Article

PURPOSE: To explore how patients with persistent unexplained pain interpret and
utilise the biopsychosocial model. This might have an impact on the outcome from
treatment programmes that adopts a biopsychosocial approach. METHOD: We conducted
three interviews with 20 patients attending a pain management programme for
persistent unexplained back pain; prior to attending the course, immediately
following the course and at 1 year. We used the methods of grounded theory.
RESULTS: Patients battled through several dialectic tensions in an attempt to
legitimise their pain: First, patients wanted a medical diagnosis but also
recognised that psychosocial factors contributed to their pain. Second, although
the outward appearance of pain was important to legitimacy, it was also important
not to appear 'too ill'. Third, meeting others with unexplained pain reinforced
credibility, but patients also described how they were not 'like the others'.
Finally, although holding on to one's self was important, patients also described
an acceptance of loss. These dialectic tensions are likely to have
an impact on a person's decision to embrace the biopsychosocial model, and might
therefore effect their outcome. Health care professionals should be sensitive to
the cultural ambiguity of patients with persistent unexplained pain.

Langue : ANGLAIS