Are multidisciplinary interventions multicultural? A topical review of the pain literature as it relates to culturally diverse patient groups

Worldwide, societies are becoming increasingly culturally diverse. International migration continues to rise, influenced by political, economic, and socioenvironmental factors and is now a structural feature of almost all contemporary nations. Cultural diversity was recognised by the United Nations Educational Scientific and Cultural Organisation (UNESCO) as a key global concern at the start of the 21st century. The changing demographics and economics of a multicultural world, and the health disparities for some culturally diverse communities, provide significant challenges for health care systems internationally.
Cross-cultural investigations demonstrate that definitions, descriptions, and perceptions of pain and pain control are culturally specific. Experimental pain investigations demonstrate significant differences in pain tolerances and thresholds according to ethnicity. The way in which pain is experienced is powerfully influenced by culturally based attitudes, beliefs, and values. Beliefs and values mediate emotional responses to pain disorders and pain coping strategies, such as stoicism, spiritual coping, hypervigilance, and catastrophising. Unravelling and understanding the multiple and fluid dimensions that construct the pain experience is fundamental to reducing suffering and ensuring equitable pain management.