Table 6 Potential negative impacts of digital pain self-reporting tools to facilitate pain management
People who would be at risk | Potential negative impact | Illustrative quote |
|---|---|---|
People with different ethnic background | Exclusion from digital health research | “if some ethnic groups have less access to the technology or the connectivity, then they may be less represented [in research]” (Researcher; FG with ethnic minorities) |
Pain perceived as a weakness | “Depending on cultural background, there is a huge difference in mindset, certain cultures don't like acknowledging pain because they actually deem it as a weakness…and if they do acknowledge it, if they are brought out of their comfort zone…does it make them feel weaker mentally and emotionally as well” (Inclusion expert; FG with ethnic minorities) | |
Gender stereotyping | “And it's a gender issue as well of women going, oh, yeah, pain, that's just life, put up with it” (Female patient participant; FG with ethnic minorities) | |
Lack of knowledge of pain terminologies | “Because I think culturally, some patients are lost because they don't know the difference between sharp pain and dull pain” (Male patient participant; FG with ethnic minorities) | |
People of older age | Fear of losing face-to-face interaction with clinicians | “…what you've not got is, you've not got that interaction, which is not necessarily a downside but I think sometimes you need that interaction with somebody there because a certain pain report might be quite alarming to a clinician, for whatever reason, and the patient may not know why but you would sort of instantly have some follow-up questions” (Older male participant; FG with older adults) |
People living in socio-economically deprived areas | Emphasis on one’s limitations | “Using the app [digital pain self-reports] could make you feel just more isolated because it might highlight your inadequacies, you know, like dyslexia…because I do struggle with that…[which] sort of damage your self-esteem” (Female patient participant; FG with deprived areas) |
People with pain related anxiety | Too much emphasis on pain | “This [pain self-reporting] is making me think about my pain more and I started to wonder if that's possibly a bad thing” (Female patient participant; FG with deprived areas) |