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KMID : 0363120170300010034
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Korean Journal of Pain
2017 Volume.30 No. 1 p.34 ~ p.43
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“I’m healthy, I don’t have pain”- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population
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Wee Liang En
Sin David
Cher Wen Qi
Li Zong Chen
Tsang Tammy
Shibli Sabina
Koh Gerald
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Abstract
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Background: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ≥ 85% own homes; public rental flats are reserved for those with low-income.
Methods: Chronic pain was defined as pain ≥ 3 months. From 2009?2014, residents aged 40?60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves.
Results: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36?3.27, P ＜ 0.001), dyslipidemia (aOR = 2.06, CI = 1.25?3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18?4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34?5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94?6.41, P ＜ 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of “major illness”; screening as a search for answers to pain; and labelling pain as an end in itself.
Conclusions: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening. (Korean
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KEYWORD
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Asian, Chronic pain, Health screening, Low-income, Mixed methods, Qualitative
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