The Effect of Physiotherapy Group Intervention in Reducing Pain Disorders and Mental Health Symptoms among Syrian Refugees: A Randomized Controlled Trial

Wegdan Hasha, Jannicke Igland, Lars T. Fadnes, Bernadette Kumar, Jasmin Haj-Younes, Elisabeth Marie Strømme, Eirin Zerwekh Norstein, Rolf Vårdal and Esperanza Diaz
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Wegdan Hasha: Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5020 Bergen, Norway
Jannicke Igland: Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5020 Bergen, Norway
Lars T. Fadnes: Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5020 Bergen, Norway
Bernadette Kumar: Norwegian Institute of Public Health, Unit for Migration and Health, 222 Skøyen, 0213 Oslo, Norway
Jasmin Haj-Younes: Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5020 Bergen, Norway
Elisabeth Marie Strømme: Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5020 Bergen, Norway
Eirin Zerwekh Norstein: OsloMet—Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavsplass N, 0130 Oslo, Norway
Rolf Vårdal: Center for Migration Health, Solheimsgaten 9, 5058 Bergen, Norway
Esperanza Diaz: Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5020 Bergen, Norway

IJERPH, 2020, vol. 17, issue 24, 1-15

Abstract: Chronic pain is common among refugees, and often related to mental health problems. Its management, however, is often challenging. A randomized waitlist-controlled trial was designed to study the effect of group physiotherapy activity and awareness intervention (PAAI) on reducing pain disorders, and secondarily improving mental health, among Syrian refugees. A total of 101 adult Syrian refugees suffering from chronic pain were randomized to either the intervention group or the control group, which thereafter also received PAAI after a waiting period. Pain intensity measured by the Brief Pain Inventory (BPI) was the primary outcome. Scores from the Impact of Events Scale-Revised (IES-R 22) and the General Health Questionnaire (GHQ-12) were secondary outcomes. Intention-to-treat analyses (ITT) showed no effect of the intervention on either pain levels (regression coefficient [B {95% CI} of 0.03 {−0.91, 0.96}], IESR scores [4.8 {−3.7, 13.4}] or GHQ-12 scores [−0.4 {−3.1, 2.3}]). Yet, participants highly appreciated the intervention. Despite the negative findings, our study contributes to the evidence base necessary to plan targeted and effective health care services for refugees suffering from chronic pain and highlights the challenge of evaluating complex interventions adapted to a specific group.

Keywords: group intervention; pain; mental health; Syrian refugees; randomized controlled trial (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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