Ethnic Differences in Reported Pain Regions - Results of a Survey at Three Clinical Emergency Rooms in Berlin/Germany

OBJECTIVE: This study investigated the influence of ethnicity, gender, socio-demographic and disease-related parameters on the degree of perceived pain and the number of reported pain regions. DESIGN: The data were collected at three large gynecological/internal medicine emergency departments (ED) in the inner city of West Berlin, Germany. The comparative study focused on native German ED-patients and immigrants from Turkey and other countries. The patients completed 30-minute standardized face-to-face interviews. A verbal rating scale and a diagram of the human body were used to indicate the degree of pain and to localize the pain regions. RESULTS: The random sample for analysis included 473 patients: 311 women and 161 men. Logistic regression analysis showed significant ethnic differences in the number of reported pain locations and the perceived severity of pain. Gender does significantly influence the reasons for visiting the ED, but neither had an impact on the number of reported pain locations nor on the perceived severity of pain. Focusing on gender-related aspects of the whole patient sample gender did not affect pain reporting patterns. The analysis revealed two additional factors: the presence of a chronic disease (OR = 1.73) and perceived pain-related impairment (OR = 1.11). CONCLUSIONS: The fact that both pain perception and pain expression and its evaluation by others are conditioned by socio-cultural factors makes it necessary to re-appraise the concept of pain and requires a critical assessment of what constitutes the “norm”.