Journal of Pain Research (Jun 2017)
Effects of acculturation, coping strategies, locus of control, and self-efficacy on chronic pain: study of Chinese immigrant women in Italy – insights from a thematic field analysis
Abstract
Tania Simona Re,1 Nicola Luigi Bragazzi,1,2 Anna Siri,1 César Cisneros Puebla,3 Susanne Friese,4 Mário Simões,5 Joël Candau,6 Hicham Khabbache7 1UNESCO Chair “Health Anthropology, Biosphere and Healing Systems”, Genoa, Italy; 2Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy; 3Department of Sociology, Metropolitan Autonomous University-Iztapalapa, San Rafael Atlixco, Mexico; 4Max Planck Institute for the Study of Religious and Ethnic Diversity, Göttingen, Germany; 5Medical Faculty, University of Lisboa, Lisboa, Portugal; 6Laboratory of Anthropology and Cognitive and Social Psychology (LAPCOS), University of Nice-Sophia Antipolis, Nice, France; 7Faculty of Literature and Humanistic Studies, Sidi Mohamed Ben Abdellah University, Fez, Morocco Abstract: Chronic pain represents a common public health concern worldwide. It is a complex phenomenon, owing to the interaction of different factors, including biological, physiological, psychological, environmental, and social variables. Some groups, such as women and immigrants, are particularly vulnerable. However, little is known about how Chinese women in Italy live with and face chronic pain. The present study aimed at filling this knowledge gap by examining the burden of chronic pain in Chinese immigrants in Italy in terms of acculturation processes, perceived control over disease, social networks, and coping strategies. A qualitative approach was used, performing a thematic field analysis. We interviewed 82 Chinese women from different Italian towns (Genoa, Milan, Turin, Bologna, Florence, and Prato) in depth. The sense of belonging to the host culture was strong in our sample. However, this did not simply reflect or translate into a linear engagement with medical systems, as health care pathways were more complex and dual (both Chinese and Western). Chinese women who felt deeply rooted in the Italian environment did not discontinue the use of traditional Chinese medicine. Chronic pain extensively and adversely affected daily life, particularly interfering with work. Coping strategies were mainly adaptive behaviors, being problem focused or maladaptive, relying upon “cope and avoid” mechanisms. Chinese women preferred to use traditional Chinese remedies rather than conventional medicine, while using the Italian system in emergencies. Perceived control over chronic pain was usually external. Finally, Chinese women with chronic pain benefit from social networks and support, which were mainly composed of Chinese peers. In conclusion, our findings underline the tremendous burden of chronic pain affecting all aspects of Chinese women’s lives. Health care workers and providers should be aware of the complexity of chronic pain Therefore, a holistic approach, involving different stakeholders, should be adopted when managing chronic pain and approaching immigrant patients. Keywords: chronic pain, Chinese immigrants, qualitative research, thematic field analysis
