Experiences of Pain Among Indigenous Peoples Globally: A Qualitative Systematic Review.

backgroundIndigenous Peoples continue to face colonisation and oppressive policies that intentionally disrupt their ways of life and wellbeing. The increased experience of disease for Indigenous Peoples, due to colonial processes, is confounded by immense difficulties accessing culturally secure healthcare. The experience of pain for Indigenous Peoples within this unjust socio-political context encompasses physical, emotional, spiritual, and mental pain.

objectiveThis systematic review aims to explore factors related to the experience of pain for Indigenous Peoples globally. SEARCH STRATEGY: Four databases: PubMed, EMBASE, Scopus, and Web of Science were searched utilising a pre-established search strategy to identify qualitative papers that focused on experiences and understandings of pain among global Indigenous Communities. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers performed title, abstract and full text screening, which resulted in the inclusion of 26 papers. Data extraction and synthesis was done in two stages which involved grouping illustrations from papers into categories, and then into four overarching synthesised findings. MAIN

resultsThe synthesised findings aligned with social ecological theories and included: intrapersonal, interpersonal, institutional and cultural levels. For Indigenous Peoples, pain is situated within a complex network of social, historical, and political determinants of health. DISCUSSION: The creation of a judgement-free space, accessibility of traditional healing practices and a greater inclusion of family and Community throughout treatment processes were identified as facilitators to care for Indigenous Peoples experiencing pain.

conclusionBy ascertaining and prioritising patient desires throughout the pain management experiences, practitioners can actualise self-determination of patient wellbeing and ensure provision of culturally respectful and comprehensive care.