From pain through chaos towards new meaning: Two case studies (original) (raw)
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Journal of Advanced Nursing, 1996
This paper reports the results of a study which investigated the experiences of 75 people with chronic non-malignant pain People with chronic non-malignant pain can find that traditional medical techniques do not help their pain, and they have to learn to live with it However, pain can affect their lives in many ways Within this study, qualitative data were collected to illustrate what it meant to people to experience this chronic pain It was found that pain adversely affected many dimensions of sufferers' lives, and the effects extended to family and friends It seemed that having others believe the pain was crucial to many patients Health care professionals can offer these patients much in helping them come to terms with the way in which pain has affected both themselves and their lives
The World of Chronic Pain: A Dialogue
Abstract: This chapter investigates the phenomenology of chronic pain, with an emphasis on the relationship between a bodily feeling of pain and interpersonal / social experience. We focus on the first author’s experience of chronic pain, and on his increasingly desperate search for a clear diagnosis and effective medical treatment. In so doing, we argue that how one experiences chronic pain is bound up with what one anticipates from other people. To be more specific, erosion of a form of interpersonal trust is inseparable from an all-enveloping feeling of distress and helplessness, a feeling that is itself integral to the experience of pain. We further argue that certain pains challenge a commonplace philosophical assumption about intentionality: that an intentional experience is either directed at something specific or more diffuse in character. Kusch’s pain was both: a feeling in a part of his body was at the same time a change in his overall relationship with the world. In considering the implications of this, we turn to Heidegger’s discussion of ‘attunement’ [Befindlichkeit] in Being and Time.
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Tidsskrift for Forskning i Sygdom …, 2011
The structure and organization of health care is a salient political issue across nations and welfare states. It is important not only from an economic perspective, but also from a social and political perspective regarding the possibility of maintaining a proper qualitative level of health ...
Chronic Pain - Perceptions, Limitations and Implications. A Social Perspective
Journal Biomedical and Biopharmaceutical Research, 2013
Chronic pain (CP) is a complex phenomenon that affects the lives of individuals at the level of well-being, family relationships and social and professional life, causing biological and psychosocial changes, and in most cases, suffering. CP is associated with physical, professional and social limitations, and compromises quality of life (QOL) provoking insecurity which results in considerable social and material losses. In this context a multidimensional pain assessment is fundamental in order to find a swift and appropriate response to the needs of each individual. The evaluation should take into account psychological and social factors in addition to physical factors. pain (CP) is a complex phenomenon that affects the lives of individuals at the level of well-being, family relationships and social and professional life, causing biological and psychosocial changes, and in most cases, suffering. CP is associated with physical, professional and social limitations, and compromises quality of life (QOL) provoking insecurity which results in considerable social and material losses. In this context a multidimensional pain assessment is fundamental in order to find a swift and appropriate response to the needs of each individual. The evaluation should take into account psychological and social factors in addition to physical factors.
Sociology of Health and Illness, 1992
Chronic pain is a problematic reality at least for two reasons. First, pain is a person's private experience, to which no one else has direct access. Second, chronic pain is lasting proof of a failure that questions the validity of actions and explanations, both past and future, of all involved. Because pain is a private sensation that cannot be reduced by objectification, it cannot, ultimately, be stablised as an unquestionable fact that can serve as the basis of medical practice and thus organise relations between professional and lay persons. This fragile factuality increases the work a physician has to do to decipher a patient's pain. The aim of this paper is to examine how physicians specialising in pain medicine work at this deciphering. Because of these characteristics of pain, physicians are forced to work on the elusive information provided by patients so as to bring into being something called chronic pain. When doing this they tap various, nearly incompatible, resources. I shall study the way these multiple resources are put to use by physicians as they form judgements about cases. By using as a field experiment two pain centres with opposite conceptions and practices, it can be shown how physicians in each centre determine patients' pain situations and formulate advice to them, how the characteristics of this work involve physicians in specific systems of relations with patients, and how these systems are related to dimensions of this work: either to a justification of physicians' actions or else to a confirmation, or realignment, of the initial doctor-patient agreement.
