title: GPs' experience of managing chronic pain in a South Asian community--a qualitative study of the consultation process.
abstract: BACKGROUND
  Chronic pain is one of the most common reasons for seeking primary care consultations. GPs' experience of managing patients with pain from a multicultural community has not previously been examined.
  
  
  OBJECTIVE
  We explored GPs' experiences of managing patients with chronic pain from a South Asian community in Leicester.
  
  
  METHODS
  Qualitative semi-structured interviews were conducted with GPs from practices in two primary care trusts within Leicester. Eighteen GPs (11 males and 7 females) were interviewed in this study.
  
  
  RESULTS
  Several emerging themes were identified from the data including consulting behaviour, presentation of pain, GPs personal challenges, psychosomatic interpretations and communication. Overall, GPs find that managing South Asian patients with chronic pain can be challenging as a consequence of the way in which patients present with pain. Difficulties for GPs were created not only by language differences but also by cultural differences, which were not seen in second or third generation South Asians. GPs felt that self-management was difficult to address, and compliance with medication difficult to determine. In such consultations, GPs perceived that patients were more likely to present with psychosomatic symptoms.
  
  
  CONCLUSIONS
  Cultural influences play an important role in the consultation process where patients' behaviour is often bound in their cultural view of health care. Patients' presentation of their condition makes diagnosis difficult but can also lead to miscommunication. Whether South Asian people are more likely to present mental health problems as chronic pain is not clear and warrants further investigation.
authors: Clinical Trials Unit, Warwick Medical School, University of Warwick Gibbet Hill, Coventry, UK. shilpa.patel@warwick.ac.uk
authors: S
authors: S
authors: Patel
authors: Sm
authors: S
authors: Peacock
authors: Rk
authors: R
authors: McKinley
authors: D Clark
authors: DC
authors: Carter
authors: P J
authors: PJ
authors: Watson
mesh_terms: D000328:Adult; D001208:Asia / Q000208:ethnology; D002908:Chronic Disease / Q000628:therapy*; D018864:Cultural Diversity; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010821:Physicians, Family; D012017:Referral and Consultation; D013222:State Medicine