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Patients' and professionals' understandings of the causes of chronic pain: Blame, responsibility and identity protection

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  • Eccleston, Chris
  • De C. Williams, Amanda C.
  • Rogers, Wendy Stainton

Abstract

A social constructionist analysis of how sense is made of the causes of chronic pain is reported. It is recognised that there is a multiplicity of stories available in any culture from which understanding can be reached. Q-factor analysis is used within a critical framework as Q-methodology. Sixty chronic pain patients and pain professionals completed the sorting procedure. Four factors were derived that account for the causes of chronic pain. These are reported as the patients' account, the professionals' account, the scientists' account and the alternative practitioner's account. Common to all four accounts are the themes of responsibility, blame and the need to protect identity. It is argued that in all accounts responsibility is repositioned away from the sufferer or the healer. In all of the accounts blame is resisted or deflected away from individual ownership. Finally, it is argued that when pain is no longer useful as a symptom, identity is challenged, weakened and at risk for both chronic pain patients and pain professionals. Implications of this study for chronic pain research and treatment are discussed.

Suggested Citation

  • Eccleston, Chris & De C. Williams, Amanda C. & Rogers, Wendy Stainton, 1997. "Patients' and professionals' understandings of the causes of chronic pain: Blame, responsibility and identity protection," Social Science & Medicine, Elsevier, vol. 45(5), pages 699-709, September.
    • Handle: RePEc:eee:socmed:v:45:y:1997:i:5:p:699-709
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    Cited by:

    1. Ida Björkman & Magnus Simrén & Gisela Ringström & Eva Jakobsson Ung, 2016. "Patients’ experiences of healthcare encounters in severe irritable bowel syndrome: an analysis based on narrative and feminist theory," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(19-20), pages 2967-2978, October.
    2. van Exel, Job & Baker, Rachel & Mason, Helen & Donaldson, Cam & Brouwer, Werner, 2015. "Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology," Social Science & Medicine, Elsevier, vol. 126(C), pages 128-137.
    3. Rosa Esteve & Alicia Eva López-Martínez & Gema Teresa Ruíz-Párraga & Elena Rocío Serrano-Ibáñez & Carmen Ramírez-Maestre, 2020. "Pain Acceptance and Pain-Related Disability Predict Healthcare Utilization and Medication Intake in Patients with Non-Specific Chronic Spinal Pain," IJERPH, MDPI, vol. 17(15), pages 1-12, July.
    4. Baker, Rachel Mairi, 2006. "Economic rationality and health and lifestyle choices for people with diabetes," Social Science & Medicine, Elsevier, vol. 63(9), pages 2341-2353, November.
    5. Bryant, Louise D. & Green, Josephine M. & Hewison, Jenny, 2006. "Understandings of Down's syndrome: A Q methodological investigation," Social Science & Medicine, Elsevier, vol. 63(5), pages 1188-1200, September.
    6. Sim, Julius & Madden, Sue, 2008. "Illness experience in fibromyalgia syndrome: A metasynthesis of qualitative studies," Social Science & Medicine, Elsevier, vol. 67(1), pages 57-67, July.

    More about this item

    Keywords

    pain identity blame Q-methodology;

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