Background & Aims
Title: Pain related beliefs in people with chronic musculoskeletal pain in low- and middle-income countries: A Scoping review
Background: Chronic musculoskeletal pain (CMP) is the main contributor to disability worldwide. About 25% of the general population in low- and middle-income countries (LMIC)?experience CMP. Pain related beliefs such as thoughts related to pain, or the prior knowledge of causes of pain may influence the recovery from CMP. Evidence suggests that pain beliefs and coping strategies are different across cultures and ethnicities. Such pain related beliefs are known to influence health seeking behaviors and influence outcomes of pain. While extensive research has been identified exploring these beliefs in developed countries the extent of research conducted on pain beliefs in LMICs is unknown.
Objective: This review aims to map the existing literature on pain related beliefs in individuals with CMP IN LMIC’s.
Methods
A comprehensive search of the literature from inception was undertaken till December 2023 in the following electronic databases: Medline (PubMed), Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Inclusion criteria was observational studies exploring pain related beliefs and pain intensity and /or disability in low middle- income countries. Conference proceedings, study protocols were excluded from the review. Two reviewers independently screened the identified studies on removing duplicates, followed by data extraction using a pretested data extraction form. The results were summarized using narrative synthesis.
Results
In total, 10,246 titles and abstracts and 102 full texts were screened for eligibility to include four studies in the final review. The included studies were conducted on participants from Nigeria, Iran, Ivory coast, Tunisia, Morocco. The participants had a diagnosis of chronic low back pain (n =3) or chronic pain (n =1) and evaluated pain related beliefs related to kinesiophobia/fear avoidance beliefs, pain catastrophizing, pain self-efficacy, coping strategies. One study reported higher levels of kinesiophobia, and lower levels of self-efficacy in 92% and 68% of the sample respectively. Another study reported a mediating role of pain catastrophizing between spiritual wellbeing and depression in a chronic pain sample.
Conclusions
Overall, our review identified very limited literature on the nature and role of pain related beliefs in chronic musculoskeletal pain individuals from LMICs, which highlights a strong need for research in this area in the LMIC countries. The existing research, though limited, indicates a trend towards a role for fear avoidance beliefs and pain catastrophizing in people with CMP in LMICs. Understanding the nature and role of pain related beliefs would help inform the development of appropriate treatment strategies to reduce the burden of CMP in LMICs.
References
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