Narratives Of Pain Research Articles

The Language of Women's Pain: Ideology and Critical Cultural Competencies in Pain Literacy

This manuscript is concerned with a key tension in health communication: How women’s pain is rhetorically constructed and culturally consumed. To date, there has been much research devoted to communicating the language of pain, rather, pain’s expressibility (Scarry, 1985), as well as the construction of health narratives from private pain into public action (Kimball, 2000). Building on that literature, we make a rhetorical turn, and argue for a more critical rhetorical approach to pain literacy. To that end, the primary goal of this essay is to explore the rhetorical nuances and ideological limitations in pain literacy and pain response, from the point of when pain is expressed to how that expression is perceived. Through a critical cultural lens, we critique dominant narratives of pain, and argue for an intersectional heuristic of rhetorical care that promotes cultural competency and awareness to bridge gaps in the expression and perception of pain literacy.

Representations of heterosexual anal sex in Cosmopolitan magazine

Anal sex has been the object of unprecedented recent media visibility; however, media discourses of anal sex are still largely unstudied. This study explores the representations of anal sex in Cosmopolitan, available online on the magazine’s website. Anal sex, mostly equated with heterosexual anal intercourse, is presented as trendy and popular, as well as potentially pleasurable and intimate. The articles pervasively characterise anal sex as a sexual activity that demands preparation, providing women with tips and techniques allegedly indispensable for a safe and pleasurable (or at least painless) practice of anal sex. The discourses offered are deeply gendered, however, picturing anal sex as a male obsession, and sometimes an expression of power and male conquest. Women’s own experiences are portrayed in a more nuanced and heterogeneous way, combining narratives of pleasure and pain, personal initiative and coercion. Although women’s individual right to refuse anal sex is often stressed, male pressure is naturalised, and certain dimensions of constraint in heterosexual interaction are normalised.

Military surgery as national romance: the memory of British heroic fortitude at Waterloo

This paper shows the ways that tales of stoicism during surgery at the Battle of Waterloo came to be a significant part of the ideological framework of Romantic Militarism. Celebrating the killing of enemies clashed with ideals of politeness, but hailing a soldier’s powers of endurance in surgery was an acceptable way of extolling courage, framing lived experience of agony into narratives of exalted pain, masculine fortitude and quasi-religious patriotic feeling. In Britain, an extensive discourse emerged about the supposed Britishness of surgical sangfroid at Waterloo, providing a narrative of national superiority in the decades of imperial expansion that followed.

Gender and Pain in Nineteenth-Century Cancer Care.

Gender and Pain in Nineteenth-Century Cancer Care.

Narrating pain: the representation of social actors

Charmaz (1995) claims that modes of living with pain are embedded in particular activity levels reflected by language use. Therefore, the contribution investigates the concept of agency in a corpus of pain narratives of chronic patients. The research questions involve the manner in which ill people experience their position related to others in society (inclusion-exclusion). Therefore, we can study ill people’s subject position with the dominant position of medical professionals. Therefore, the analysis also uses the Systemic Functional Linguistics and the socio-semantic approach as a methodological framework. The paper demonstrates the discourse structures on the representational, positional levels of metafunctions, and giving an account on role allocation and nomination/categorization of social actors framing agency. The study analyzed 14 narratives of individuals afflicted with chronic pain. In conclusion, the analysis reveals that narrators are active participants in the process of experiencing and coping with pain.

Storytelling, Statistics, and the Ethics of Responsibility

In this essay, I reflect on the process of conducting research into an Australian welfare reform experiment that targets Indigenous people: the trial of a cashless debit card. Selectively deployed statistical research has been key to making and contesting the political case regarding the cashless debit card’s effectiveness. However, pursuing narrative research in contradistinction to this preponderance of statistical research does not necessarily salve ongoing questions about power and research ethics, which have been reinvigorated amid renewed calls for anthropology’s decolonisation. I draw on Eve Tuck’s (2009) analysis of ‘pain narratives’ and Sujatha Fernandes’ (2017) critical account of storytelling to probe aspects of my research. When settler anthropologists elicit, listen to, collect, and then disseminate stories gifted by Indigenous interviewees, this demands we take serious ‘responsibility for the decisions we make as writers’ (Birch 2019: 26). Demystifying the particular relations and everyday processes that lie at the heart of our research practice is thus warranted.

