An exploration of experiences and beliefs about low back pain with Arab Muslim patients

Abstract

Purpose

Pain has psychological, social, physical and spiritual dimensions and therefore this experience is influenced by culture. The aim of this study was to explore the experiences and beliefs of Arab Muslim patients with low back pain (LBP) in Bahrain.

Methods

We recruited Arab Muslim patients attending physiotherapy with LBP ≥3 months, and ≥18 years of age. Socio-demographic information and a Visual Analogue Scale (VAS) score for pain intensity were collected. Focus groups were conducted between 2013–2014, using pre-determined semi-structured interview questions. Qualitative content analysis was applied with single counting and inclusion of negative instances.

Results

18 participants attended three focus groups (14 females and 4 males) with a mean VAS(SD) = 5.28(±1.97). Five themes were identified; (1) loss of independence, (2)change in identity causes distress, (3) beliefs and attitudes towards low back pain, (4)trying to cope with LBP, and (5)experiences within the healthcare system.

Conclusions

Religious and cultural beliefs influenced pain-related beliefs, fear-avoidance beliefs and catastrophizing. We recommend addressing cultural gender roles and using “active” forms of religious coping to inform treatment. Participants’ experiences within and experiences of the healthcare system were similar to Western cultures. This encourages the application of Western findings into practice to facilitate the management of these patients.

IMPLICATIONS FOR REHABILITATION

• A qualitative exploration was undertaken to explore the experiences of Muslim and/or Arab patients with LBP.

• Our findings show that females have prioritised family needs over their own, primarily due to perceived gender roles.

• Contrary to previous findings labelling religious coping as a passive strategy, our findings suggest that religious coping strategies can be both positive and active strategies; such as participation in religious occasions and frequenting mosques.

• We support recommendations from Western literature to manage LBP; such as prioritising patient education and joint decision-making.

Keywords:

• Arabic
• pain beliefs
• low back pain
• pain coping mechanisms
• cultural competency
• culture

Acknowledgements

This work was part of a research project for a Ph.D. at the former Health and Social Care Division (now School of Population Health and Environmental Sciences), Faculty of Life Sciences and Medicine at King’s College London (London, United Kingdom). The authors are grateful for the cooperation of the physiotherapy departments at Salmaniya Medical Complex, and Isa Town Health Care Centre in the Kingdom of Bahrain.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This is funded by the Crown Prince International Scholarship Program (Kingdom of Bahrain).