Understanding women in pain - New pathways suggested by Umea researchers: qualitative research and feminist perspectives

A substantial proportion of GPs' patients are women who suffer from "unexpl ained" pain conditions, often from the musculoskeletal system. Pew medical findings are revealed, although the symptoms lead to extensive suffering an d disability. Two experienced Swedish GPs, Katarina Hamberg and Eva E Johan sson, took their own frustration as their paint of departure to explore the expectations, experiences, family Lives and working Lives of women who wer e sick-listed due to chronic musculoskeletal pain. Their doctoral dissertat ions, defended at the University of Umea in September this year, are based on a qualitative interview study with 20 women aged 21-61 years. Johansson and Hamberg found that when seeing a doctor, the women expect to be seen, h eard and taken seriously, to get information and time for discussion with t he doctor, and to receive help and support over time. However, they experie nced being ignored, disregarded and rejected. Symptom perception was charac terized by loss of control and feelings ol threat and unpredictability. The women believed that the pain had a bodily origin triggered by various mech anisms such as heavy and monotonous work, environmental influences, tension s and worries, rightful punishment or heritage. The Swedish study showed th at family considerations had a strong impact on organizations and prioritie s in paid work. In this sample of working class women, family orientation s trengthened and works aspiration declined in a situation of pain and sick l eave. Problems related to rehabilitation could be explained by looking more closely on home conditions, especially the unwritten deal among the woman and her partner regarding the division of duties and power structure - the marital contract. Experiences of abuse and violence were reported to Hamber g and Johansson by several women, most of them considering this to be one r oot of their pain and ill health. The women emphasized that an understandin g doctor would ask about violence, apprehend the hints, confirm that it was acceptable to talk about it, and avoid the questioning and blame that easi ly might increase the woman's feelings of guilt.