TY - JOUR
PY - 2022//
TI - Self-reported pain among Cambodian Americans with depression: patient-provider communication as an overlooked social determinant
JO - Journal of patient-reported outcomes
A1 - Berthold, S. Megan
A1 - Feinn, Richard
A1 - Bermudez-Millan, Angela
A1 - Buckley, Thomas
A1 - Buxton, Orfeu M.
A1 - Kong, Sengly
A1 - Kuoch, Theanvy
A1 - Scully, Mary
A1 - Ngo, Tu Anh
A1 - Wagner, Julie
SP - e103
EP - e103
VL - 6
IS - 1
N2 - OBJECTIVES: Pain is common among torture survivors and refugees. Clear communication about one's pain is vital to timely and precise diagnosis and treatment but is rarely recognized as a social determinant of health. We examined whether self-reported difficulty communicating with their health care provider, along with standard social determinants, is associated with self-reported pain in Cambodian American refugees.
METHODS: Secondary data analysis was conducted on n = 186 baseline assessments from a diabetes prevention trial of Cambodian Americans with depression. Bilingual, bicultural community health workers (CHWs) conducted surveys including social determinants of health and past week pain occurrence and interference.
RESULTS: The sample was 78% female, modal household income = $25,000, mean age = 55 years, and mean education = 6.9 years. About one-third had private insurance and two-thirds could not speak English conversationally. The average pain score was 2.8 on a scale from 0-8 with 37% reporting no pain at all. In bivariate analyses, predictors of higher pain scores were higher difficulty understanding healthcare provider, depressive symptoms, trauma symptoms, food insecurity, and social isolation; predictors of lower pain scores were higher years of education, income, English language proficiency, social support, working, and having private insurance. In the multivariate backward elimination model only two predictors were retained: difficulty understanding healthcare provider and depressive symptoms.
DISCUSSION: We propose that healthcare communication is a modifiable social determinant of health. Healthcare institutions should receive the resources necessary to secure patients' rights to clear communication including trained community health workers.
Language: en
LA - en SN - 2509-8020 UR - http://dx.doi.org/10.1186/s41687-022-00504-4 ID - ref1 ER -