The Pain Narrative

The Pain Narrative

Invalidation of chronic pain: a thematic analysis of pain narratives

Purpose Many people with chronic pain report feeling disbelieved or disparaged by others regarding their pain symptoms. Given the widely documented relationship between stress and pain, the importance of identifying psychosocial stressors such as pain-invalidation is apparent. This study was designed to identify and illustrate using first-person narratives, the effects of pain-invalidation by the self, family, friends, and healthcare professionals, toward individuals with chronic pain. Method A systematic search of five databases was performed using a search strategy consisting of terms related to pain-invalidation. A review of 431 peer-reviewed journal articles, containing narratives from a pool of over 7770 study participants with a wide range of pain conditions, was conducted, followed by a thematic analysis to establish themes of invalidation experienced by those with chronic pain. Findings Five major pain-invalidation themes were revealed: Not being believed, lack of compassion, lack of pain awareness/understanding, feeling stigmatized, and critical self-judgement. Themes additional to pain-invalidation included: Threats to Self-Image, Loss of Identity, and Isolation. Conclusion Themes were largely interrelated and, together, build a picture of how levels of perceived social unacceptability of pain symptoms can impact on the emotional state and self-image of those with chronic pain. As such, pain-invalidation may potentially impede help-seeking or the effectiveness of therapeutic interventions. IMPLICATIONS FOR REHABILITATION Pain-invalidation can occur at the level of the self, social others, or healthcare professionals. Pain-invalidation can arise through a lack of understanding by others in the social network about having chronic pain. Pain-invalidation may be a barrier to seeking therapy for pain management and rehabilitation, and thus, efforts to identify and acknowledge invalidation experiences may be beneficial in the rehabilitation process.

Symptom description in patients with chest pain-A qualitative analysis of emergency medical calls involving high-risk conditions.

To explore the symptoms descriptions and situational information provided by patients during ongoing chest pain events caused by a high-risk condition. Chest pain is a common symptom in patients contacting emergency dispatch centres. Only 15% of these patients are later classified as suffering from a high-risk condition. Prehospital personnel are largely dependent on symptom characteristics when trying to identify these patients. Qualitative descriptive. Manifest content analysis of 56 emergency medical calls involving patients with chest pain was carried out. A stratified purposive sampling was used to obtain calls concerning patients with high-risk conditions. These calls were then listened to and transcribed. Thereafter, meaning units were identified and coded and finally categorised. Consolidated criteria for reporting qualitative studies guidelines have been applied. A wide range of situational information and symptoms descriptions was found. Pain and affected breathing were dominating aspects, but other situational information and several other symptoms were also reported. The situational information and these symptoms were classified into seven categories: Pain narrative, Affected breathing, Bodily reactions, Time, Bodily whereabouts, Fear and concern and Situation management. The seven categories consisted of 17 subcategories. Patients with chest pain caused by a high-risk condition present a wide range of symptoms which are described in a variety of ways. They describe different kinds of chest pain accompanied by pain from other parts of the body. Breathing difficulties and bodily reactions such as muscle weakness are also reported. The variety of symptoms and the absence of a typical symptomatology make risk stratification on the basis of symptoms alone difficult. This study highlights the importance of an open mind when assessing patients with chest pain and the requirement of a decision support tool in order to improve risk stratification in these patients.

Narratives of Chronic Pain in Sport

Sports injury research has predominantly focused on acute injuries, often overlooking the complexities that may be associated with chronic injury. Consequently, the aim of the present study was to understand the experiences of individuals who continued to take part in sport with a chronic injury. Using a narrative methodology, 10 athletes who had experienced chronic pain for at least one year took part in interviews which asked them to narrate their story of pain. Results identify the imprisonment metaphor used to describe chronic injury and consider that the causes of this imprisonment may be both physical and environmental. Further, this study illustrates how athletes have coped with chronic pain, emphasizing the body-self relationship and the difficulties associated with adapted sport. These findings have important implications for practitioners working with injured athletes, emphasizing that the experiences of athletes in chronic pain may differ considerably from those in acute pain.

Memória, catástrofe e narrativas da dor: Primo Levi, Riobaldo e os fantasmas na experiência do trauma

RESUMO Este artigo problematiza a narrativa da dor e do trauma em obras testemunhais e em trabalhos ficcionais, tomando como objetos de análise textos memorialísticos do escritor italiano Primo Levi, sobrevivente dos campos de concentração nazistas, e o romance Grande sertão: veredas, de Guimarães Rosa, em especial as lembranças descritas por seu protagonista, o personagem Riobaldo Tatarana. Para tanto, propomos uma abordagem multidisciplinar, com escopos teóricos da narrativa e dos conhecimentos sobre afeto e memória, tendo em perspectiva as figuras fantasmáticas que esses textos trazem. As correspondências e aproximações entre os discursos em análise revelam efetivos laços que os unem, desde que lidos sob horizontes que ampliem suas mensagens, redefinam seus contornos e apostem em encontros simbólicos que enriqueçam o olhar a respeito da produção dos autores investigados.

Pain prevalence and treatment in patients with metastatic bone disease.

