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An integral vision of pain and its persistence: a whole-person, whole-system, salutogenic perspective.

作者信息

Johnson Mark I

机构信息

Centre for Pain Research, School of Health, Leeds Beckett University, Leeds, United Kingdom.

出版信息

Front Pain Res (Lausanne). 2025 Aug 14;6:1641571. doi: 10.3389/fpain.2025.1641571. eCollection 2025.


DOI:10.3389/fpain.2025.1641571
PMID:40893407
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12391091/
Abstract

Persistent pain remains a significant global health challenge, with prevailing biomedical and biopsychosocial models often falling short in capturing its full complexity. These models frequently lack conceptual and contextual coherence, overlooking the deeply subjective, cultural, and systemic dimensions of pain. As a result, care can become fragmented and suboptimal. This perspective article introduces an integral vision of pain, grounded in the All Quadrants, All Levels (AQAL) framework, which offers a multidimensional approach that integrates subjective experience, objective mechanisms, cultural meaning, spiritual perspectives, and systemic structures. The article outlines how a simplified AQAL framework can serve as a heuristic tool to synthesise individual and collective dynamics-including psychological development and socio-environmental conditions-thereby informing a more comprehensive understanding of pain and its persistence. This includes recognising the role of painogenic environments and the impact of evolutionary mismatch in shaping pain experiences. This integral perspective reframes persistent pain within a salutogenic social model of health, adopting a whole-person, whole-system approach that supports the co-creation of compassionate, community-driven, and context-sensitive care. Ultimately, it reconceptualises persistent pain not merely as a disease state or clinical symptom, but as a dynamic, relational, and meaning-laden experience embedded within the evolving journey of life. This integral vision challenges reductionist paradigms, advancing a more coherent, salutogenic, and humanistic model for understanding and addressing persistent pain.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2957/12391091/a8918315be29/fpain-06-1641571-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2957/12391091/98ab8404bcfd/fpain-06-1641571-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2957/12391091/a8918315be29/fpain-06-1641571-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2957/12391091/98ab8404bcfd/fpain-06-1641571-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2957/12391091/a8918315be29/fpain-06-1641571-g002.jpg

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本文引用的文献

[1]
Editorial commitment to trust and integrity in science: implications for pain and anesthesiology research.

Pain. 2025-7-3

[2]
Social dimensions as explanatory approaches for the development of chronic pain: a meta-ethnography of qualitative studies.

Int J Equity Health. 2025-7-7

[3]
Reconfiguring Pain Interpretation Within a Social Model of Health Using a Simplified Version of Wilber's All Quadrant All Levels Framework: An Integral Vision.

Behav Sci (Basel). 2025-5-20

[4]
"We do not stop being Indigenous when we are in pain": An integrative review of the lived experiences of chronic pain among Indigenous peoples.

Soc Sci Med. 2025-5

[5]
Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000-24.

Reg Anesth Pain Med. 2025-2-4

[6]
Global and regional trends and projections of chronic pain from 1990 to 2035: Analyses based on global burden of diseases study 2019.

Br J Pain. 2024-12-24

[7]
An ecosystem of accepting life with chronic pain: A meta-ethnography.

Br J Pain. 2024-8

[8]
Divine resilience: Unveiling the impact of religious coping mechanisms on pain endurance in arab older adults battling chronic pain.

Geriatr Nurs. 2024

[9]
Perspectives on community-based system change for people living with persistent pain: insights from developing the "Rethinking Pain service".

Front Pain Res (Lausanne). 2024-3-20

[10]
Painogenicity: an ecological approach to reduce the burden of chronic pain.

Public Health. 2024-5

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