Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Walk a Mile in My Shoes: An Auto-Ethnographic Study

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Walk a Mile in My Shoes: An Auto-Ethnographic Study

Article excerpt

INTRODUCTION

Chronic pain is an increasingly widespread health issue confronting western societies, with substantial economic and social costs (Gardner 2003). According to the 2004-2005 Australian National Health Survey (Australian Institute of Health and Welfare 2005) 31% (6 million) of the population (33% of females and 29% of males) reported having a long-term disease of the musculoskeletal system and connective tissue, 15% of which were back problems. Nearly one third of those persons reporting a disease of the musculoskeletal system or connective tissue had either profound or severe core activity limitation in mobility, self care or communication (Australian Bureau of Statistics 2005).

Chronic, non-malignant back pain sufferers are a marginalised group, about whom very little research has been undertaken. Many sufferers report a lack of understanding from the community at large, as well as less than positive hospitalization experiences where negative attitudes and stereotyping by nurses and doctors can make a difficult experience traumatic.The impetus of this study came from the experiences of one of the authors, Susan, a former nurse, and reports from other non-malignant pain sufferers.The study sought to uncover and understand the reality of living with chronic, intractable non-malignant back pain.

BACKGROUND AND LITERATURE REVIEW

The international Association for the Study of Pain (IASP), drawing on Merskey and Bogduk (1994: 210), defined pain as 'a sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage'. Persistent or chronic pain, unlike acute pain, is characterised by the continuance of pain beyond the usual time of recovery and which no longer appears to serve a useful purpose. It is often associated with adverse behavioural changes, such as limitation of function which appears disproportionate to the precipitating event and/or the ongoing observable structural damage (Loeser & Egan 1989; Loeser 1982; Melzack & Wall 1982 cited in the Australian Pain Society's position paper, November 2002). Severe pain, particularly chronic long term pain, is an alienating experience and is often closely associated with suffering defined as 'a highly emotional response to that which was endured, to the changed present, or to anticipating the altered future' (Morse 1997). Suffering is not only confined to physical symptoms, such as loss of function, but also to social isolation often linked to loss of employment, the feeling of no longer being able to communicate, and the distress caused by others' disbelief (Smith & Friedemann 1999), along with inadequate pain control (Vilensky 2002). Suffering, like pain, is ultimately highly individual and personal (Cassell 1982) and usually results in a quest for interpretation and meaning (Leder 1990). That is, the sufferer will question the meaning and the cause of the pain in an attempt to come to terms with changed circumstances.

Explorations of experiences of chronic pain have included young people's perception of their pain and its impact on their lives (Carter, Lambrenos & Thursfield 2002), the experiences of pain and pain management (Chronic Pain in America: Roadblocks to relief survey 1999), coping strategies employed (Hillevi 2005) and dimensions of chronic pain and the factors influencing the pain experience (Strong et al. 1994).

In the 'Roadblocks to relief' survey conducted by the American Academy of Pain, only 22% of sufferers reported having been referred to a specialized pain treatment program and only one in four respondents reported that that had received adequate pain management.The study by Strong, et al investigated the dimensions of chronic low back pain from the patients' perspective (the currently recognised gold standard) in order to gain a better understanding of chronic pain and develop more effective assessment and measurement tools for nurses. Strong et al. …

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