A scoping review: physical pain among Indigenous Peoples in Canada

Purpose: Pain is a multifaceted experience shaped by various factors including context of pain, previous life events, and ongoing ethnocultural circumstances. Moreover, pain’s definition is inconsistent across cultures. Western medicine views physical pain (e.g., fractured bone) and non-physical pain (e.g., depression) as two distinct conditions. Indigenous perspectives are often more wholistic, encompassing mental, spiritual, emotional, and physical hurt. The subjective nature of pain invites ample opportunity for discrimination in both its assessment and management. As such, it is important to consider Indigenous perspectives of pain in research and clinical practice. To investigate what aspects of Indigenous pain knowledge is currently considered by Western research, we conducted a scoping review on pain among Indigenous Peoples of Canada. Methods: In June 2021, 9 databases were searched with 8,220 papers downloaded after duplicates removed. Abstract and full-text screening was conducted by two independent reviewers. Principle Findings: 77 papers were included for analysis. Using grounded theory, five themes emerged: pain measures/scales (n=7), interventions (n=13), pharmaceuticals (n=17), pain expression/experiences (n=45), and pain conditions (n=70). The lack of research in pain measurement and scales (n=7) is discouraging, considering the emerging perspective that Indigenous peoples perceive their pain as ignored, minimized, or disbelieved. Conclusions drawn from the pain expression and experiences theme also highlight a divide between pain expression in Indigenous peoples and pain assessment in medical professionals. Conclusion: The limited research on pain measurement is discouraging in light of numerous studies reporting Indigenous Peoples experience their pain is ignored, minimized, or disbelieved. Furthermore, a clear disconnect emerged between pain expression in Indigenous Peoples and assessment in medical professionals. Overall, this review intends to translate current knowledge to other non-Indigenous academics and to initiate meaningful collaboration with Indigenous partners. Future research led by Indigenous academics and community partners is critically needed to better address pain needs in Canada.Medicine, Faculty ofExperimental Medicine, Division ofGraduat