Bernadette Brady1,2,3, Toni Andary4, Sheng Min Pang3, Sarah Dennis3,5, Pranee Liamputtong1,6, Robert Boland3,4, Elise Tcharkhedian2, Matthew Jennings1,2, Natalie Pavlovic4, Marguerite Zind1, Paul Middleton2,7,8,9,10, Lucy Chipchase1,11. 1. School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia. 2. Liverpool Hospital, Liverpool, NSW, Australia. 3. Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia. 4. Fairfield Hospital, Fairfield, NSW, Australia. 5. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia. 6. Translational Health Research Institute, Western Sydney University, NSW, Australia. 7. South Western Emergency Research Institute (SWERI), The Ingham Institute, Liverpool, Australia. 8. South Western Sydney Clinical School, University of New South Wales, Sydney, Australia. 9. Discipline of Emergency Medicine, University of Sydney, Sydney, Australia. 10. The MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Sydney, Australia. 11. College of Nursing and Health Sciences, Flinders University, South Australia, Australia.
Abstract
OBJECTIVE: This study explored factors that underpin decisions to seek emergency department (ED) care for chronic noncancer pain in patients identifying as culturally and linguistically diverse (CALD) or Australian born. DESIGN AND METHODS: This mixed-methods study was underpinned by the Behavioral Model of Health Services Use conceptual framework. Consenting consecutive patients attending the ED for a chronic pain condition were recruited to a CALD (n = 45) or Australian-born (n = 45) cohort. Statistical comparisons compared the demographic, pain, health literacy, and episode of care profiles of both cohorts. Twenty-three CALD and 16 Australian-born participants consented to an audio-recorded semi-structured interview (n = 24) or focus group (n = 5 focus groups) conducted in their preferred language. Interviews were translated and transcribed into English for analysis using applied thematic analysis, guided by the conceptual framework. Data were triangulated to investigate the patterns of ED utilization and contributing factors for both cohorts. RESULTS: ED attendance was a product of escalating distress, influenced by the degree to which participants' perceived needs outweighed their capacity to manage their pain. This interaction was amplified by the presence of predisposing factors, including constrained social positions, trauma exposure, and biomedical health beliefs. Importantly, experiences varied between the two cohorts with higher degrees of pain catastrophizing, lower health literacy, and greater social challenges present for the CALD cohort. CONCLUSION: This study highlights the role contextual factors play in amplifying pain-related distress for CALD and Australian-born patients with chronic pain. The findings support a need for health care providers to recognize features of higher vulnerability and consider streamlining access to available support services.
OBJECTIVE: This study explored factors that underpin decisions to seek emergency department (ED) care for chronic noncancer pain in patients identifying as culturally and linguistically diverse (CALD) or Australian born. DESIGN AND METHODS: This mixed-methods study was underpinned by the Behavioral Model of Health Services Use conceptual framework. Consenting consecutive patients attending the ED for a chronic pain condition were recruited to a CALD (n = 45) or Australian-born (n = 45) cohort. Statistical comparisons compared the demographic, pain, health literacy, and episode of care profiles of both cohorts. Twenty-three CALD and 16 Australian-born participants consented to an audio-recorded semi-structured interview (n = 24) or focus group (n = 5 focus groups) conducted in their preferred language. Interviews were translated and transcribed into English for analysis using applied thematic analysis, guided by the conceptual framework. Data were triangulated to investigate the patterns of ED utilization and contributing factors for both cohorts. RESULTS: ED attendance was a product of escalating distress, influenced by the degree to which participants' perceived needs outweighed their capacity to manage their pain. This interaction was amplified by the presence of predisposing factors, including constrained social positions, trauma exposure, and biomedical health beliefs. Importantly, experiences varied between the two cohorts with higher degrees of pain catastrophizing, lower health literacy, and greater social challenges present for the CALD cohort. CONCLUSION: This study highlights the role contextual factors play in amplifying pain-related distress for CALD and Australian-born patients with chronic pain. The findings support a need for health care providers to recognize features of higher vulnerability and consider streamlining access to available support services.
Authors: Javier Martinez-Calderon; Mark P Jensen; Jose M Morales-Asencio; Alejandro Luque-Suarez Journal: Clin J Pain Date: 2019-03 Impact factor: 3.442
Authors: Abdullah Sulieman Terkawi; Michael Sullivan; Abdullah Abolkhair; Tariq Al-Zhahrani; Rayan Suliman Terkawi; Esraa M Alasfar; Shadi Sharif Abu Khait; Ahmed Elkabbani; Nasib Kabbani; Khaild A Altirkawi; Siny Tsang Journal: Saudi J Anaesth Date: 2017-05