Beaton D E, Tarasuk V, Katz J N, Wright J G, Bombardier C
Institute for Work & Health, Toronto, Ontario, Canada.
Arthritis Rheum. 2001 Jun;45(3):270-9. doi: 10.1002/1529-0131(200106)45:3<270::AID-ART260>3.0.CO;2-T.
Research into the meaning of illness has often focused on an individual's transition into a state of being ill, for example the adoption of a sick role. The question "Are you better?" addresses the transition out of this state and is fundamental to the patient-clinician relationship, guiding decisions about treatment. However, the question assumes that all patients have the same meaning for "being better." The purpose of this study was to explore the meaning of the concept of recovery (getting better) in a group of people with upper limb musculoskeletal disorders.
Qualitative (grounded theory) methods were used. Individual interviews were conducted with 24 workers with work-related musculoskeletal disorders of the upper limb. The audiotaped interviews were transcribed and coded for content. Categories were linked, comparisons made, and a theory built about how people respond to the question "Are you better?"
The perception of "being better" is highly contextualized in the experience of the individual. Being better is not only reflected in changes in the state of the disorder (resolution) but could be an adjustment of life to work around the disorder (readjustment) or an adaptation to living with the disorder (redefinition). The experience of the disorder can be influenced by factors such as the perceived legitimacy of the disorder, the comparators used to define health and illness, and coping styles, which in turn can influence being better.
Two patients could mean very different things when saying that they are better. Some may not actually have a change in disease state as measured by symptoms, impairments, or function.
对疾病意义的研究常常聚焦于个体向患病状态的转变，例如承担病人角色。“你好些了吗？”这个问题涉及从这种状态中脱离出来，并且对于医患关系至关重要，它指导着治疗决策。然而，这个问题假定所有患者对“好转”有着相同的理解。本研究的目的是探究一组上肢肌肉骨骼疾病患者康复（好转）概念的意义。
采用定性（扎根理论）方法。对24名患有与工作相关的上肢肌肉骨骼疾病的工人进行了个体访谈。对录音访谈进行转录并对内容进行编码。将类别联系起来，进行比较，并构建了一个关于人们如何回答“你好些了吗？”这个问题的理论。
“好转”的认知在个体经历中高度情境化。好转不仅体现在疾病状态的变化（缓解）上，还可能是围绕疾病对生活进行调整（重新调整）或适应与疾病共存（重新定义）。疾病经历会受到诸如疾病的感知合理性、用于界定健康与疾病的参照标准以及应对方式等因素的影响，而这些因素反过来又会影响好转情况。
两名患者说自己好转时可能意味着截然不同的情况。有些人实际上在症状、损伤或功能所衡量的疾病状态方面可能并未发生变化。
