School of Health and Life Sciences, Teesside University, UK.
School of Health and Life Sciences, Teesside University, UK; Pain Education Team to Advance Learning (PETAL), UK.
Musculoskelet Sci Pract. 2024 Nov;74:103196. doi: 10.1016/j.msksp.2024.103196. Epub 2024 Sep 27.
Pain Science Education (PSE) seeks to increase patients understanding of their pain, to improve clinical outcomes. It has been primarily developed and tested within western cultures. There is a lack of research exploring its use with people from ethnically minoritised groups.
To explore Healthcare Professionals (HCPs) experiences of delivering PSE to people with persistent pain from ethnically minoritised groups.
In this qualitative study semi-structured interviews were carried out with a convenience sample of 14 HCPs who routinely deliver PSE to patients from ethnically minoritised groups. The interviews were analysed using reflexive thematic analysis.
Three themes were identified: 1) Biomedical model or disengagement, 2) Pain is a taboo topic, and 3) The importance of cultural competence. Participants believed that people from ethnically minoritised groups disengaged with PSE sooner in comparison to non-ethnically minoritised groups and this was rooted in a strong biomedical understanding of pain and preference for biomedical treatments. Addressing patients' beliefs was deemed difficult as participants felt that pain was considered a taboo amongst some ethnically minoritised groups and HCPs lacked sufficient training in cultural competency to confidently address their pain-related misconceptions.
Overall, HCPs found that many people from ethnically minoritised groups held strongly biomedical views and/or a cultural reluctance to discuss pain. These factors made pain discussions challenging leading to disengagement from PSE and a preference for passive care. Cultural competency training and access to culturally competent PSE resources may facilitate engagement with PSE for people from ethnically minoritised background.
疼痛科学教育(PSE)旨在提高患者对疼痛的理解,改善临床结果。它主要在西方文化中开发和测试。缺乏研究探索其在少数民族群体中的应用。
探索医疗保健专业人员(HCP)向少数民族群体中持续性疼痛患者提供 PSE 的经验。
在这项定性研究中,对 14 名 HCP 进行了方便抽样的半结构式访谈,他们经常向少数民族群体的患者提供 PSE。使用反思性主题分析对访谈进行分析。
确定了三个主题:1)生物医学模型或脱节,2)疼痛是一个禁忌话题,3)文化能力的重要性。参与者认为,与非少数民族群体相比,少数民族群体的患者更早地脱离 PSE,这源于对疼痛的强烈生物医学理解和对生物医学治疗的偏好。解决患者的信念被认为是困难的,因为参与者认为在一些少数民族群体中,疼痛被认为是一个禁忌,而 HCP 缺乏足够的文化能力培训,无法自信地解决他们与疼痛相关的误解。
总体而言,HCP 发现许多少数民族群体的人持有强烈的生物医学观点和/或对讨论疼痛的文化抵触情绪。这些因素使得疼痛讨论具有挑战性,导致对 PSE 的脱离和对被动护理的偏好。文化能力培训和获得文化上合格的 PSE 资源可能有助于少数民族背景的人参与 PSE。