Who am I? The sense of self in chronic/persistent pain

One of the most pervasive descriptions of what it is like to live with persistent pain is the loss of sense of self. Time after time in qualitative research we read about people feeling they’re in “limbo land”, losing confidence that they can do what matters in their lives, feeling stigmatised and isolated – not themselves any more. An in-depth meta-ethnography of qualitative research showed that pain undermined participation, ability to carry out daily activities, stymied a sense of the future, and intruded on the sense of self (MacNeela, Doyle, O’Gorman, Ruane &McGuire, 2015). To understand the idea of “self”, I poked about a little in the literature, and found a title I like “Becoming who you are” (Koole, Schlinkert, Maldei &Baumann, 2019). The theoretical propositions of this paper relate more to self-determination than self-concept – but that title “Becoming who you are” resonated strongly with me. When I read through pain rehabilitation research and theory, especially that dealing with learning how to live well with pain, I rarely see anything written about how we might help people who feel alienated from their sense of self. Scarcely a word. Except in the psychological literature. There’s a bit about self-discrepancy theory (See E. Tory Higgins works for much more about self-discrepancy), where the “imagined self”, the “real self”, the “feared self...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Uncategorized Source Type: blogs

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Conclusions: Personal conflicts were identified between clinicians' descriptions of their wishes to "sell" their own perspectives to patients while simultaneously wanting to demonstrate a patient-focused approach and avoid the interpersonal conflicts which arose from clashes with patients' beliefs. Building a good initial rapport, showing empathy and adapting approaches in response to perceptions of patients' reactions were perceived as strategies to help mitigate the risks of failed communication, but this was something for which participants felt unprepared by their prior training. PMID: 31744369 [PubMed -...
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research
Resumo O Problema Cr ônico de Coluna (PCC) é uma das doenças mais prevalentes no mundo e representa uma das principais causas de anos de vida perdidos por incapacidade. Embora de grande relevância para a saúde pública, estudos sobre o acesso e a utilização dos tipos de tratamento são escassos. O objetivo deste artigo é descrever os principais tratamentos para PCC no Brasil, analisar os fatores associados à sua utilização e discutir possíveis desigualdades na utilização de fisioterapia /exercícios e a utiliza...
Source: Ciencia e Saude Coletiva - Category: Occupational Health Source Type: research
ConclusionThere was no additional benefit of an internet-delivered CBT program (MoodGYM) to physical treatments in those with chronic non-specific LBP at medium risk of ongoing disability measured at post-treatment, or at 6 and 12  months.Trial registrationThis trial was prospectively registered with Australian New Zealand Clinical Trials Registry Number (ACTRN)12615000269538.
Source: Chiropractic and Manual Therapies - Category: Complementary Medicine Source Type: research
CONCLUSION: CFT reduced disability, but not pain, at 6 and 12 months compared with the group-based exercise and education intervention. Future research should examine whether the greater reduction in disability achieved by CFT renders worthwhile differences for health systems and patients. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov registry (NCT02145728). PMID: 31630089 [PubMed - as supplied by publisher]
Source: British Journal of Sports Medicine - Category: Sports Medicine Authors: Tags: Br J Sports Med Source Type: research
Once you begin to dip your toes into psychological therapies, it doesn’t take long before you begin to see TLAs all over the place. So today I’m going to post on two things: some of the TLAs, and why or how we might consider using these approaches in pain rehabilitation. The first one is CBT, or cognitive behavioural therapy. CBT grew out of two movements: behaviour therapy (Skinner and the pigeons, rats and all that behaviour modification stuff), and cognitive therapy (Ellis and Beck and the “cognitive triad” – more on this later). When the two approaches to therapy are combined, we have c...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: ACT - Acceptance & Commitment Therapy Clinical reasoning Cognitive behavioral therapy Coping strategies Interdisciplinary teams Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice Source Type: blogs
Kaia Health, a health technology company based in New York City, has developed a smartphone app that can guide users through exercises to help with back pain and COPD. The technology uses AI powered motion tracking technology to monitor users’ ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Exclusive Medicine Orthopedic Surgery Source Type: blogs
Authors: Sheng Y, Duan Z, Qu Q, Chen W, Yu B Abstract OBJECTIVE: To evaluate the effect comparison of kinesio taping on chronic non-specific low back pain with that of other general physical therapies. METHODS: Relevant studies published up to 31 July 2018 were searched in electronic databases (PubMed, Web of Science, Science Direct, Physiotherapy Evidence Database (PEDro), Cochrane Library, Wanfang Data, Vip Data and China National Knowledge Infrastructure). The quality of included studies was assessed using a risk of bias assessment tool, as recommended by the Cochrane Collaboration. Data from visual analogue...
Source: Journal of Rehabilitation Medicine - Category: Rehabilitation Tags: J Rehabil Med Source Type: research
Today’s post is another one where there’s very little to guide my thinking… Have you ever wondered why we read so much research looking at the characteristics of the people who look for help with their pain – yet not nearly as much about us, the people who do the helping? There are studies about us – thanks Ben – and others! (Darlow, Dowell, Baxter, Mathieson, Perr &Dean, 2013; Farin, Gramm &Schmidt, 2013; Parsons, Harding, Breen, Foster, Pincus, Vogel &Underwood, 2007). We know some things are helpful for people with pain: things like listening capabilities (Matthias, Ba...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Coping strategies Pain conditions Professional topics Research Science in practice attitudes beliefs communication nocebo Source Type: blogs
Conclusion: The GPES demonstrated adequate psychometric properties. This study's findings supported its use in clinical and research studies with patients with chronic low back pain. IMPLICATIONS FOR REHABILITATION The European Portuguese version of the Global Perceived Effect Scale demonstrated adequate reliability, validity and responsiveness. This instrument is suitable to evaluate meaningful changes in patients with chronic low back pain. The contribution of baseline status to GPES scores was confirmed by specific and recommended methods. The use of the GPES as external criterion of change in clinimetric studies was su...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
This is a long…… readooops, sorry, not. Low back pain is, we know, the greatest contributor to days lived with disability (Rice, Smith &Blyth, 2016). And no-one anywhere in the world has found a good mix of services to reduce the number of days lived with disability as a result of this problem. And yet billions of dollars are used to fund research into the many contributors to a shift from acute low back pain to ongoing disability associated with low back pain. At the same time, treatments that directly target disability, rather than pain (a target considered the most important outcome by Sullivan a...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Low back pain Pain conditions Research Science in practice health funding health systems models of care Source Type: blogs
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