Western University, London, ON, Canada.
Womens Health (Lond). 2022 Jan-Dec;18:17455057221103994. doi: 10.1177/17455057221103994.
Of the 6.2 million Canadians aged 15 years or older who live with disability, 61% have disabilities that are not static or continuous. These dynamic conditions are known as episodic disabilities and many disproportionately experienced by women. Chronic pain is also a common feature associated with many episodic disabilities. The purpose of this article is to explore the experience of chronic pain for women living with episodic disabilities.
This qualitative study draws on the tenets of interpretive description. Thirty women, with one or more episodic disabilities and chronic pain, participated in a semi-structured interview and answered questions about their chronic pain levels, using Von Korff et al.'s graded chronic pain scale.
Women experienced gendered treatment within the healthcare system and reported that they were frequently dismissed by their healthcare providers, most often physicians. Healthcare professionals' practices around pain assessment were another common challenge for women. Women who were able to access financial support from government disability programs were more likely to access allied health professionals. Many of the holistic strategies that women researched and used to treat chronic pain were self-enacted. While diet, exercise, and other self-care activities are general health promotion strategies for all, they were seen as aspects of living that helped women have control over chronic pain and modifying the course of their episodic disability.
Living with chronic pain and an episodic disability is complex. The findings of this study present the impact that gendered treatment in the healthcare system has on women who live with an episodic disability and experience chronic pain. It is evident that the current system did not meet the needs of the women in our study and system changes could result in better experiences, more disclosure of alternative therapies, and increase women's agency in their care.
在 620 万 15 岁及以上的加拿大残疾人群体中，61%的人存在非静态或持续性残疾。这些动态状况被称为发作性残疾，许多残疾女性中比例过高。慢性疼痛也是许多发作性残疾相关的常见特征。本文旨在探讨发作性残疾女性的慢性疼痛体验。
这项定性研究基于解释性描述的原则。30 名患有一种或多种发作性残疾和慢性疼痛的女性参加了半结构化访谈，并使用 Von Korff 等人的分级慢性疼痛量表回答了她们的慢性疼痛程度问题。
女性在医疗保健系统中经历了性别化的待遇，她们报告说经常被医疗保健提供者（通常是医生）忽视。医疗保健专业人员在疼痛评估方面的做法是女性面临的另一个常见挑战。能够从政府残疾计划中获得经济支持的女性更有可能获得联合健康专业人员的帮助。许多女性研究和使用的治疗慢性疼痛的整体策略都是自我实施的。虽然饮食、运动和其他自我保健活动是所有人群的一般健康促进策略，但这些策略被视为帮助女性控制慢性疼痛和改变发作性残疾病程的生活方面。
患有慢性疼痛和发作性残疾是复杂的。本研究的结果提出了医疗保健系统中的性别化待遇对患有发作性残疾和慢性疼痛的女性的影响。显然，目前的系统不能满足我们研究中的女性的需求，系统变革可能会带来更好的体验、更多替代疗法的披露，并增强女性在护理中的自主权。