The accomplishment of successful pain treatment requires evaluation, characterization and quantification. The present study characterized pain and survival in a cohort of patients with cancer with bone metastasis who were treated with intravenous bisphosphonates. A total of 84 patients self-completed the Brief Pain Inventory (BPI) and 36-Item Short Form Survey (SF-36), between November 2010 and March 2011 with a 5-year survival follow-up as a surrogate marker of cancer burden. The median age was 62 years old (34–85), 64% of patients were female and 58% of these females had breast cancer. In the population, self-reported pain was 91.6%, with 29 patients (34.5%) reporting severe pain (score 7–10). Among these patients, only 13 (44.8%) presented a similar report to that of their clinical files and 5 were undergoing treatment with strong opioids (17.2%). A total of 45 patients (46%) had not been prescribed analgesic drugs, of these patients, 32 were treated with a weak opioid, and 13 with a strong opioid. An association was observed between pain records and the prescribed analgesic (P=0.031). BPI maximum pain and overall survival data were analyzed, and a significant association was identified between male patients presenting severe pain and decreased survival (P=0.004). Male survival was associated with severe pain, which is consistent with other data. The results revealed a skeletal-related events (SRE)-free survival (time elapsed from diagnosis of the first bone metastasis to the first SRE) of 9 months (4.39–13.73, 95% CI) with a statistically significant difference between subgroups of time since diagnosis of bone metastasis (P=0.005). The added value of the present study is the suggestion that complete and accurate pain narratives are mandatory and may contribute to the optimization of analgesia, and may help to increase survival rates. Optimal pain management for patients with cancer remains an urgent requirement.

기억과 고통의 서사로 숙영낭자전 읽기

기억과 고통의 서사로 숙영낭자전 읽기

Personality and treatment-related correlates of trustworthiness: A web-survey with chronic pain narratives

ObjectivesThis study examined personality and treatment-related correlates of trustworthiness in chronic pain narratives. Methods727 adults participated in an online survey and rated eight narratives written by patients with chronic pain. Eighty-six percent of the participants identified themselves as having experienced chronic pain (n = 626) and 14% identified themselves as people with a medical background (n = 101). The survey examined psychological characteristics, trustworthiness and expressions of pain severity, desire for medication, and frustration with pain care. ResultsPain narratives that were rated as likable, stoic, or appreciative were significantly associated with higher trustworthiness; narratives that were rated as depressed, hostile, or histrionic were significantly associated with lower trustworthiness. Similar results were found for patient peers and clinicians. Patients that expressed a high level of pain severity were rated as significantly less trustworthy (P < .001). Pain narratives that expressed frustration with pain care were also rated as significantly less trustworthy (P = .009). For pain narratives that expressed frustration with pain care, patient peers gave higher ratings of trustworthiness compared to providers (P = .008), whereas both gave similar ratings when no frustration with pain care was expressed in the narrative. DiscussionOur results show that the way in which patients communicate about their pain are significantly associated with how trustworthy they are perceived. Future research should explore how trustworthiness is related to subsequent pain management and interpersonal dynamics.

An audit of paediatric pain prevalence, intensity, and treatment at a South African tertiary hospital.

Introduction:Pain in paediatric inpatients is common, underrecognised, and undertreated in resource-rich countries. Little is known about the status of paediatric pain prevention and treatment in low- and middle-income countries.Objectives:This audit aimed to describe the prevalence and severity of pain in paediatric patients at a tertiary hospital in South Africa.Method:A single-day prospective observational cross-sectional survey and medical chart review of paediatric inpatients at Grey's Hospital, Pietermaritzburg, South Africa.Results:Sixty-three children were included, and mean patient age was 9.7 years (SD 6.17). Most patients (87%) had pain during admission, with 29% reporting preexisting (possibly chronic) pain. At the time of the study, 25% had pain (median pain score 6/10). The worst pain reported was from needle procedures, including blood draws, injections, and venous cannulation (34%), followed by surgery (22%), acute illness/infection (18%), and other procedures (14%). Pharmacological treatments included WHO step 1 (paracetamol and ibuprofen) and step 2 (tramadol, tilidine, and morphine) analgesics. The most effective integrative interventions were distraction, swaddling, and caregiver participation. Although a pain narrative was present in the majority of charts, only 16% had documented pain intensity scores.Conclusion:The prevalence of pain in hospitalised children in a large South African Hospital was high and pain assessment inadequately documented. There is an urgent need for pain education and development of guidelines and protocols, to achieve better pain outcomes for children. This audit will be repeated as part of a quality-improvement initiative.

