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EPA-1473 – Ethnic Differences in Pain Expression – Myth or Reality? Examples from the Berlin Emergency Room and the Transcultural Menopause Study

Published online by Cambridge University Press:  15 April 2020

T. Borde*
Affiliation:
Alice Salomon Hochschule Berlin, Berlin, Germany

Abstract

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Introduction/Objective

In an emergency department (ED) study and in a transcultural menopause study we investigated the influence of ethnicity and socio-demographic factors on the perception and expression of pain respectively menopausal symptoms.

Methods

Data for the ED-study were collected in three large ED's in Berlin based on standardized face-to-face interviews with ED-patients containing a verbal rating scale and a diagram of the human body to indicate the degree of pain and to localize the pain regions. The participants of the menopause study (aged 45–60 years) were recruited via random and snowball sampling in Berlin and Istanbul and surveyed with a structured questionnaire including the Menopause Rating Scale II (MRS II). Statistical analyses were performed with univariate Fisher's exact test, factor analysis, and multivariate logistic regression.

Results

In both studies German participants had a relatively higher social and educational status. 473 patients were included in the ED-study. Compared to German and other ethnic groups the logistic regression analysis showed significantly higer scores in perceived severity of pain and in the number of reported pain locations for migrants from Turkey. A total of 963 women (Berlin: 418 German, 264 migrants from Turkey; Istanbul: 281 women) participated in the menopause study. Turkish migrants in Berlin and women in Istanbul rated their their complaints significantly higher than German women. In both studies gradual multivariate logistic regression revealed that ethnicity as well as other social determinants influence the pain expression.

Conclusions

Ethnic differences in pain perception and expression are reality but ethnicity may not be regardes as single factor. It is necessary to re-appraise the concept of pain both in science and in healthcare practice, particularly on the basis of a critical assessment of what constitutes the ‘norm’.

Type
S520 - Shades of Pain: Cultural and Liaison-Psychiatric Perspectives on a Major Health Issue - joint symposium of EPA sections “Cultural Psychiatry” and “CL-Psychiatry and Psychosomatics”
Copyright
Copyright © European Psychiatric Association 2014

References

Literature Boral, S.Borde, T.Kentenich, H.Wernecke, K.D.David, M.Migration and symptom reporting at menopause: A comparative survey of migrant women from Turkey in Berlin, German women in Berlin and women in Istanbul. Menopause 2022013 169178CrossRefGoogle Scholar
David, M.Pant, H.A.Oligmüller, A.-K.Babitsch, B.Borde, T.Ethnic Differences in Reported Pain Regions – Results of a Survey at Three Clinical Emergency Rooms in Berlin/Germany. Geburtshilfe und Frauenheilkunde 2011; 71: 4452CrossRefGoogle Scholar
David, M.Schwartau, I.Pant, H.A.Borde, T.Emergency outpatient services in the city of Berlin: factors for appropriate use and predictors for hospital admission. EJEM – European Journal of Emergency Medicine 2006; 13: 352357CrossRefGoogle ScholarPubMed
Babitsch, B.Braun, T.Borde, T.David, M.Physician perception of doctor-patient relationships in emergency clinics: What roles do gender and ethnicity play? BMC Health Services Research 8 2008 82CrossRefGoogle Scholar
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