Andersen Lotte Nygaard, Kohberg Maria, Herborg Lene Gram, Søgaard Karen, Roessler Kirsten Kaya
Institute of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Scand J Psychol. 2014 Aug;55(4):333-42. doi: 10.1111/sjop.12121. Epub 2014 Apr 14.
Musculoskeletal pain impacts upon everyday life. A degree of chronicity may pose an increased risk of sickness absence. One of two rehabilitative interventions, "Tailored Physical Activity" or "Chronic Pain Self-Management Program", was offered to sick-listed citizens who experienced pain. The objectives of this paper were to: (1) Assess what factors are experienced as problematic for sick-listed citizens in everyday life with chronic pain, and (2) Evaluate the significance of two distinct rehabilitative interventions on the future everyday lives of sick-listed citizens. Seven semi-structured interviews with sick-listed citizens were analyzed using a phenomenological-hermeneutical approach. Results were discussed by applying the theoretical framework of Antonovsky's salutogenetic model and Yaloms principles for group psychology. The potential for development of citizen's coping is evaluated based on Roessler's notion of progression. The analysis revealed four main themes: (1) Living with pain and unemployment; (2) "Putting my foot down" and "asking for help"; (3) Significance of the group, including instructors, and; (4) Aspects significant to progression. Unemployment is a major life event that promotes stress and can be accompanied by problems related to depressed mood, acceptance of the life situation, feelings of not being useful, feelings of losing control and identity conflicts. Group characteristics that gave a significant basis for progression in the self-management program are both emotional and instrumental, while the physical training program offers a "here-and-now"-experience and motivation to participate. This study indicates that the self-management program could potentially improve coping while the physical activity program revealed one example of a means of progression.
肌肉骨骼疼痛会影响日常生活。一定程度的慢性疼痛可能会增加病假缺勤的风险。针对有疼痛症状的病假人员，提供了两种康复干预措施之一，即“量身定制的体育活动”或“慢性疼痛自我管理计划”。本文的目的是：（1）评估对于患有慢性疼痛的病假人员来说，日常生活中哪些因素被认为是有问题的；（2）评估两种不同的康复干预措施对病假人员未来日常生活的重要性。采用现象学-诠释学方法，对七名病假人员进行了半结构化访谈。运用安托诺夫斯基的健康本源模型理论框架和亚隆的团体心理学原则对结果进行了讨论。基于罗斯勒的进步概念，评估了公民应对能力发展的潜力。分析揭示了四个主要主题：（1）与疼痛和失业共存；（2）“坚定立场”和“寻求帮助”；（3）团体（包括指导员）的重要性；（4）与进步相关的方面。失业是一个会引发压力的重大生活事件，可能会伴有情绪低落、接受生活现状、无用感、失去控制感和身份认同冲突等问题。在自我管理计划中，能为进步提供重要基础的团体特征既有情感方面的，也有工具方面的，而体育训练计划则提供了一种“此时此地”的体验和参与的动力。本研究表明，自我管理计划可能会改善应对能力，而体育活动计划则展示了一种进步方式的实例。
