To understand how Indigenous peoples across the globe make sense of pain when experiencing chronic non-cancer pain. To understand how Indigenous peoples across the globe make sense of pain when experiencing chronic non-cancer pain.
This integrative literature review focused on qualitative data reported by Indigenous adults with chronic non-cancer pain in empirical and theoretical studies. Electronic searches were performed in databases from health and humanities scopes, in addition to grey literature, from 1990 to August 2023. We drew from critical theory approaches to thematically analyze data from the included studies, privileging Indigenous perspectives through a Western intellectual framework (Two-Eyed Seeing epistemology). Data extraction and thematic analysis were performed using NVivo. Primary data were mapped according to geography and theoretical framework.
After removal of duplicates, 1352 studies were screened using title and abstract, from which 99 full texts were assessed. Twenty-nine studies and three dissertations/thesis were included in this review. Included studies reported lived experiences of chronic pain among Indigenous peoples from Oceania, North America, and South America. Two main themes were collated after thematic analysis: 1) Interconnected ways of embodying pain and 2) Structural and relational dilemmas of embodying pain. Our findings suggest that pain is interconnected to a broader scenario of feelings, thoughts, peoples and places.
Findings highlight the layered and complex aspects of the lived experiences of chronic pain among Indigenous people and relate to broader concepts discussed by Indigenous and non-Indigenous scholars using critical approaches. To cite a few, the concept of structural violence is illustrated by the experiences of Indigenous peoples when seeking help in the mainstream care for pain management; the diverse ways in which different groups express their suffering is consistent with idioms of distress; and the collective embodiment of pain pointed to the community-centred relational aspects involved in making sense of pain, which aligns with interconnected system of relationships and knowledge exchange.
Because non-Western perspectives are powerful and transformative to redefine, rethink and redesign pain care to all peoples, this review findings stimulate critical reflections by health professionals working with pain management. Indigenous-led alternatives focusing on culturally safe care can guide approaches to clinical pain practice and contribute to achieving health equity.
Indigenous peoples
Chronic pain
