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Det könade patientskapet : Om det biopsykosociala perspektivets frånvaro när smärtpatienter möter allmänläkare

Melander, Stina LU and Lundberg, Tove LU (2018) In Tidskrift för genusvetenskap 39(2-3). p.48-67
Abstract
Approximately 20% of the population experience long-term pain. Women are generally more affected than men. Currently, pain researchers advocate a biopsychosocial perspective, which emphasises the importance of addressing psychological and social factors as well as biomedical ones in clinical practice. However, previous research shows that this holistic perspective is not always materialized in medical practice. The main objective of this paper is to explore what obstructs the biopsychosocial approach from being explicitly used in primary care services. Our empirical material consists of qualitative interviews conducted with 33 pain patients and 15 general practitioners.
The results suggest that participants agree that a biopsychosocial... (More)
Approximately 20% of the population experience long-term pain. Women are generally more affected than men. Currently, pain researchers advocate a biopsychosocial perspective, which emphasises the importance of addressing psychological and social factors as well as biomedical ones in clinical practice. However, previous research shows that this holistic perspective is not always materialized in medical practice. The main objective of this paper is to explore what obstructs the biopsychosocial approach from being explicitly used in primary care services. Our empirical material consists of qualitative interviews conducted with 33 pain patients and 15 general practitioners.
The results suggest that participants agree that a biopsychosocial perspective is important to promote good care. However, the underpinning conditions for the clinical consultation, implicating a lack of time, continuity and knowledge as well as requirements related to societal regulations, limited the possibilities to adopt a biopsychosocial perspective in practice. Instead, many consultations focused on medications and work ability, which, in turn, led to gendered consequences. Women and men agreed that work was an important part of their identity. However, men described different opportunities than women to invest all their energy in work. A main focus on work ability in consultations therefore confirmed the values highlighted by men, but at the same time obscured many areas that were the everyday reality
of many of the women. Finally, all patients described an ambivalent stance towards being a patient. Many distanced themselves from the shameful and negative gendered patient stereotypes, but also needed to make their patienthood convincing to general practitioners in order to receive care. We conclude that important life areas affecting pain can be uncovered, and a less shameful patienthood enabled, when a biopsychosocial perspective is materialized with dignity in clinical practice. (Less)
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author
and
organization
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type
Contribution to journal
publication status
published
subject
in
Tidskrift för genusvetenskap
volume
39
issue
2-3
pages
48 - 67
publisher
Tidskrift för genusvetenskap, Karlstads universitet
ISSN
2001-1377
language
Swedish
LU publication?
yes
id
c63688c8-a836-49c2-ad66-758266bb62f8
alternative location
http://ojs.ub.gu.se/ojs/index.php/tgv/article/view/4631/3634
date added to LUP
2019-04-08 13:13:40
date last changed
2021-03-22 16:11:30
@article{c63688c8-a836-49c2-ad66-758266bb62f8,
  abstract     = {Approximately 20% of the population experience long-term pain. Women are generally more affected than men. Currently, pain researchers advocate a biopsychosocial perspective, which emphasises the importance of addressing psychological and social factors as well as biomedical ones in clinical practice. However, previous research shows that this holistic perspective is not always materialized in medical practice. The main objective of this paper is to explore what obstructs the biopsychosocial approach from being explicitly used in primary care services. Our empirical material consists of qualitative interviews conducted with 33 pain patients and 15 general practitioners.<br/>The results suggest that participants agree that a biopsychosocial perspective is important to promote good care. However, the underpinning conditions for the clinical consultation, implicating a lack of time, continuity and knowledge as well as requirements related to societal regulations, limited the possibilities to adopt a biopsychosocial perspective in practice. Instead, many consultations focused on medications and work ability, which, in turn, led to gendered consequences. Women and men agreed that work was an important part of their identity. However, men described different opportunities than women to invest all their energy in work. A main focus on work ability in consultations therefore confirmed the values highlighted by men, but at the same time obscured many areas that were the everyday reality<br/>of many of the women. Finally, all patients described an ambivalent stance towards being a patient. Many distanced themselves from the shameful and negative gendered patient stereotypes, but also needed to make their patienthood convincing to general practitioners in order to receive care. We conclude that important life areas affecting pain can be uncovered, and a less shameful patienthood enabled, when a biopsychosocial perspective is materialized with dignity in clinical practice.},
  author       = {Melander, Stina and Lundberg, Tove},
  issn         = {2001-1377},
  language     = {swe},
  month        = {11},
  number       = {2-3},
  pages        = {48--67},
  publisher    = {Tidskrift för genusvetenskap, Karlstads universitet},
  series       = {Tidskrift för genusvetenskap},
  title        = {Det könade patientskapet : Om det biopsykosociala perspektivets frånvaro när smärtpatienter möter allmänläkare},
  url          = {http://ojs.ub.gu.se/ojs/index.php/tgv/article/view/4631/3634},
  volume       = {39},
  year         = {2018},
}