UnPPAC

Project Description

The Understanding Pediatric Pain in Aboriginal Communities (UnPPAC) pilot project was the first ACHH project. To begin to understand the pain and hurt experience of Indigenous children and youth, Dr. Latimer partnered with Eskasoni First Nation’s Health Director, Sharon Rudderham and community members who took part in conversation sessions regarding their pain and hurt. Participants included a total of 114 participants with 76 children and youth, 12 parents, 7 teachers and 6 Elders. The participants invited us into their homes and community and shared their personal, often difficult, stories in an effort to contribute their knowledge and improve the wellbeing of Indigenous children in their community. The Eskasoni community remains a key partner on all ACHH Initiative work.

Results

Analysis of the gathered stories and demographic data found that children and youth experienced a significant amount of self-reported pain and hurt. This pain often kept them from school and often required pain medication. You can see below the self-reported pain experiences outlined by the participating Indigenous school children.

Additional Findings

Several factors were identified through the UnPPAC work as impacting how Indigenous children’s pain is assessed and treated.

Children and youth are often stoic and hide their pain. In fact, the Mi’kmaq language does not have a word for pain. This can lead to misunderstandings by non-Indigenous health professionals.
Children and youth may not cry, complain or verbally express their pain. Cultural traditions and a legacy of oppression and abuse has led to Indigenous children developing this reaction.
Children and youth often feel unheard. When participants sought treatment for health issues, they feel they were ‘not listened to’.
Common pain assessments are not culturally appropriate. Many health providers use a numerical scale or facial expression to assess patient pain. Historically, Indigenous people express their experiences through story and depiction.
Systemic racism and discrimination – Participants reported that health professionals stereotyped community members as having alcohol and drug problems. This led to feelings of distrust and frustration, and delays in treatment.

Testimonials

Healing Through Stories

The themes created based on the analysis of conversation sessions included pain expression, seeking care and self management.

Seeking Care

“Nine hours I waited”

https://youtu.be/GzRKFnAlE-g

Expression

“Who am I to complain”

https://youtu.be/UI38G5fYYpk

Self Management

“We use a lot of humor… you distract yourself from feeling the pain”

https://youtu.be/KsXFUnRuMQ4

Publication

Latimer, M., Finley, G.A., Rudderham, S., Inglis, S., Francis, J., Young, S. & Hutt-MacLeod, D. (2014). Expression of pain in Mi’kmaq children from one Atlantic Canadian community: A qualitative study.Canadian Medical Association Journal Open, 2(3). E133-E138.

Find Out More

The ACHH Initiative work is dependent on the Indigenous communities who have provided their insight, wise counsel and a shared commitment to improving the lives of children and reducing their hurt. Check out the Partners in Research page to learn more about who we’ve partnered with along the way!