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Background: Refugee women exhibit some of the highest rates of chronic pain yet the diversity and challenges of health care systems across countries pose numerous challenges for refugee women trying to access quality health care. Objective: We sought to explore the experiences of Assyrian refugee women seeking care for chronic pain. Methods: Semi-structured interviews (face-to-face and virtual) were undertaken with 10 Assyrian women of refugee background living in Melbourne, Australia. Audio recordings and field notes of interviews were collected and themes were identified using a phenomenological approach. Women were required to be conversant in English or Arabic and willing to use a translator if necessary. Results: We identified five major themes of women's experiences accessing care for chronic pain: (1) the story of pain; (2) the experience of help seeking in Australia and home country; (3) factors shaping the ability to access appropriate care; (4) support seeking systems; and (5) influence of culture and gender roles. Conclusion: Exploring refugee women's experience of seeking care for chronic pain reinforces the need to explore hard to reach population's perspectives in research and helps to understand how vectors of disadvantage may intersect. For successful integration into health care systems of host countries, particularly for complex conditions such as chronic pain, there is a need to work with women community members to develop programs that are culturally aligned to enhance access pathways to care. [ABSTRACT FROM AUTHOR]

Background: Refugee women are one of the most vulnerable groups in our society and exhibit some of the highest rates of chronic pain. However, the relationship between migration experiences and the development and perpetuation of chronic pain remains unclear. Aim/Objective: To identify the pre- and post-migration factors associated with chronic pain in refugee women living in Australia. Methods: A secondary analysis of a prospective longitudinal cohort was conducted using resettlement data from the 'Building a New Life in Australia', a study of humanitarian refugees living in Australia. The primary outcome was chronic pain and predictors include migration and resettlement factors collected between October 2013 to March 2018. Logistic regression modelling was used to examine the association between predictor variables and chronic pain. Findings: 310 refugee women aged between 18 to 75 years were included in this study. Almost half reported having chronic pain, 65% of whom also reported having a long-term disability. After controlling for potential covariates, the strongest predictors associated with chronic pain were age, Women at Risk visa category, general health, region of settlement and discrimination. Our final model showed that women who migrate on the Women at Risk visa had 2.3 times higher odds of reporting chronic pain than women migrating on any other visa category (95% CI 1.20, 4.24). Implications: This study has provided rich insights into the health of resettling refugee women, informing an evidence base for chronic pain assessment and guiding broader practice protocols, to support women resettling and dealing with chronic pain. [ABSTRACT FROM AUTHOR]

Context: Chronic pain has been long recognised as a defining feature among the wide range of healthrelated problems exhibited in women belonging to refugee backgrounds. Insights into the health and socio-cultural experiences of refugee women seeking care for chronic pain may help inform practice protocols and reduce health inequalities in populations that are systematically marginalised. Objective: To explore the health-seeking narratives of Assyrian refugee women and the factors that influence their care for chronic pain in Australia. Study Design and Analysis: A qualitative study using a phenomenological perspective to understand the lived experience of Assyrian refugee women seeking care for chronic pain. Analysis involved reflexive thematic analysis based in identifying meaningful patterns and organising these into themes. Setting: The study was set in Melbourne, Victoria where recruitment began by approaching Iraqi Assyrian refugee community leaders, acting as key informants, through pre-existing partnerships with settlement services. Purposive sampling and a snowballing approach was used to identify eligible participants. Population Studied: Ten Assyrian refugee women who identified as having chronic pain. Women were aged between 19 to 85 years and had lived in Australia for four years or longer. Instrument: Semi-structured, in-depth interviews lasting between 30 to 90 minutes were conducted in English or in Arabic with an interpreter present. Outcome Measured: The lived experience of refugee women receiving care for chronic pain in Australia. Results: Overall, experiences such as their culture and family caregiver role in their homeland heavily influenced their experiences seeking healthcare in Australia. Five key themes emerged from this, including 1) Trust in health care systems 2) Accessibility to care 3) Perceptions of pain 4) Support seeking mechanisms and 5) Health knowledge. These themes played a significant role on shaping and forming their models of thought around accessing health care and living life with chronic pain. Conclusions: Refugee women arriving in Australia were confronted with social and cultural conditions and health systems that were radically different to their past experiences. This study provides rich insights into the health needs of refugee women, and highlights a need for an evidence base for better patient advocacy around chronic pain management and practice protocols to support refugee women resettling in Australia. [ABSTRACT FROM AUTHOR]

