Facilitation of a Person-Centered Approach in Health Assessment of patients with chronic pain: An Ethnographic Study

Þórarinsdóttir, Kristín Anna; Kristjánsson, Kristján; Gunnarsdóttir, Þóra Jenný; Björnsdóttir, Kristín

doi:10.1177/1049732318770628

Cited by 10 publications

(10 citation statements)

References 38 publications

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“…11. K Thorarinsdottir et al, 2018 et al ., “Facilitation of a Person-Centred Approach in Health Assessment of patients with chronic pain: An Ethnographic Study,” Qual Health Res (Apr 1 2018), https://doi.org/10.1177/1049732318770628…”

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confidence: 99%

The singular patient in patient-centred care: physiotherapists’ accounts of treatment of patients with chronic muscle pain

et al. 2019

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A patient-centred approach has gained increasing interest in medicine and other health sciences. Whereas there are discussions about the meaning of a patient-centred approach and what the concept entails, little is known about how the patient as a person is understood in patient-centred care. This article investigates understandings of the patient as a self in patient-centred care through physiotherapy of patients with chronic muscle pain. The material consists of interviews with five Norwegian physiotherapists working in a rehabilitation clinic. Drawing on Kristeva’s discussion of subjectivity in medical discourse, the study highlights two different treatment storylines that were closely entwined. One storyline focuses on open singular healing processes in which the treatment was based on openness to a search for meaning and sharing. In this storyline, the “person“ at the centre of care was not essentialised in terms of biological mechanisms, but rather considered as a vulnerable, irrational and moving self. By contrast, the second storyline focused on goal-oriented interventions aimed at restoring the patient to health. Here, the person in the centre of the treatment was shaped according to model narratives about “the successful patient”; the empowered, rational, choosing and self-managing individual. As such, the findings revealed two conflicting concepts of the individual patient inherent in patient-centred care. On the one hand, the patient is seen as being a person in constant movement, and on the other, they are captured by more standardised terms designed to focus on a more stable notion of outcome of illness. Therefore, our study suggests that the therapists’ will to recognise the individual in patient-centred care had a counterpart involving a marginalisation of the singular.

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confidence: 99%

The singular patient in patient-centred care: physiotherapists’ accounts of treatment of patients with chronic muscle pain

et al. 2019

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“…The lived experiences of women with chronic pain furthermore suggest a need for affirmation and understanding, in particular in the encounter with health carea phenomenon that is well-known from previous research (Ojala et al, 2015;Samulowitz et al, 2018;Svenaeus, 2015;Thórarinsdóttir et al, 2019;Toye et al, 2013). This absence of acknowledgment, reliable relations, and support might contribute to the women's feelings of being abandoned by the health care system, but also by their partners, families, and by their own bodies.…”

Section: Further Interpretation and Discussionmentioning

confidence: 93%

Women’s Lived Experiences of Chronic Pain: Faces of Gendered Suffering

et al. 2019

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Women are overrepresented in pain rehabilitation. They seem to be more exposed to comorbidity between mental illness and diseases of the musculoskeletal system than men, implying that besides biopsychosocial factors, gender relations and cultural context should be considered. The aim of the study is to understand the lived experience of women with chronic pain from a caring science and gender perspective. Gadamerian philosophical hermeneutics has been used to analyze interviews from 21 women living with chronic pain in Sweden. The hermeneutical process revealed intertwined experiences of overperformance, loneliness, pain, and exhaustion. Women’s experience of an overwhelming life situation and the significance of mutual dependency seem to be central to health and suffering in women with chronic pain. We suggest, contemporary health care to acknowledge women’s health and suffering in relation to their life situation and prevailing gender roles.

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“…The researcher (GB) was familiar with rehabilitation for older people within acute care from past clinical experience as an occupational therapist although had not worked clinically within the hospital at the centre of this study and did not have prior working relationships with members of the clinical team. An additional feature of this branch of ethnography is the use of relatively short periods of fieldwork whilst still adopting traditional ethnographic approaches [29].…”

Section: Methodsmentioning

confidence: 99%

The meaning of rehabilitation: a qualitative study exploring perspectives of occupational therapists and physiotherapists working with older people in acute care

Bradley

Baker

Bailey

2019

Disability and Rehabilitation

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Facilitation of a Person-Centered Approach in Health Assessment of patients with chronic pain: An Ethnographic Study

Cited by 10 publications

References 38 publications

The singular patient in patient-centred care: physiotherapists’ accounts of treatment of patients with chronic muscle pain

The singular patient in patient-centred care: physiotherapists’ accounts of treatment of patients with chronic muscle pain

Women’s Lived Experiences of Chronic Pain: Faces of Gendered Suffering

The meaning of rehabilitation: a qualitative study exploring perspectives of occupational therapists and physiotherapists working with older people in acute care

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