Meaning out of chaos:: a way to understand chronic pain
Meaning out of chaos:: a way to understand chronic pain
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DOI：
10.1046/j.0283-9318.2003.00244.x
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发表时间：
2003-12-01
影响因子：
1.9
通讯作者：
Sjöström-Flanagan, C
中科院分区：
文献类型：
--
作者：
Bullington, J;Nordemar, R;Sjöström-Flanagan, C
疼痛是一种位于生物学和文化交叉点的多维现象。现代对疼痛的理解考虑了疼痛的情感、心理、社会政治和存在方面以及生理、解剖学因素。我们这项研究的目的是加深对疼痛的社会心理和存在方面的理解，并讨论临床医生如何更好地理解和治疗慢性疼痛患者。一个焦点小组由一名研究人员和一组在专业疼痛诊所工作的具有不同背景的临床医生（n = 3）组成。该小组在 6 个月的时间内每月开会一次。调查了有关疼痛患者生活世界的问题以及对“良好临床遭遇”条件的询问。这项研究的结果包括在研究人员和小组参与者之间的协作努力中收集和分析的数据（焦点小组会议）的系统化。研究结果以主题形式呈现。用于描述从寻求医疗帮助到成功康复的过程的主要比喻是混乱中的秩序。秩序混乱是一个从诊断到增强自我意识阶段再到患者承担责任的过程。本文提出、说明和讨论的相关主题涉及联系问题、灵活性和创造力在治疗过程中的作用，以及有利于从混乱到创造新意义的旅程的临床遭遇。
Pain is a multidimensional phenomenon lying at the intersection between biology and culture. The modern understanding of pain takes into account emotional, psychological, socio-political and existential aspects of pain as well as physiological, anatomical factors. Our aim in this study was to deepen the understanding of psychosocial, existential aspects of pain and to discuss how clinicians can better understand and treat patients with chronic pain. A focus group was formed consisting of a researcher and a group of clinicians (n = 3) with various backgrounds working at a specialized pain clinic. The group met once a month during a 6-month period. Questions concerning the life-world of the pain patient as well as inquiries into the conditions for 'the good clinical encounter' were investigated. The results of this study consist of a systematization of the data (focus group meetings) collected and analysed in a collaborative effort between the researcher and group participants. The findings are presented in terms of themes. The main metaphor used to describe the path from the seeking of medical help to successful rehabilitation was order out of chaos. Ordering chaos was a process moving from diagnosis through a phase of heightened self-awareness towards responsibility-taking on the part of the patient. Related themes presented, illustrated and discussed in the paper concern problems of linkage, the role of flexibility and creativity in the healing process and the kind of clinical encounter conducive for the journey from chaos to the creation of new meaning.