Background: The experiences of GPs in Australia highlight key considerations regarding workload demands, remuneration incentives and the practical implications of working in regions with high ethnic density. This exploration helps to understand the elements that influence GPs delivery of care, particular for refugee women who exhibit disproportionately higher rates of chronic pain. This qualitative study explored the experiences of GPs providing care for refugee women living with chronic pain., Methods: Semi-structured interviews were undertaken with 10 GPs (9 female and 1 male) practicing across metropolitan Melbourne, Australia. GPs were recruited via purposive sampling and a snowballing strategy. Participants work experience ranged from one to 32 years. Audio recordings of the interviews were transcribed verbatim and stored in qualitative data Nvivo 12 software for coding. Transcripts of interviews were analysed thematically using a phenomenological approach., Results: Three overarching themes were identified: (1) meeting the needs of refugee women living with chronic pain; (2) the role of the GP; and (3) the challenges of the health care system. These themes reflected the complexity of consultations which arose, in part, from factors such as trust, the competencies of clinician's and the limitations posed by time, funding and interpreter use., Conclusion: GPs acknowledged the uniqueness of refugee women's chronic pain needs and whilst doctors welcomed care, many were often challenged by the complex nature of consultations. Those that worked in settings that aligned with refugee women's needs highlighted the importance of cultivating culturally safe clinical environments and listening to their patients' stories. However, system level challenges such as time, funding and resource constraints created significant challenges for GPs. Exploring GPs experiences allows for a better understanding of how vectors of disadvantage intersect in health care and highlights the need to better support doctors to improve health care provision for refugee women living with chronic pain., (© 2024. The Author(s).)

Background: Refugee women are potentially at increased risk for chronic pain due to circumstances both in the pre-migration and post-settlement setting. However, this relationship between refugee-related challenges introduced along their migration trajectories and chronic pain remains unclear. This study will therefore examine the association between pre- and post-migration factors and chronic pain in refugee women five years into resettlement in Australia., Methods: The first five waves of data from the 'Building a New Life in Australia' longitudinal study of humanitarian refugees living in Australia was analysed using logistic regression models to investigate the association between predictor variables and chronic pain. The study outcome was chronic pain and predictors were migration process and resettlement factors in both the pre-and post-settlement setting., Results: Chronic pain was reported in 45% (n = 139) of women, and among these a further 66% (n = 120) also reported having a long-term disability or health condition that had lasted 12 months. Pre- migration factors such as increasing age (OR 1.08; 95% CI 1.05, 1.11) and women who migrated under the Women at Risk Visa category (OR 2.40; 95% CI 1.26, 4.56) had greater odds of experiencing chronic pain. Interestingly, post migration factors such as women with better general health (OR 0.04; 95% CI 0.01, 0.11) or those who settled within metropolitan cities (OR 0.29; 95% CI 0.13, 0.68) had lower odds of experiencing chronic pain, and those who experience discrimination (OR 11.23; 95% CI 1.76, 71.51) had greater odds of experiencing chronic pain., Conclusion: Our results show that there is a high prevalence of chronic pain in refugee women across the initial years of resettlement in Australia. This may be in part due to pre-migration factors such as age and migration pathway, but more significantly the post migration context that these women settle into such as rurality of settlement, poorer general health and perceived discriminatory experiences. These findings suggest that there may be many unmet health needs which are compounded by the challenges of resettlement in a new society, highlighting the need for increased clinical awareness to help inform refugee health care and settlement service providers managing chronic pain., (© 2022. The Author(s).)