Identifying Factors Impacting Latinx/Hispanic Pain Ratings and Treatment Utilization

Dissertation Summary Submitted by Daniella Norena

The current study looked at factors that predicted pain ratings and treatment utilization in Latinx patients with chronic pain. 28 self-identified Latinx/Hispanic/Latine/Latino/a participants with chronic pain, defined as pain lasting three months of more, completed virtual surveys posted on social media, shared at churches, and distributed by recruitment by other providers from underserved communities. The survey included demographic information, insurance and diagnosis information, the Brief Pain Inventory to measure pain ratings (pain severity and pain disability), the Patient Health Questionnaire to measure psychological distress (depression, anxiety, somatization, eating concerns, and alcohol concerns), the Pain Catastrophizing Scale to measure pain catastrophizing, the Psychological Acculturation Scale and Language Acculturation Scale to measure levels of acculturation, the Everyday Discrimination Scale to measure perceived discrimination, and the International – Complementary and Alternative Medicine Questionnaire to measure utilization of conventional and complementary/alternative medical providers. Multiple regression analysis analyzed the model of psychological distress, acculturation, pain catastrophizing, and discrimination as predictors of pain ratings and treatment utilization. Multiple regression analysis also considered the predictive model of psychological distress, acculturation, and discrimination on pain catastrophizing. Additional exploratory analyses compared differences between age groups, acculturation levels, and insurance status. Further regression analyses analyzed differences in the predictive model between pain severity and pain disability.

The following results were observed:

• The model of psychological distress, acculturation, pain catastrophizing, and perceived discrimination, entered in hierarchical order, significantly predicted pain ratings
• Psychological distress was a significant predictor on its own for pain ratings as well
• The model of psychological distress, acculturation, pain catastrophizing, and perceived discrimination, entered in hierarchical order, did not significantly predict either forms of treatment utilization
• Psychological distress, acculturation, and perceived discrimination significantly predicted pain catastrophizing
• Psychological distress was a significant predictor on its own for pain catastrophizing as well
• Somatization, depression, anxiety, eating concerns, and alcohol concerns significantly predicted pain ratings
• Somatization was a significant predictor for pain ratings
• The model of Rumination, Magnification, and Helplessness (Pain Catastrophizing Subscales) significantly predicted pain severity but not disability
• Rumination was a significant predictor of pain disability
• When split between high and low acculturation groups, participants with high acculturation had significantly higher levels of psychological distress
• Patients 30 and under had significantly higher levels of language acculturation, psychological distress, and anxiety
• There were no significant differences between genders
• Patients without any insurance had higher pain ratings than those with either public or private insurance

Overall, these results highlight importance treatment considerations in a traditionally underserved community. Considering the impact of psychological distress, acculturation, catastrophizing, and discrimination can help tailor culturally congruent interventions.

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