Dow Clare M, Roche Patricia A, Ziebland Sue
Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK.
Chronic Illn. 2012 Sep;8(3):176-91. doi: 10.1177/1742395312443692. Epub 2012 Apr 2.
To improve understanding of the sources of frustration for people with chronic pain and consider the potential influence of frustration on the chronic pain experience and relationships with health professionals.
Qualitative in-depth interviews with a diverse, maximum variation sample of 46 participants with chronic pain, 30 of whom talked about frustration. Analysis paid close attention to how people talked about their frustration as well as what they said.
Frustration is a multi-faceted emotion and its effects are cumulative. Sources of frustration include interference with everyday activities, the interruption of life goals and roles and the unpredictability of pain; here we focus on the frustrations associated with the invisibility of chronic pain and the perceived limitations of diagnosis and pain management (both related to the perceived legitimacy of the condition). Several of the participants who had lived with chronic pain for many years described overcoming, or managing, their frustrations.
If patients think that their pain is not being believed this is clearly a barrier to an effective consultation. Communication with chronic pain patients may improve if the frustration of living with an invisible, debilitating condition that is hard to diagnose and treat is explicitly (and perhaps repeatedly) acknowledged by the health professional.
增进对慢性疼痛患者挫折来源的理解，并思考挫折对慢性疼痛体验以及与医疗专业人员关系的潜在影响。
对46名慢性疼痛患者进行了定性深入访谈，样本具有多样性且涵盖范围广泛，其中30人谈到了挫折感。分析过程密切关注人们谈论挫折感的方式以及他们所说的内容。
挫折是一种多方面的情绪，其影响具有累积性。挫折来源包括对日常活动的干扰、生活目标和角色的中断以及疼痛的不可预测性；在此我们重点关注与慢性疼痛的隐匿性以及诊断和疼痛管理的感知局限性相关的挫折感（两者均与对病情的感知合理性有关）。几位长期患有慢性疼痛的参与者描述了克服或应对挫折的经历。
如果患者认为他们的疼痛未被相信，这显然是有效咨询的障碍。如果医疗专业人员明确（或许还需反复）承认因患有难以诊断和治疗的隐匿性、使人衰弱的疾病而产生的挫折感，那么与慢性疼痛患者的沟通可能会得到改善。
