Beyond Symptom Reduction: A Qualitative Study of Refugees' Experiences of a Trauma-Informed Community-Based Pain...

Chronic pain is common among refugees, who have often experienced significant trauma and have needs distinct from those of the non-refugee population. Pain programs do exist but little is known about how and in what ways they meet, or do not meet, refugees' needs. To that end, we sought to understand refugee experiences of a pain management program specifically designed for and with refugees, within a trauma-informed, biopsychosocial framework.

Collaborating with a torture and trauma rehabilitative service, six focus groups and one interview were conducted with 31 refugees in a semi-structured format. These were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis.

Five themes were generated capturing refugees' perspectives on the program, its content and format: (1) We learned to rethink pain as complex and not just physical; (2) Exercise does wonders for our pain and more; (3) We valued connecting with (our) people; (4) We found great value and meaning in the program and want it to continue; and (5) Our engagement with the program is impacted by broader life challenges. Social connection and reduced isolation were linked to the program's group format and culturally tailored activity design. Participants' emphasised understanding of the multidimensional nature of pain prompted new coping strategies they employed beyond the program, and they expressed a desire for the program to continue.

Our findings demonstrate the value of culturally responsive, group-based approaches to pain management that include exercise, social and education components, but also highlight the complex challenges that refugees face beyond their pain experience.

This study offers novel insights into how refugees experienced a pain management program. By demonstrating how elements such as exercise, social connection, cultural responsiveness and trauma-informed approaches fostered engagement and reshaped participants' understanding and management of pain, it meaningfully informs a neglected area of pain research. The findings identify practical and methodological considerations for designing and delivering tailored group-based pain programs for refugees, offering evidence to inform more equitable, responsive and culturally safe pain care.