. The study highlights the complexity of pain management among marginalised communities, such as pastoralists. Health professionals perceive Somali pastoralists to have distinct illness beliefs and pain concepts influencing their health-seeking behaviour. The study highlights the importance of reaching this patient group with culturally acceptable and comprehensive pain management strategies.
疼痛是撒哈拉以南非洲护理中最被忽视的领域之一。获得足够的疼痛管理非常重要，尤其是在边缘化人群中，如牧民。对于索马里牧民的疼痛相关护理，健康专业人员的看法知之甚少。本研究旨在了解埃塞俄比亚东部的健康专业人员在疼痛管理背景下对索马里牧民的看法。在这项定性多中心研究的范围内，我们对 17 名有治疗索马里牧民疼痛经验的卫生专业人员（主要是护士）进行了半结构化访谈。数据分析基于 Strauss 和 Corbin 在扎根理论方法中提出的编码范式，并得出了一个针对牧民特定的疼痛管理的概念模型。我们在研究设计中让牧民发声，例如，在本研究之前进行了焦点小组讨论。我们的研究是一个更大的正在进行的研究项目的一部分，涉及卫生专业人员和牧民社区。牧民的观点将在后续研究中进行探讨。“医患关系”是我们在概念模型中确定的核心类别。该类别与“（信任）缺失”和“沟通（障碍）”等问题密切相关。“患者相关条件”（例如，疼痛的（漏）报、护理偏好和信念）和“卫生专业人员相关条件”（例如，培训不足、对当地文化的（缺乏）了解）对核心类别有影响。背景因素也被证明是相关的，例如年龄和性别。该研究强调了边缘化社区（如牧民）的疼痛管理的复杂性。健康专业人员认为索马里牧民有独特的疾病信念和疼痛概念，影响他们的寻医行为。该研究强调了为这个患者群体提供文化上可接受和全面的疼痛管理策略的重要性。
