Conceptualisations of pain amongst resettled Nepali-speaking Bhutanese adults in rural and regional Australia.

INTRODUCTION: Nepali-speaking Bhutanese refugees have been subject to one of the largest resettlement programs in the world and experience higher rates of chronic pain when compared to the general population. The purpose of this study was to explore qualitative conceptualisations of chronic pain among a group of Nepali-speaking Bhutanese adults with a refugee background who relocated to rural and regional Australia. METHODS: Participants included 22 individuals (females n=15) with chronic pain, who took part in structured qualitative focus groups exploring their experiences of chronic pain. Data were analysed using thematic analysis and five main themes were developed. RESULTS: The themes were: (1) pain is persistent and creates suffering, (2) pain is subjective and poorly understood, (3) pain is a biomedical problem that needs to be solved, (4) pain is complex and more than a biomedical problem, and (5) coping with pain is multi-faceted.Some participants viewed pain through a predominantly biomedical lens, and some recognised social and psychological factors as contributors to pain. Overwhelmingly, the participants believed pain is complex and multifaceted, requiring active and passive strategies for management, some of which are culturally informed. CONCLUSION: The experiences of resettled Nepali-speaking Bhutanese refugees living with pain are important to elucidate to improve healthcare inequalities among this marginalised group. This research will inform future assessment guidelines and treatment programs for Nepali-speaking Bhutanese adults living with chronic pain.

The relationship between mindfulness facets, depression, pain severity and pain interference.

The high prevalence of depression among chronic pain populations is well-established: however, treatments for both depression and chronic pain remain only moderately effective. Previous research has indicated that mindfulness is a promising treatment pathway for both depression and chronic pain, however, the mechanisms of change underlying mindfulness are unclear. The purpose of this study was to examine the effects of the mindfulness facets on depression and pain, using two pain measures; severity and interference. One hundred and fifty-eight Australian females and 32 males with chronic pain participated in the study. Higher levels of mindfulness were associated with lower depression as well as lower pain. Path models using depression as a mediator, found that the mindfulness facets observing and describing had a direct effect on pain, while non-judgement, non-reactivity and describing showed indirect effects on pain through depression. Greater effects were seen for pain interference compared to pain severity, highlighting its importance as a potential treatment outcome. Future research should continue to analyse the effects of the mindfulness facets and consider using pain interference as a core treatment outcome.