Daily Occupations with or without Pain: Dilemmas in Occupational Performance

Abstract

This explorative study examined the influence of chronic lower back pain on the motives for occupational performance. A narrative interview was conducted with seven Dutch clients. Three phases in the process of living with lower back pain were identified in which the self, the pain, and the environment were seen as interrelated elements that influence the creation of motives. In the first phase, clients wanted to meet social and personal expectations, which led to their ignoring the lower back pain. In the second phase, the pain took control and the clients withdrew from social participation, which led to “emotional pain.” In the third phase, clients became more conscious of the dynamics and dilemmas between the self, the pain, and the environment. Analysis of study results suggests that clients' narratives can help occupational therapists gain a deeper understanding of clients' experiences of dealing with chronic pain.

A comparison of perceived occupational gaps between people with stress-related ill health or musculoskeletal pain and a reference group

“…Our study also shows that areas of leisure and social activities are affected. This declining process has also been confirmed in previous research (13)(14)(15). However, so far it has been unknown to what extent occupations in everyday life have been affected.…”

“…Differences here might mirror a process over time and this has also been described in some qualitative studies (8,14). We found two interesting differences that could be seen to be interconnected.…”

“…In summary, there are a number of studies that address how persons struggle to perform desired activities in everyday life despite their decreased capacity preceding sick leave (13)(14)(15). However, few studies (8) explore what happens to the person's occupational repertoire over time when he/she is on sick leave.…”

“…It has been recognized that activities in everyday life are affected in people with musculoskeletal pain and stress-related ill health (13,14). Prior to a period of sick leave, persons with stress-related ill health struggle to continue to manage all the responsibilities at work and in their private life that they want to manage (15).…”

Performing occupations under pain: the experience of persons with chronic pain

“…Finally the personal desire for engaging in occupations leads to the dilemma ''engaging in occupations with or without pain''. Satink (12) describes the changing motives for occupations for people with pain, but he does not describe the actual experience during the performance of occupations. Different studies have described the relationship between occupations, motives, and pain, but there is still a lack of knowledge about the experience during performance of occupations.…”