Background & Aims
There is a disparate burden of high-impact pain in minority groups in the United States, which includes Black communities. There is great cultural diversity within the Black community that is often not recognized despite research suggesting that different cultures vary in qualities of pain perception, beliefs, and behaviors. Cultural influences on pain beliefs and behaviors are known to be associated with pain severity, pain chronicity, quality of life, and functional disability. One culture that has been overlooked in pain research is the Haitian immigrant population which is one of the fastest growing Caribbean immigrant populations in the United States. It has been well documented that there are complex barriers impacting their healthcare in the United States; however, no published research explores the pain experience or pain beliefs of this population. The purpose of this current research is to explore the meaning and experience of pain in the Haitian immigrant population.
Methods
This study is a sub analysis of a larger study that produce culturally sensitive videos to provide education on transcutaneous auricular vagus nerve stimulation to African American (English speaking), Hispanic (Spanish speaking), and Haitian (Creole speaking) participants with chronic pain (>3 months). Five adult Haitians with chronic pain, who reported Haitian-Creole was their primary language, were recruited in the community through a health fair and within an academic health care system in Miami-Dade, Florida, USA. Focus groups and 1:1 semi-structured interviews were conducted in Haitian-Creole. The sub analysis focused on the interview questions that explored the meaning of pain and pain experience in the Haitian participants. A reflexive approach to thematic analysis was used to generate codes and meaning themes. This project is supported by the Miami Clinical and Translational Science Institute (#UL1TR002736), from the National Center for Advancing Translational Sciences.
Results
Three themes were developed from the thematic analyses: 1) Pain meaning is embedded in body function, 2) Pain meaning is embodied and holistic, and 3) Pain coping as acceptance and self-reliance. Theme 1 was discussed in connection with an inability to perform functional tasks. For example, one participant described “You are limited. Often when I have pain, I can’t drive.” Theme 2 highlights how pain understanding is expressed as a bodily experience that encompasses the full body. One participant stated when describing pain “Just say you don’t feel well…” Others described pain as “sleepless”, “decreased appetite”, and “It makes me lazy.” Theme 3 describes coping strategies for pain as self-mediated with minimal care seeking. Also highlighted in this theme is the preference of natural remedies, for example, “I take more natural leaves and then try to exercise.”
Conclusions
To our knowledge, this study provides the first description of the meaning of pain and the pain experience among Haitian immigrants. Uniquely, these Haitian individuals did not describe pain as primarily a sensory phenomenon; instead, they described pain in terms of overall wellness and function. In addition, there was general acceptance of their chronic pain, and they focused on self-management with either little awareness or less inclination towards medical pain management.
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