Understanding and Advancing Communication Between People Living with Chronic Pain and Their Healthcare Providers in Ethiopia

Abstract

This dissertation examines the communication experiences between patients with chronic primary musculoskeletal pain and healthcare providers in Ethiopia to enhance communication. It includes three parts: an interpretative phenomenological analysis of patients’ experiences, an interpretive description of healthcare professionals' perspectives, and an evaluation of the Amharic BPI for assessing chronic pain. The first study identifies themes such as patients’ uncertainty about what to communicate, family involvement, and the need for comprehensive questioning. The second study highlights barriers for healthcare professionals, including limited pain-management knowledge, time constraints, and systemic issues. The third study demonstrates the reliability and validity of the Amharic BPI in assessing chronic pain. The overall findings reveal that communication about chronic pain is complex, influenced by cultural and social contexts, and hindered by patients' struggles to articulate pain and providers' lack of understanding. Integrating tools like the BPI can bridge communication gaps, enabling more effective pain communication. Empathetic, comprehensive discussions and involving family members are crucial for improving patient outcomes. Despite limitations such as gender imbalance and translation issues, the findings guide the development of culturally sensitive communication strategies to improve chronic pain care in Ethiopia. Future research should focus on diverse participant samples and specific communication strategies within different cultural contexts. Policymakers should support holistic care approaches, invest in infrastructure improvements, and develop training programs to enhance healthcare providers' communication skills. Promoting patient education initiatives will help individuals better understand and articulate their pain, ultimately improving patient satisfaction and outcomes.