Perception of Pain Expression Among Surgical Patients and Families from Three Ethnic Groups of a Nation: A Multicenter Qualitative Study

Getu Ataro Hanago; Matthias Siebeck; Samuel Jilo Dira; Tefera Tadesse; Dominik Irnich

doi:10.2147/JPR.S447676

Perception of Pain Expression Among Surgical Patients and Families from Three Ethnic Groups of a Nation: A Multicenter Qualitative Study

J Pain Res. 2024 Jan 16:17:241-251. doi: 10.2147/JPR.S447676. eCollection 2024.

Authors

Getu Ataro Hanago¹, Matthias Siebeck², Samuel Jilo Dira³, Tefera Tadesse⁴, Dominik Irnich⁵

Affiliations

¹ Department of Anesthesia, Hawassa University, Hawassa, Ethiopia.
² Institute of Medical Education, LMU University Hospital, LMU Munich, Munich, Germany.
³ Department of Anthropology, Hawassa University, Hawassa, Ethiopia.
⁴ Institute of Educational Research, Addis Ababa University, Addis Ababa, Ethiopia.
⁵ Multidiciplinary Pain Center, Department of Anesthesiology, LMU University Hospital LMU Munich, Munich, Germany.

Abstract

Background: Despite its universal nature; perception, coping, responses, treatment options, and overall experiences of pain are influenced by biopsychosocial factors to various extents. Pain perception, expression, and control are progressively learned behaviors among members of a society and are culture-specific. Effects of ethnicity-related culture (ethnoculture) on pain experience in a broader context have increasingly been reported. However, evidence from ethnoculturally diverse groups of a nation, particularly based on surgical patients, is limited. Therefore, as a qualitative research effort of a broader project aimed at assessing ethnocultural determinants of surgical pain management, this study explored the perception of ethnoculturally diverse patients and families about expressing surgical disease-related pain.

Methods: This study follows subjectivist-interpretivist philosophical assumptions as an underpinning research paradigm. We purposively selected 11 patients for in-depth interviews and 12 patients' family members for focus group discussions in three hospitals of ethnic-based regions of Ethiopia. In the phenomenological frame, thematic analysis was employed.

Finding: Ethnocultural background influences how individuals express and respond to pain according to emergent themes of finding- Pain and overlooked cultural influence, Pain expressiveness in cultural context, Stereotypes of pain expressiveness, and Bravehood through stoic response. Pain feelings are commonly hidden where the domestic culture values stoic response to pain compared to ethnoculture where pain expressiveness is encouraged.

Conclusion: Individuals can express and respond to pain differently due to ethnocultural diversity within a nation. Researchers and clinicians should consider cultural context while applying the prevailing one-size-fits-all pain assessment tools among surgical patients of a nation with ethnocultural diversity.

Keywords: pain and culture; pain behavior; pain expression; pain response; stoic response; surgical pain.

Grants and funding

Please refer to the details in the “Conflict of Interest and Source of Funding” section above.