Print Evidence indicates that pain perception may be attenuated when an individual performs cognitive tasks or is distracted. Cognitive and emotional influences on the perception of pain constitute a complex emotional experience that varies significantly from one individual to the next. Psychological state can play a role in the success of pain treatment: In contrast, a positive emotional state and a positive expectation of pain relief can lower pain and enhance clinical effect of treatment.
Abstract The relationship between pain and ethnicity is shaped by experience, learning and culture. Mistaken beliefs about the nature of pain and disability, resistance to treatment seeking, reluctance to comply with treatment and failure to accept responsibility of the treatment outcome are not culturally or sub-culturally specific obstacles to pain management.
The reviewed literature shows disparities in pain treatment based on ethnic background. Multidisciplinary research needs to investigate the models of pain and treatment in different cultural groups to allow us to understand how pain is presented and how beliefs and expectations about treatment can be married with practical solutions and effective evidence-based pain management.
Introduction Increasing ethnic diversity means clinicians are regularly required to meet the needs of people from different cultures and offer culturally relevant health care. Hence there is a growing necessity to understand the influence of race and ethnicity in pain management.
Cross-cultural differences are evident in many aspects of human behaviour and in the prevalence of illness and in healthcare usage. Cultural factors influence beliefs, behaviour, perceptions and emotions, all of which have important implications on health and health care.
Chronic pain affects approximately 1 in 5 adults in Europe resulting in substantial healthcare costs 1.
Evidence that cultural influences have an impact on pain is readily available from the UK where pain is the most common symptom encountered by the medical profession.
This can be seen in the sickness absence for back pain, which increased dramatically in the UK between anddespite no change in the incidence of the conditions that cause back pain. This trend has reversed in recent years, leading commentators to conclude the changes were most likely a cultural phenomenon.
Race is described as a construct, which distinguishes groups of people according to their ancestry 3. To aid our understanding of cultural influences on pain the notion of acculturation should be explored. Acculturation has been defined as the extent to which an individual, who migrates from the country of birth, adopts the values, beliefs, cultures and lifestyles of the country to which they emigrate.
Those who are more acculturated report similar levels of pain and illness to the country they have emigrated to, in particular, second and third generation immigrants are more likely to share the beliefs and behaviours of the host nation; however this remains poorly researched 7.
The variation in health between groups could partly be explained by the idea that newly arrived immigrants tend to be situated in lower social economic groups and there is strong evidence of the link between low social economic status and poor health including the report of pain.
Experience, learning and culture shape the relationship between pain and ethnicity rather than any fundamental neurological differences 8.
The distinction between race and ethnicity is particularly important for pain research based on the biopsychosocial model. This model suggests the experience of pain is derived via the interaction of biological, psychological and social factors.
Laboratory pain studies Findings from laboratory studies have suggested there are ethnic differences in experimental pain but other research has questioned this 39.
Sensitivity to experimental pain stimuli is demonstrated to be greater among African-Americans compared to non-Hispanic Caucasians In a study focusing on ethnic variations in pain tolerance among South Asian males and White British males the results indicated South Asian males had significantly lower thermal pain thresholds and experienced higher pain intensity than White males.
This was only true of thermal pain, no differences were reported for cold pain threshold or heat unpleasantness Similarly, ethnic differences have also been reported in studies of acute clinical pain including post-operative pain, low back pain and exercise induced angina where African-American patients reported greater pain intensity than Caucasians.
We must treat these results with caution as some studies have failed to report any ethnic differences in acute clinical pain. Moreover, other studies have found when matching ethnic groups on selected confounding variables such as education, pain duration and work status, the differences in pain related sequelae and emotional distress may be reduced 12 It could be that similar effects occur in the context of ethnic characteristics.
Factors influencing the clinical situation Pain beliefs are brought to the clinical situation by both clinician and patient and can have a profound effect on care.or ecological factors like environmental factors that affect pain outcomes.
The examples of social factors would include an, an individual's income, education, where does this person live, the geographical area. The Emotional Impact of the Pain Experience. Many different factors influence the experience of pain, which is different for everyone.
These include: Age; Gender; Culture; for example, may respond to a child’s pain in a certain manner, setting a foundational pain response for an individual that may influence future pain experiences.
Over the past 20 years, our understanding of social factors on pain experience has increased. Keogh E. Psychosocial factors and their influence on the experience of pain: response to commentary. PAIN Reports e Pain is a dichotomous phenomenon. A true double-edged sword, it can protect us from injury in the short term, but can also.
What can influence the perception of pain Prior unpleasant experience, anticipatory fear or anxiety, magnifying the extent of the pain, individuals temperament, individuals personality What circumstances can exist at the time of the incident that may affect perception.
The Social Security Administration (SSA) specifically asked the Institute of Medicine (IOM) study committee to address the psychosocial aspects of the pain experience and to describe how the concept of illness behavior provides a framework for understanding the observed discrepancies between the clinical manifestations of pain and the behaviors of people with pain.
Although pain is subjective, it does not occur in isolation, and we are currently examining social-contextual influences, and how these may influence individual differences in pain. For example, we are currently developing our interests in the nonverbal communication of pain in men and women.