Cupit Caroline, Finlay Teresa, Pope Catherine
Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK.
Sociol Health Illn. 2025 Feb;47(2):e70008. doi: 10.1111/1467-9566.70008.
Fibromyalgia is a syndrome characterised by persistent unexplained pain and fatigue. People with fibromyalgia report receiving little support to manage symptoms, difficult interactions with healthcare practitioners and stigma associated with this contested condition. In this article, we employ Dorothy E Smith's Sociology for People to undertake a systems-focused literature review from the standpoint of people with fibromyalgia, moving beyond individual subjectivities to map how problems are socially organised. This is a novel application of a Sociology for People which, although previously used to structure research projects, has not previously been reported as a framework for literature review. Our findings highlight how, within a biomedically orientated healthcare system, practitioners' activities are organised to withdraw support from people with fibromyalgia and characterise problems as "psychological". Those looking to make service improvements for this patient group need to specifically challenge biomedical systems and ideology, in order to promote alternative models of care. We highlight a Sociology for People as a powerful lens for systems-focused literature review that links frontline experiences with dominant power relations, and provides an alternative to traditional qualitative evidence syntheses. Additionally, the theoretically-grounded and creative use of published literatures is an ethical approach adding value to extant research.
纤维肌痛是一种以持续不明原因疼痛和疲劳为特征的综合征。纤维肌痛患者表示,在症状管理方面几乎得不到支持,与医护人员的互动困难,且这种存在争议的病症还会带来污名。在本文中,我们运用多萝西·E·史密斯的《面向大众的社会学》,从纤维肌痛患者的角度进行以系统为重点的文献综述,超越个体主观性,以描绘问题是如何在社会层面上组织起来的。这是对《面向大众的社会学》的一种新颖应用,尽管此前它被用于构建研究项目,但此前尚未有将其作为文献综述框架的报道。我们的研究结果凸显了在以生物医学为导向的医疗体系中,医护人员的活动是如何组织起来,减少对纤维肌痛患者的支持,并将问题定性为“心理问题”的。那些希望为该患者群体改善服务的人需要特别挑战生物医学体系和意识形态,以推广替代护理模式。我们强调《面向大众的社会学》是进行以系统为重点的文献综述的有力视角,它将一线经验与主导权力关系联系起来,为传统的定性证据综合提供了替代方案。此外,对已发表文献进行基于理论且富有创造性的运用是一种符合伦理的方法,能为现有研究增添价值。