Projects

Pain sufferers in social interaction with the health care

Background of the Research

Various chronic pain conditions are a major public health problem in Finland. About 26 percent of all work related disability pensions are due chronic musculoskeletal diseases and chronic back pain affects 10 percent of men and 11 percent of women in Finland. Although chronic pain conditions are a major public health problem, there is little research on how it is managed and experienced in everyday life.

Pain is an ambiguous medical problem because it lacks objective and measurable bodily symptoms. The uncertain and long-lasting diagnostic process profoundly challenges the individual’s identity, the doctor-patient relationship and work relations. As a consequence, the back pain sufferers often experience being excluded, stigmatised and refused adequate health care.

The Research Questions

1. The knowledge basis. How do individual sufferers present their pain and knowledge of it in interaction with health care professionals? How is subjective knowledge of pain explained and how is it negotiated with health care professionals?
2. The logic of intervention. How are effective interventions defined in lay and professional framework of knowledge? What are the lay experiences of practical medical treatments of back pain? What is the logic of the encounters between back pain sufferers and professionals?

• Moral issues. How do institutional health care interactions evaluate individuals’ normality and moral accountability? How do the pain sufferers cope with the moral issues of pain experience when professionals confront the validity of subjective knowledge of pain?

The Data Obtained for the Study

During the spring 1999, in-depth interviews were conducted with 16 women and 7 men. This material provides information on questions regarding back pain and work related circumstances. Another set of data consists of 165 individually written autobiographies, obtained through the national writing competition "Elämän selkäranka".

The Research Schedule

The time frame of this project: 1.8.2005-31.7.2007.

The Significance of the Research

This research provides new knowledge and understanding of the complex micro-social circumstances of what interaction with health care are like for people suffering from (back)pain. The study offers new practical and theoretical knowledge of how to conceptualise the subjective experience of pain between pain sufferers and the health care system. Moreover, it contributes new knowledge of how to improve the health care and the rehabilitation management, thus filling hitherto neglected areas of relevant research.

Previous publications in the area:

Lillrank, Annika (2005). Kärsimys, kipu ja moraali: Kertomus selkäkipupotilaan ja terveydenhuollon kohtaamisesta. Sosiaalilääketieteellinen aikakauslehti 42, 5-17.

Lillrank, Annika (2003). Back Pain and the resolution of diagnostic uncertainty in illness narratives.

Social Science & Medicine 57, 1045-1054.

Lillrank, Annika (2002). The tensions between overt talk and covert emotions in

illness narratives: Transition from clinician to researcher. Culture, Medicine and

Psychiatry 26, 111-127.

Lillrank, Annika & Seppälä, U-M (2000). Sairauden ja terveyden kokemus maallikkonäkökulmasta.

In (eds) Kangas, Karvonen, Lillrank Terveyssosiologian suuntauksia Gaudeamus: Helsinki.