The lived experiences of chronic pain among immigrant Indian-Canadian women: A phenomenological analysis.

Background: Chronic pain is a growing public health concern affecting 1.5 million people in Canada. In particular, it is a concern among the expanding immigrant population, because immigrant groups report higher pain intensity than non-immigrants. In 2011, the Indian population became the largest visible minority group and continues to be the fastest growing. Though the prevalence of chronic pain among Canadian Indians is unknown, research has found a higher prevalence among Indian women than men in India, Malaysia, Singapore, and the United Kingdom, with women reporting more severe pain. An understanding of how pain is experienced by this particular group is therefore important for providing culturally sensitive care. AIMS: This study explores the lived experiences of chronic pain among immigrant Indian women in Canada. METHODS: Thirteen immigrant Indian women participated in one-on-one interviews exploring daily experiences of chronic pain. RESULTS: Using thematic analysis informed by van Manen's phenomenology of practice, four themes emerged: (1) the body in pain, (2) pain in the context of lived and felt space, (3) pain and relationships, and (4) pain and time. Women revealed that their experiences were shaped by gender roles and expectations enforced through culture. Specifically, a dual gender role was identified after immigration, in which women had to balance traditional household responsibilities of family labor and care alongside employment outside the home, exacerbating pain. CONCLUSIONS: This research uncovers the multifaceted nature of chronic pain and identifies factors within the sociocultural context that may place particular groups of women at greater risk of living with pain.

Contexte: La douleur chronique est un problème de santé publique croissant qui touche 1,5 million de personnes au Canada. Elle est particulièrement préoccupante au sein de la population immigrante en expansion, car les groupes d'immigrants signalent une intensité de douleur plus élevée que les non-immigrants. En 2011, la population indienne est devenue le plus grand groupe de minorités visibles et continue d'être celui qui connaît la croissance la plus rapide. Bien que la prévalence de la douleur chronique chez les Indo-Canadiens soit inconnue, des études ont montré que la prévalence de cette maladie chez les femmes indiennes était supérieure à celle des hommes en Inde, en Malaisie, à Singapour et au Royaume-Uni, les femmes faisant état de douleurs plus intenses. Une compréhension de la manière dont la douleur est ressentie par ce groupe particulier est donc importante pour fournir des soins adaptés à la culture.Objectifs: Cette étude se penche sur les expériences de douleur chronique vécues par les immigrantes indiennes au Canada.Méthodes: Treize immigrantes indiennes ont participé à des entretiens individuels portant sur leurs expériences de douleur chronique quotidiennes.Résultats: Grâce à une analyse thématique fondée sur la phénoménologie de la pratique de van Manen, quatre thèmes ont émergé : (1) le corps douloureux, (2) la douleur dans le contexte de l'espace vécu et ressenti, (3) la douleur et les relations, et (4) la douleur et le temps. Les femmes ont révélé que leur expérience était façonnée par les rôles sexo-spécifiques et les attentes étaient imposées par la culture. Plus précisément, un double rôle sexo-spécifique a été découvert après l'immigration, dans laquelle les femmes doivent équilibrer les responsabilités traditionnelles du travail familial et des soins parallèlement à l'emploi en dehors du domicile, ce qui exacerbe la douleur.Conclusions: Cette étude révèle la nature multidimensionnelle de la douleur chronique et recense les facteurs propres au contexte socioculturel qui peuvent placer des groupes particuliers de femmes à plus grand risque de vivre avec la douleur.

'You want to show you're a valuable employee': A critical discourse analysis of multi-perspective portrayals of employed women with fibromyalgia.

Background Advice on fibromyalgia, a chronic illness primarily affecting women, often presents it as incompatible with work and rarely covers how to remain employed. Yet many women do. Objectives We aimed to understand how these women, their family members, and workmates portrayed employees with fibromyalgia, and how these portrayals helped women retain employment. Methods We interviewed 22 participants, comprising five triads and three dyads of people who knew each other. Using the methodology of critical discourse analysis, we analysed the interview data within and across the triads/dyads through coding, narrative summaries, and relational mapping. Results Participants reported stereotypes that employees with fibromyalgia are lazy, malingering, and less productive than healthy workers. Countering these assumptions, participants portrayed the women as normal, valuable employees who did not 'give in' to their illness. The portrayals drew on two discourses, normalcy and mind-controlling-the-body, and a related narrative, overcoming disability. We propose that participants' portrayals helped women manage their identities in competitive workplaces and thereby remain employed. Discussion Our findings augment the very sparse literature on employment with fibromyalgia. Using a new approach, critical discourse analysis, we expand on known job-retention strategies and add the perspectives of two key stakeholders: family members and workmates.

The Long Live Kids campaign: awareness of campaign messages.

Media interventions are one strategy used to promote physical activity, but little is known about their effectiveness with children. As part of a larger evaluation, the purpose of this study was to assess the short-term effect of a private industry sponsored media literacy campaign, Long Live Kids, aimed at children in Canada. Specifically, we investigated children's awareness of the campaign and its correlates. Using a cohort design, a national sample (N = 331, male = 171; mean age = 10.81, SD = 0.99) completed a telephone survey two weeks prior to the campaign release, and again 1 year later. Only 3% of the children were able to recall the Long Live Kids campaign unprompted and 57% had prompted recall. Logistic regression found family income (Wald χ(2) = 11.06, p < .05), and free-time physical activity (Wald χ(2) = 5.67, p < .01) significantly predicted campaign awareness. Active children (≥3 days/week) were twice as likely to have recalled the campaign compared with inactive children (<3 days/week), whereas children living in high-income households (>$60,000/yr) were between 3.5 to 5 times more likely to have campaign recall compared with children living in a low-income households (<$20,000/yr). These findings suggest that media campaigns developed by industry may have a role in promoting physical activity to children although our findings identified a knowledge gap between children living in high- and low-income households. Future research needs to examine how children become aware of such media campaigns and how this mediated information is being used by children.