Culturally and linguistically diverse experiences of chronic pain in Australia: a qualitative synthesis.

BACKGROUND: People from culturally and linguistically diverse (CALD) backgrounds are disproportionately impacted by chronic pain. To inform the design of culturally responsive pain care that can reduce health disparities and improve health outcomes, this scoping review examined the perspectives and experiences of pain and pain care of people from CALD backgrounds in Australia. METHODS: Scoping review design based on Arksey and O'Malley's framework. Six databases (MEDLINE, EMBASE, APA PsychInfo, CINAHL, SCOPUS, Social Sciences Abstract - Proquest) were searched from inception to July 2023 and repeated in February 2024 using the keywords 'chronic pain', 'CALD' and 'Australia'. Inclusion criteria were qualitative or mixed-methods studies exploring the perceptions and experiences of adults aged ≥18 years with non-cancer pain of ≥3 months duration from CALD backgrounds (born in a non-English speaking country and/or speak a language other than English at home). Qualitative data were analysed using thematic analysis. RESULTS: Of 546 studies screened, five met the inclusion criteria. These studies involved 167 participants from Assyrian (Iraq), Mandaean (Iraq), Vietnamese and Indian communities. Whilst perspectives and experiences unique to each community were observed, three major themes characterised the CALD communities' chronic pain experiences: holistic beliefs about pain including physical, mental, cultural and spiritual aspects; the importance of social support networks; and barriers to accessing the healthcare system such as cost and lack of trust. CONCLUSION: To improve access, uptake, and outcomes for people from CALD backgrounds, future research is needed to co-design a multidisciplinary pain programme that is widely accessible through primary care, adopts a strengths-based approach, and is delivered by trusted healthcare professionals with the support of the wider community. The findings of this study give rise to recommendations at the clinician, health service, and broader health system levels, including the hiring of culturally diverse staff who reflect the community.