Interdisciplinary pain rehabilitation for immigrants with chronic pain who need language interpretation - a one-year...

Chronic pain is a major health problem and is more common among women than men. Interdisciplinary pain rehabilitation programmes (IPR) are effective in reducing pain and restoring function for patients with chronic pain. However, in Sweden, immigrants who do not speak Swedish are commonly not selected for participation in IPR. There is thus a knowledge gap regarding whether IPR has positive effects for immigrants with chronic pain and inadequate Swedish language skills. The aim of this study was to investigate outcomes in patients with chronic pain and inadequate Swedish language skills at one-year follow-up after participation in an IPR with language interpreters, both on the whole group level and separately for women and men, and in comparison with a reference group of patients.

Design: prospective multi-centre cohort study. Patients: 74 patients (60 women and 14 men). Pain intensity, anxiety and depression, health-related quality of life, fear of movement and the number of doctor visits due to pain were evaluated at baseline, at treatment conclusion (except for doctor visits) and one year after the programme. Patients were compared with a reference group comprising Swedish-speaking patients in a standard interdisciplinary pain rehabilitation programme (135 patients (122 women and 13 men)).

At one-year follow-up, the patients showed significant improvements in pain intensity, depression, and fear of movement, and when subgrouping, the female patients showed significant improvements in the same variables: pain intensity (p=0.002), depression (p=0.015), and fear of movement (p=0.007). Anxiety was significantly deteriorated, both for the whole group and for the female patients (p=0.011). The men did not improve, but low numbers preclude statistics or conclusions. On the whole group level, there was also a significantly reduced number of doctor visits due to pain (p<0.001) at one-year follow-up. Compared to those in the reference group, the patients rated themselves significantly poorer before the programme for the variables measured over time (p=/<0.004). All variables improved significantly for the patients in the reference group at one-year follow-up.

Patients with chronic pain and inadequate language skills in the Swedish language seem to benefit from participating in an interdisciplinary pain rehabilitation programme with language interpreters. The result could be of value for the further development of such rehabilitation programmes, but further studies are needed regarding men´s needs in and after a rehabilitation programme. Ethical committee number (IRB#/REC#): Regional ethics review board Stockholm, ref: 2016/858-31; completion 2016/2059-32 and 2020/06982.