Development of pain science education for chronic low back pain in India.

Background: Pain Science Education (PSE) has been shown to reduce pain and disability in chronic low back pain (CLBP), a prevalent and disabling condition. PSE helps reconceptualize pain using aids like pictures, metaphors, and stories, and supports pain self-management. Due to variations in pain beliefs across different cultures, the PSE resources need to be customized to accommodate respective literacy levels, cultures and languages.

Objective: This study aimed to develop PSE booklets in three Indian languages: Bengali, Hindi and Kannada.

Method: Thirty chronic pain experts (i.e. physiotherapists, pain physicians, psychiatrists, psychologists, public health professionals, nurses) independently examined the PSE booklet's content and rated it under: (1) Content adequacy, (2) Simplicity and clarity, (3) Topical flow, (4) Metaphors' appropriateness (5) Illustration suitability (6) Color scheme and (7) Culture-specific content. Five people with lived CLBP experience contributed. The content validity ratio (CVR) was used to rate the content of the PSE booklet in seven domains (e.g. cultural relevance). A priori criterion for acceptance of the content was set at 70%.

Results: Five booklet chapters were developed and were deemed acceptable. Cultural relevance domain received the highest score.

Conclusion: This is the first study to develop culturally relevant PSE booklets in Bengali, Hindi, and Kannada, which are likely to be useful in educating patients with CLBP. The new intervention needs to be tested for effectiveness in respective language-speaking samples.