Dysvik Elin, Natvig Gerd Karin, Furnes Bodil
Faculty of Social Sciences, Department of Health Studies, University of Stavanger, Stavanger, Norway.
Patient Prefer Adherence. 2013 Aug 9;7:751-9. doi: 10.2147/PPA.S46272. eCollection 2013.
The aim of this study was to explore grief caused by chronic pain and treatment adherence, and how these experiences are integrated into ongoing life stories.
A 6-year follow-up using a qualitative mixed-methods design based on written narratives and image narratives was performed. Five women suffering from chronic pain comprised the purposive sample. They had completed an 8-week group pain-management program with two follow-ups, and thereafter continued as a self-help group. A narrative approach was used to analyze the written and image narratives guided by three analytic steps.
Findings showed that experiences of grief over time were commonly associated with chronic pain. The participants' past experiences reflected their grief at having to abandon jobs and social networks, and revealed loneliness and despair. The present life situation seemed to reflect adaptation, and hope for the future had been established. Overall, forward progression means an ongoing struggle towards a reintegrated body and a meaningful life.
Through such narratives, health-care workers can identify treatment adherence related to grief and pain, and learn how people might regain their lives beyond using traditional interviews.
本研究旨在探讨慢性疼痛和治疗依从性所引发的悲痛，以及这些经历如何融入到持续的人生故事中。
采用基于书面叙述和图像叙述的定性混合方法设计进行了为期6年的随访。五名患有慢性疼痛的女性构成了目的样本。她们完成了一个为期8周的团体疼痛管理项目，并进行了两次随访，之后继续作为一个自助小组。采用叙事方法，在三个分析步骤的指导下分析书面和图像叙述。
研究结果表明，随着时间的推移，悲痛经历通常与慢性疼痛相关。参与者过去的经历反映了他们因不得不放弃工作和社交网络而产生的悲痛，并揭示了孤独和绝望。目前的生活状况似乎反映了适应情况，并且已经确立了对未来的希望。总体而言，向前发展意味着为实现身体重新整合和有意义的生活而持续奋斗。
通过这样的叙述，医护人员可以识别与悲痛和疼痛相关的治疗依从性，并了解人们如何在不使用传统访谈的情况下重新掌控自己的生活。
