Chronic pain in Afghan immigrant women : an exploratory mixed methods study
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Purpose: The purposes of this study were: (a) to describe the physical and mental health status of Afghan immigrant women in one Canadian city; (b) to construct an Afghan cultural model of pain (experience and management) using interview data and available literature; (c) to explore the experience of chronic pain and its management among Afghan immigrant women, both culturally and individually; and (d) to identify potential barriers to chronic pain management for both Afghan immigrant women and their health care providers. Methods: This study has two parts; questionnaires were used in Part 1, and semi-structured interviews supplemented by three short questionnaires were used in Part 2. Interpretive description methodology using thematic analysis and conceptual mapping was used for analysis of interviews in Part 2. Results: SF-36 responses (n = 9) in Part 1 suggested that the physical health status of the Afghan women was better than their mental health status. Health sciences literature and interviews with 6 Afghan immigrant women and 1 healthcare professional were used to construct cultural models of pain experience and pain management. Findings indicated that Afghan immigrant women who experienced and managed their chronic pain within their cultural model did so holistically across multiple factors: environmental, spiritual, biological, and psychological. However, each individual internalized their cultural model of pain in varying amounts. Barriers in healthcare access that prevented Afghan immigrant women from managing their pain well included: (a) different cultural perspectives between Afghan immigrant women and healthcare professionals regarding how pain is experienced and managed; and (b) communication difficulties between healthcare professionals and Afghan immigrant women. Significance of Findings: Cultural perspectives on pain experience and pain management influence treatment expectations and pain management. Differences in cultural perspectives are a barrier in healthcare access that prevents Afghan immigrant women from managing their pain well. Addressing the differences in perspective identified in this study will increase understanding for healthcare professionals as they work together with Afghan immigrant women patients, thereby improve communication and reduce barriers to pain management.
DegreeMaster of Science (M.Sc.)
SupervisorBusch, Angela J.
CommitteeChirkov, Valery I.; Holtslander, Lorraine F.; Schachter, Candice L.
Copyright DateMay 2013