A grounded theory study with repeated semi-structured interviews was conduc
ted to explore the meaning of the illness experiences of women patients, im
paired by biomedically undefined musculoskeletal pain. Twenty female patien
ts were recruited at an urban primary health care centre in northern Sweden
, where two of the researchers work as family physicians. In this paper we
focus on considerations of patient pain and analyze the findings from aspec
ts linking together body, gender, and society.
Four categories of symptom description were identified: bodily presentation
s, explanatory models, consequences of pain for the patient's activities, a
nd consequences for her self-perception. The bodily symptoms signaled loss
of control. The explanatory models consisted of physical damage and strain
injuries, but were also psychological and self-blaming. The consequences of
pain were described as negative consequences for the women's everyday life
that challenged their self-perception as women. The participants' search a
nd need for legitimization of their illness experiences, and the expectatio
ns placed on doctors as legitimizing agents was evident. To achieve the des
ired shared understanding in consultations, doctors must be aware of and co
nsider not only physical signs and symptoms, but also the patients' gendere
d concerns and psycho-social circumstances. (C) 1999 Elsevier Science Ltd.
All rights reserved.