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The Influence of Culture on Chronic Pain: A Collective Review of Local and International Literature

Thivian Kandasamy Pillay, Hendrik Adriaan van Zyl and David Roy Blackbeard

Chronic pain poses a therapeutic challenge to the healthcare community and is particularly prevalent in the psychiatric patient population. Research supports that chronic pain is a multifaceted process and the concurrent interplay between pathophysiology, cognitive, affective, behavioral and sociocultural factors summate to what is referred to as the chronic pain experience. The adequate treatment of pain has been highlighted in recent years with emphasis on the need for a multidisciplinary approach. It has emerged that chronic pain is experienced differently among patients of differing cultures and ethnicities. Objectives: The objectives were to identify and critically appraise relevant research and give an integrated comprehensive overview of key considerations for the interaction of culture and chronic pain. Findings would potentially identify and stimulate areas for local research, while promoting awareness, multidisciplinary cooperation and policy development to inform decision-making and culturally relevant clinical practice. Methods: A collective review of local and international literature was conducted using a systematic approach. Articles from the last 20 years, across three major disciplines were identified by relevance to the research question and key words. A final total of 30 articles were retrieved, categorized, analyzed, and synthesized. Results: The reviewed data yielded a large number of potential outcomes to examine, ranging from patient variables, to limitations of healthcare providers to shortcomings of the healthcare system. Discussion: Chronic pain is a multidimensional, composite experience shaped by interweaving and coinfluencing biological and psychosocial factors. Understanding the culmination of these factors is pivotal to appreciating the differences in its manifestation and management.