Manderson Lenore, Warren Narelle, Markovic Milica
School of Psychology, Psychiatry and Psychosocial Sciences, Monash University, Caufield East, Victoria, Australia.
Qual Health Res. 2008 Apr;18(4):522-34. doi: 10.1177/1049732308315432.
Pain resulting from endometriosis is experienced as both a chronic, ongoing condition and an acute episode at time of menstruation, often occurring in association with diarrhea, vomiting, nausea, heavy bleeding, and other reactions. Women expect pain with menstruation, however, and even if they experience major disruptions as a result, they find it difficult to distinguish normal from pathological discomfort. Drawing on qualitative research conducted from 2004 to 2006, we describe the "circuit breakers" that lead Australian women to seek medical advice. These include outside intercession, major disruptions to everyday life, changes in embodied experience, and difficulties in conception and pregnancy. Women's ideas of menstrual pain as "normal" are shared by doctors, resulting in further delays before a definitive diagnosis of endometriosis is made. During this time, women move between doctors and in and out of medical care, which they described through particular narrative styles to highlight the complexity of help seeking. We explore the ways in which ideas of gender, informed by women's embodiment but also the quality of their reporting of symptoms, influence their interactions with health professionals.
子宫内膜异位症引起的疼痛既表现为一种慢性的、持续存在的状况，也表现为月经期间的急性发作，常常伴有腹泻、呕吐、恶心、大量出血及其他反应。然而，女性认为月经期间疼痛是正常的，即便她们因此经历了严重困扰，也很难区分正常不适与病理性不适。基于2004年至2006年开展的定性研究，我们描述了促使澳大利亚女性寻求医疗建议的“触发因素”。这些因素包括外界干预、日常生活受到严重干扰、身体体验发生变化以及受孕和怀孕困难。医生与女性一样认为月经疼痛是“正常的”，这导致在最终确诊子宫内膜异位症之前进一步延误。在此期间，女性辗转于不同医生之间，反复接受医疗护理，她们通过特定的叙述方式来描述这一过程，以突出寻求帮助的复杂性。我们探讨了性别观念如何受到女性身体状况以及她们症状报告质量的影响，进而影响她们与医疗专业人员的互动。
