TY - JOUR
T1 - Self-reported pain among Cambodian Americans with depression
T2 - patient-provider communication as an overlooked social determinant
AU - Berthold, S. Megan
AU - Feinn, Richard
AU - Bermudez-Millan, Angela
AU - Buckley, Thomas
AU - Buxton, Orfeu M.
AU - Kong, Sengly
AU - Kuoch, Theanvy
AU - Scully, Mary
AU - Ngo, Tu Anh
AU - Wagner, Julie
N1 - Funding Information:
DK103663 to JW. The funding body had no role in the design of the study and collection, analysis, and interpretation of the data and in writing the manuscript. The funding was provided by National Institute of Diabetes and Digestive and Kidney Diseases.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
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.
AB - 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.
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U2 - 10.1186/s41687-022-00504-4
DO - 10.1186/s41687-022-00504-4
M3 - Article
C2 - 36138333
AN - SCOPUS:85138746422
SN - 2509-8020
VL - 6
JO - Journal of Patient-Reported Outcomes
JF - Journal of Patient-Reported Outcomes
IS - 1
M1 - 103
ER -