561: How Sociocultural Histories Shape Refugee Pain Experiences: Perspectives of Healthcare Professionals

Topic: Education, Societal Impact, and Others
Subtopic: Pain related to torture, organized violence and war

Background and Aims: Chronic pain is highly prevalent (83%) among refugees [1] and frequently remains undertreated. Healthcare professionals often face challenges in providing pain care for refugees with lack of evidence or guideline to inform effective management strategies [2]. Some studies have engaged refugees with lived experiences [3] but there is scarcity of research involving healthcare professionals working directly with refugees. We aimed to understand a broader range of healthcare professionals’ insights and perspectives related to the factors that influence refugees’ access to and engagement with pain management.

Methods: Adopting an interpretivist ontology and a relativist social constructionist perspective, the study examined how refugees’ diverse and complex histories influenced their interactions with pain care, as reported by healthcare professionals. We recruited 22 international participants through purposive sampling using research team’s wider international professional network. Healthcare professionals with at least six months experience of providing health, pain management or wellbeing programs for refugees in any care settings in the resettlement countries were eligible. An online (Zoom) semi-structured interview was conducted from November 6, 2024, to December 20, 2024. We employed Reflexive Thematic Analysis to the interview data to generate themes.

Results: The participants were physiotherapists (17), physicians (3), and psychologists (2) from 10 different countries. We identified three broad themes: 1) ‘Adversity and pain experiences are intertwined’ suggested that health professionals saw pain in refugees as a manifestation of trauma, loss, and cultural dislocation. 2) ‘Disempowerment shapes refugee engagement with care’ suggested that a loss of autonomy, invalidation and disruption of social networks disrupts refugees’ engagement with pain care. 3) ‘Barriers within and beyond the healthcare system’ suggested that refugees face significant barriers to access and engagement, often associated with systemic issues within and related to the healthcare setting.

Conclusions: We identified three themes of healthcare professionals’ perspectives on refugee access to and engagement in pain care. Displacement, disempowerment and system-based challenges highlight the need for trauma-informed and culturally adapted practice and health professional training to understand and meet complex needs of refugees. Research to develop and evaluate more effective pain care for refugees is urgently required.

References: 1. Rometsch-Ogioun El Sount C, Windthorst P, Denkinger J, et al. Chronic pain in refugees with posttraumatic stress disorder (PTSD): A systematic review on patients' characteristics and specific interventions. J Psychosom Res. 2019;118:83-97. doi:https://dx.doi.org/10.1016/j.jpsychores.2018.07.014
2. Nissen A, Hynek KA, Scales D, Hilden PK, Straiton M. Chronic pain, mental health and functional impairment in adult refugees from Syria resettled in Norway: a cross-sectional study. BMC Psychiatry. Aug 24 2022;22(1):571. doi:10.1186/s12888-022-04200-x
3. Au M, Anandakumar AD, Preston R, Ray RA, Davis M. A model explaining refugee experiences of the Australian healthcare system: a systematic review of refugee perceptions. BMC Int Health Hum Rights. 2019;19(1):22-23. doi:10.1186/s12914-019-0206-6

Presenting Author: Karma Phuentsho
Submitting Author: Karma Phuentsho

Senior Author: G. Lorimer Moseley

IASP 2026 Global Year theme of Neuropathic Pain: No

• Karma Phuentsho: BPT, MBA - IIMPACT in Health, Adelaide University
• Kristin Graham: PhD - IIMPACT in Health, Adelaide University
• Emma L. Karran: PhD - IIMPACT in Health, Adelaide University
• Aparnadas Amritha: BSc - Survivors of Torture and Trauma Assistance and Rehabilitation Service
• Ruth P. Appiah: MD - IIMPACT in Health, Adelaide University
• G. Lorimer Moseley: PhD - IIMPACT in Health, Adelaide University