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康复情境中的(去)性别化:慢性肌肉疼痛故事中性别与自我的叙事分析

(Un)doing gender in a rehabilitation context: a narrative analysis of gender and self in stories of chronic muscle pain.

作者信息

Ahlsen Birgitte, Bondevik Hilde, Mengshoel Anne Marit, Solbrække Kari Nyheim

机构信息

Institute of Health and Society, University of Oslo , Oslo , Norway.

出版信息

Disabil Rehabil. 2014;36(5):359-66. doi: 10.3109/09638288.2013.793750. Epub 2013 May 20.

Abstract

PURPOSE

To explore how gender appears in the stories of self-told by men and women undergoing rehabilitation for chronic muscle pain.

METHOD

The material, which consists of qualitative interviews with 10 men and 6 women with chronic neck pain, was analyzed from a gender sensitive perspective using narrative method. The analysis was inspired by Arthur Frank's typologies of illness narratives (restitution, chaos and quest).

FINDINGS

The women's stories displayed selves that were actively trying to transcend their former identity and life conditions, in which their pain was embedded. Their stories tended to develop from "chaos", towards a quest narrative with a more autonomous self. The selves in the men's stories appeared to be actively seeking a solution to the pain within a medical context. Framed as a restitution narrative, rooted in a biomedical model of disease, the voice often heard in the men's stories was of a self-dependent on future health care. Our findings contribute greater nuance to a dominant cultural conception that men are more independent than women in relation to health care.

CONCLUSION

Understanding the significance of gender in the construction of selves in stories of chronic pain may help to improve the health care offered to patients suffering from chronic pain. Implications for Rehabilitation Patients tell stories that powerfully communicate their particular illness experiences. Cultural expectations of femininity and masculinity play a significant role with regard to how the patients construct their stories, which may be important to health professionals' perceptions of the patients' problem. Health care professionals should listen carefully to the patient's own story and be sensitive to the significance of gender when trying to understand these people's health problem.

摘要

目的

探讨性别如何在慢性肌肉疼痛康复中的男性和女性自述故事中呈现。

方法

采用叙事方法,从性别敏感视角分析了对10名患有慢性颈部疼痛的男性和6名女性进行定性访谈所获得的材料。该分析受到亚瑟·弗兰克疾病叙事类型学(复原、混乱和探索)的启发。

研究结果

女性的故事展现出积极尝试超越自身以往身份和嵌入疼痛的生活状况的自我。她们的故事往往从“混乱”发展为具有更自主自我的探索叙事。男性故事中的自我似乎在医疗背景下积极寻求疼痛的解决方案。以基于生物医学疾病模型的复原叙事为框架,男性故事中常听到的声音是依赖未来医疗保健的自我。我们的研究结果为一种主流文化观念增添了更多细微差别,即男性在医疗保健方面比女性更独立。

结论

理解性别在慢性疼痛故事中自我建构的意义,可能有助于改善为慢性疼痛患者提供的医疗保健。对康复的启示患者讲述的故事有力地传达了他们独特的疾病经历。关于女性气质和男性气质的文化期望在患者如何构建他们的故事方面起着重要作用,这对医疗专业人员对患者问题的认知可能很重要。医疗保健专业人员在试图理解这些人的健康问题时,应仔细倾听患者自己的故事,并对性别意义保持敏感。

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