Department of Family Medicine, McGill University, Montréal, Quebec, Canada.
Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada.
J Pain. 2024 Nov;25(11):104626. doi: 10.1016/j.jpain.2024.104626. Epub 2024 Jul 11.
The importance of gender is undertheorized in chronic pain research, meaning extant research cannot sufficiently shed light on how chronic pain experience and treatment are connected to institutions and societal structures. Much literature on gender and pain is not critical in orientation, making it difficult to translate data into recommendations for improved treatment and care. Our study takes a critical approach informed by social theory to understand chronic pain among women who experience socioeconomic marginalization. Drawing on a gender-based subanalysis of interview data collected in Canada as part of an institutional ethnography of chronic pain among people who are socioeconomically marginalized, from women's narratives, we identified 4 themes that speak to gender, chronic pain, and marginalization. These are 1) gendered minimization of women's health concerns, 2) managing intergenerational poverty, 3) living with violence and trauma, and 4) gendered organization of family care. Together, these themes highlight how women's experiences of chronic pain and marginalization amplify gendered vulnerabilities in health care, social services, and society in general. Our findings depict a deeply gendered experience of chronic pain that is inseparable from the daily struggle of managing one's life with pain with heavy responsibilities, the baggage of past trauma, and responsibility for others with few resources. We emphasize the importance of chronic pain care and health and social services that are both gender- and trauma-informed. PERSPECTIVE: This article draws on an institutional ethnography (a holistic qualitative methodology) of chronic pain and socioeconomic marginalization to demonstrate the importance of chronic pain care and health and social services that are both gender- and trauma-informed.
慢性疼痛研究中性别问题的重要性被低估了，这意味着现有的研究无法充分说明慢性疼痛的体验和治疗与机构和社会结构有何关联。许多关于性别和疼痛的文献在定向方面没有批判性，使得难以将数据转化为改善治疗和护理的建议。我们的研究采用了一种受社会理论启发的批判性方法，来理解经历社会经济边缘化的女性的慢性疼痛。我们借鉴了在加拿大进行的一项针对社会经济边缘化人群慢性疼痛的机构民族志研究中收集的访谈数据的性别基础子分析，从女性的叙述中，我们确定了 4 个主题，这些主题涉及性别、慢性疼痛和边缘化。这些主题包括：1）女性健康问题被性别化地最小化；2）管理代际贫困；3）生活在暴力和创伤中；4）家庭护理的性别化组织。这些主题共同强调了女性慢性疼痛和边缘化的经历如何放大了医疗保健、社会服务和整个社会中性别脆弱性。我们的研究结果描绘了一种深刻的性别化慢性疼痛体验，这种体验与日常管理疼痛生活的斗争密不可分，包括沉重的责任、过去创伤的包袱，以及对他人的责任，而这些人资源很少。我们强调需要提供既性别敏感又创伤敏感的慢性疼痛护理以及健康和社会服务。观点：本文借鉴了慢性疼痛和社会经济边缘化的机构民族志（一种整体定性方法），展示了需要提供既性别敏感又创伤敏感的慢性疼痛护理以及健康和社会服务。
