Margot Latimer1, G Allen Finley2, Sharon Rudderham3, Stephanie Inglis4, Julie Francis3, Shelley Young5, Daphne Hutt-MacLeod3. 1. Faculty of Health Professions, Dalhousie University, Halifax, NS ; Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS. 2. Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS. 3. Eskasoni Community Health Centre, Eskasoni, NS. 4. Unama'ki College, Cape Breton University, Sydney, NS. 5. Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS.
Abstract
BACKGROUND: First Nation children have the highest rates of pain-related conditions among Canadian children, yet there is little research on how this population expresses its pain or how and whether the pain is successfully treated. The aim of this study was to understand how Mi'kmaq children express pain and how others interpret it. METHODS: We conducted a qualitative ethnographic study in a large Canadian Mi'kmaq community using interviews and conversation sessions. Participants included children and youth (n = 76), parents (n = 12) teachers (n = 7), elders (n = 6) and health care professionals (n = 13). RESULTS: Interpretive descriptive analysis was used and themes regarding pain expression, care seeking and pain management were identified. Pain expression included stoicism and hiding behaviour, and, when pain was discussed, it was via storytelling and descriptive language, such as similes. Participants reported feeling unheard, stereotyped and frustrated when they sought pain care. Frustration led to avoidance of seeking further care, perceptions of racism and repeat visits because of unsuccessful previous treatment. Participants voiced concerns about the utility of the numeric and faces pain scales to describe pain meaningfully. Positive encounters occurred when participants felt respected and heard. INTERPRETATION: Mi'kmaq children are stoic and often hide their pain. Community members feel frustrated and discriminated against when their pain is not identified, and conventional pain assessment tools may not be useful. If clinicians consider cultural context, build trust and allow for additional time to assess pain via storytelling or word descriptions as well as a family-centred approach, better pain care may occur.
BACKGROUND: First Nation children have the highest rates of pain-related conditions among Canadian children, yet there is little research on how this population expresses its pain or how and whether the pain is successfully treated. The aim of this study was to understand how Mi'kmaq children express pain and how others interpret it. METHODS: We conducted a qualitative ethnographic study in a large Canadian Mi'kmaq community using interviews and conversation sessions. Participants included children and youth (n = 76), parents (n = 12) teachers (n = 7), elders (n = 6) and health care professionals (n = 13). RESULTS: Interpretive descriptive analysis was used and themes regarding pain expression, care seeking and pain management were identified. Pain expression included stoicism and hiding behaviour, and, when pain was discussed, it was via storytelling and descriptive language, such as similes. Participants reported feeling unheard, stereotyped and frustrated when they sought pain care. Frustration led to avoidance of seeking further care, perceptions of racism and repeat visits because of unsuccessful previous treatment. Participants voiced concerns about the utility of the numeric and faces pain scales to describe pain meaningfully. Positive encounters occurred when participants felt respected and heard. INTERPRETATION: Mi'kmaq children are stoic and often hide their pain. Community members feel frustrated and discriminated against when their pain is not identified, and conventional pain assessment tools may not be useful. If clinicians consider cultural context, build trust and allow for additional time to assess pain via storytelling or word descriptions as well as a family-centred approach, better pain care may occur.
Authors: Angela M Mills; Frances S Shofer; Ann K Boulis; Daniel N Holena; Stephanie B Abbuhl Journal: Am J Emerg Med Date: 2010-05-01 Impact factor: 2.469
Authors: Margot Latimer; John R Sylliboy; Julie Francis; Sharon Amey; Sharon Rudderham; G Allen Finley; Emily MacLeod; Kara Paul Journal: Paediatr Neonatal Pain Date: 2020-05-22