Morality and values in Pavel Vilikovský’s The Autobiography of Evil

Abstract Morality is often referred to as the code of conduct of society. This code determines what is considered correct behaviour and enforces values society deems beneficial. Values themselves are protected by laws and social or moral norms. Authors combine all the mentioned concepts and convey them through the actions taken or not taken by characters. Their writings provide the reader with characters’ motivations, reasoning and try to line them up with a final judgment – to see whether individual morals and values line up with the ones upheld by the rest of society. When dealing with morality in narratives of pain and trauma, the objective is then not only to analyse the protagonists’ psyche but also consider societal pressures. The focus of our analysis lies in Pavel Vilikovský’s novel The Autobiography of Evil, in which the author depicts morally sound characters becoming morally ambiguous while living in an oppressively authoritarian political system. Our aim is to explore the pain and trauma of Jozef K. whose moral core is affected by blackmail and threats. His actions are misguided and they perpetuate the cycle of violence instead of stopping it.

The Multimodal Assessment Model of Pain: A Novel Framework for Further Integrating the Subjective Pain Experience Within Research and Practice.

Objectives:Pain assessment is enigmatic. Although clinicians and researchers must rely upon observations to evaluate pain, the personal experience of pain is fundamentally unobservable. This raises the question of how the inherent subjectivity of pain can and should be integrated within assessment. Current models fail to tackle key facets of this problem, such as what essential aspects of pain are overlooked when we only rely on numeric forms of assessment, and what types of assessment need to be prioritized to ensure alignment with our conceptualization of pain as a subjective experience. We present the multimodal assessment model of pain (MAP) as offering practical frameworks for navigating these challenges.Methods:This is a narrative review.Results:MAP delineates qualitative (words, behaviors) and quantitative (self-reported measures, non–self-reported measures) assessment and regards the qualitative pain narrative as the best available root proxy for inferring pain in others. MAP offers frameworks to better address pain subjectivity by: (1) delineating separate criteria for identifying versus assessing pain. Pain is identified through narrative reports, while comprehensive assessment is used to infer why pain is reported; (2) integrating compassion-based and mechanism-based management by both validating pain reports and assessing underlying processes; (3) conceptualizing comprehensive pain assessment as both multidimensional and multimodal (listening/observing and measuring); and (4) describing how qualitative data help validate and contextualize quantitative pain measures.Discussion:MAP is expected to help clinicians validate pain reports as important and legitimate, regardless of other findings, and help our field develop more comprehensive, valid, and compassionate approaches to assessing pain.

The Poetics of Disclosure Narrating the Six-Day War in the Poetry of Nizar Qabbani

Within defined political and aesthetic contexts, the 1967 war poetry was an attempt to re-describe and re-constitute projections of the war in Arab media and popular culture. Repudiating war and its diabolical motives, several Arab poets question and subvert a complex pattern of nationalist myths that gave rise to the 1967 war and sustained it. In this context, the paper explores the provocative war poetry of the great Arab poet, Nizar Qabbani , written in the aftermath of the 1967 war between Israel and three Arab armies. In his denial of the process that aims to obscure the war and bury its atrocities beneath cultural amnesia, Qabbanireveals narratives of trauma and pain demystifying a phenomenon that centuries of history have glorified. Within the parameters of contemporary critical theory, the central argument, in the paper, aims to interrogate the war narratives purveyed by Arab politicians and official state media and their destructive impact on collective Arab memory. The poems, investigated in the paper, aim to engage the politics and the language of war questioning the myths and the monolithic political discourse that triggered the war and paved the way for the defeat.

No One Should Have to Prove Their Worth to Get Medical Care, Regardless of Addiction or Pain.

Comparing pain and addiction stories provides a unique insight into the way these issues are seen through different moral lenses. Addiction stories are tales of sin and redemption, while pain narratives focus on suffering and worthiness of care. In order to improve ethical treatment of both conditions, we cannot continue to see addiction as immorality and patient abandonment or criminalization as an acceptable approach to it.

Home-Based Palliative Care Program Relieves Chronic Pain in Kerala, India: Success Realized Through Patient, Family Narratives.

An estimated 1.5 billion people across the globe live with chronic pain, and an estimated 61 million people worldwide experience unrelieved serious health-related suffering. One-sixth of the global population lives in India, where approximately 10 million people endure unrelieved serious health-related suffering. The state of Kerala is home to Pallium India, one of the most sophisticated palliative care programs in the country. This private organization in Trivandrum provides palliative and hospice care to underresourced populations and emphasizes holistic pain treatment. The current project features the pain stories of six patients who received treatment from Pallium India. Basic patient demographic information was collected, and a Pallium India staff member who was fluent in Malayalam and English asked questions about each patient's pain experience. Pain narratives illustrate the substantial impact of Pallium India's home visit program and the role of total pain assessment in delivering high-quality palliative care.