Revising the negative meaning of chronic pain - A phenomenological study
Chronic Illness, 2014
Objectives: Chronic pain may disable the body, depress the mind and ruin the quality of life. The aim of this study was to use the participants' personal experiences to explore the meaning of the experience of chronic pain and to find successful ways to manage chronic pain. Methods: Thirty-four participants with chronic pain were interviewed. The transcribed interviews were analysed using Giorgi's phenomenological method consisting of four phases: (1) reading the transcriptions several times, (2) discriminating meaning units, (3) collecting meaning units into groups and (4) the synthesis. Results: The participants stated that the key to managing chronic pain was to reconsider the individual meaning of the experience of pain. As a result of the interviews, seven subthemes were found based on the 'Negativity of chronic pain', namely, 'State of reflection', 'Reconsidering values', 'Acceptance of pain', 'Support network', 'Altered self', 'Joys in life' and 'Pain dissociation'. Conclusions: Pain is an aversive sensation, which leads to the conclusion that the meaning of the experience is also negative, but it can be reversed. In clinical practice, the focus should be on revising the subjective meaning of pain in order to manage pain and to restore positivity in personal life.
Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
Despite many recent advances in the past 40 years in the understanding of pain mechanisms, and in pain diagnosis and management, considerable gaps in knowledge remain, with chronic pain present in epidemic proportions in most countries. It is often unrelieved and is associated with significant socioeconomic burdens. Several opportunities and approaches to address this crisis are identified in the present article. Most crucial is the need to increase pain awareness, enhance pain education, improve access to pain care and increase pain research resources. Given the variability among countries in health care policies and programs, resources and educational programs, many of the approaches and strategies outlined will need to be tailored to each country's socioeconomic and educational situation.
The Study and Management of Pain Require a New Discipline about Suffering
It is proposed to create a discipline, called 'algonomy', that would be specifically dedicated to the study of suffering. The word suffering is used here in the broad sense of 'unpleasantness'. Algonomy would allow to deal with the unpleasant aspect of 'physical pain' in a more adequate manner than it is the case presently in pain research or management, where the focus is de facto on the sensory aspect rather than on the suffering component of pain. As suggested by Sascha Benjamin Fink in his 2011 article 'Independence and Connections of Pain and Suffering' (Journal of Consciousness Studies, v. 18, n. 9-10, pp. 46-66), the distinctive feature of pain is its sensory aspect, and that sensory aspect is NOT 'painful' by itself : some people, for instance patients with pain asymbolia, may experience pain without unpleasantness, and that raises a query about how the International Association for the Study of Pain defines its subject of concern. Besides, unpleasantness is common to many experiences other than pain. Therefore, if scientists, clinicians, or others want to tackle the suffering aspect of physical pain with the best chance of success, then it is suggested that they acquire the adequate conceptual framework to do so, and such a framework can only be offered by a discipline that deals with suffering as its specialty.
Pain, the unknown: epistemological issues and related clinical implications
Despite the huge development of pain management in the past decades, pain remains elusive and many patients still remain in the middle of the ford struggling between low drug efficacy and their overuse. A reason for pain elusiveness is its nature of subjective phenomenon, escaping the meshes of the objectivist, mechanist-reductionist net prevailing in medicine. actually, pain is not only a symptom but an essential aspect of life, consciousness and contact with the world and its noetic and autonoetic components play a key role in the development of the concepts of pleasure-unpleasure and good-evil. the intensity and tolerability of pain and suffering also depend on what the pain means to the patient. the outstanding effects of placebo and nocebo, behavioral and non-pharmacological techniques warrant the need for a shift from the traditional positivist idea of patient as passive carrier of disease to the patient as active player of recovery and move toward a patient's centered approach exploiting individual resources for recovery. among the mentioned techniques, hypnosis has proved to increase pain threshold up to the level of surgical analgesia, improve acute and chronic pain as well as coping and resilience, helping to decrease both drug overuse and the costs of pharmacological therapy. the plethora of available data suggests the need for a holistic approach, aiming to take care of the individual as an inseparable mind-body unit in its interplay with the environment, where patient's inner world, his/her experience and cognition are taken into due account as powerful resources for recovery through a phenomenological-existential approach.