The pain self-management paradox: why do we focus on the individual when life context plays such a major role?

2021 ◽  
Author(s):  
Karen Rodham
Keyword(s):  
Pain Management ◽  
Health System ◽  
The Self ◽  
Self Management ◽  
Life Context ◽  
The Individual

Although there has been a drive toward pain self-management, self-management has not yet in my opinion been successfully defined or evaluated and neither has it been consistently translated from idea to practice. In this perspective article, I identify gaps in our approach to pain management and argue that even though we know life context plays a huge role in influencing our health, by and large we fail to take this into account. I argue for a shift in focus away from the ‘self’ and explore how we might be able to do this within the constraints of our tired and over-stretched health system.

scholarly journals Individual-, Community-, and Health System–Level Barriers to Optimal Type 2 Diabetes Care for Inner-City African Americans: An Integrative Review and Model Development

2019 ◽  
Vol 46 (1) ◽  
pp. 11-27
Author(s):  
Jennifer A. Campbell ◽  
Leonard E. Egede
Keyword(s):  
Type 2 Diabetes ◽  
African Americans ◽  
Inner City ◽  
Health System ◽  
System Level ◽  
Self Management ◽  
Social Ecological ◽  
Multiple Levels ◽  
The Individual

Purpose The purpose of this integrative review is (1) to elucidate the unique barriers faced by inner-city African Americans for type 2 diabetes (T2DM) care; (2) to identify effective interventions/programs for optimal T2DM care at the individual, community, and health systems levels; and (3) to integrate 2 behavioral models and 1 social ecological model for framing interventions for inner-city African American to optimize T2DM care. Methods PRISMA guidelines were followed to systematically search PubMed, PsychInfo, and CINAHL. Integration of models was based on underlying principles of social ecological models. Results The search returned 1183 articles. Forty-six articles were synthesized after applying inclusion criteria. Multiple barriers for the individual level, community level, and health system level were identified. Major barriers include lack of knowledge, lack of social support, and self-management support. Interventions identified in this review show that among inner-city African Americans with T2DM, the focus is placed at the health systems level, with very limited focus toward addressing individual- and community-level barriers. Final synthesis includes development of a new integrated model that explains barriers to care across multiple levels. Conclusions These findings highlight the fragmentation that may be occurring between policy, research, and practice for achieving health equity and addressing health disparities for T2DM care among inner-city African Americans. The new model is an important step in the pursuit of equity in T2DM by specifying the complex barriers that occur across multiple levels. The application of this model using the 2017 National Standards for Diabetes–Self Management Education and Support are discussed.

A Brief Report on the Evaluation of a Pain Self-Management Program for Older Adults

2012 ◽  
Vol 26 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Clair Barefoot ◽  
Thomas Hadjistavropoulos ◽  
R. Nicholas Carleton ◽  
James Henry
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Behavioral Therapy ◽  
Management Program ◽  
The Self ◽  
Self Management ◽  
Control Group ◽  
Self Help ◽  
Professional Intervention

Chronic pain is often resistant to traditional medical management and other types of professional intervention. As such, several investigators have conducted studies of pain self-management programs. These self-management programs, however, were often led by therapists and shared much in common with traditional cognitive behavioral therapy (CBT); the efficacy of which, despite some inconsistencies, is largely supported in the literature. Although, like CBT, many therapist led programs involve a component of self-management in the form of “homework assignments,” it is important to evaluate the effectiveness of pain self-management, which is not therapist led. Within the context of controlled investigation, we evaluated a pain self-management program that involved use of a comprehensive self-help pain management book for older adults. Contrary to expectation, we did not identify any differences in the outcomes observed in the self-help patient group as compared to the control group (i.e., participants who did not receive the pain management book until after the study was completed) despite a great deal of satisfaction with the manualized program that was expressed by the participants. The implications of these findings are discussed.

scholarly journals Patient Assessment and Chronic Pain Self-Management in Ethnomedicine: Seasonal and Ecosystemic Embodiment in Ayurvedic Patient-Centered Care

2020 ◽  
Vol 17 (8) ◽  
pp. 2842
Author(s):  
Vinita Agarwal
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Patient Centered Care ◽  
Self Management ◽  
Seasonal Cycles ◽  
Chronic Pain Management ◽  
Patient Assessment ◽  
Patient Centered ◽  
Centered Care ◽  
The Individual

Background: Ayurveda’s preventive focus complements its strength with the interventionist approach of the biomedical in chronic pain self-management. Patient-centered care (PCC) using ethnomedicine promises greater patient self-management; however, few studies have examined environmental relationships and PCC in self-management of chronic pain through Ayurveda. Objective: To examine how Ayurveda’s philosophical focus on whole system frameworks describes the integration of the individual and the ecological in tailoring an integrative patient-centered diagnostic and prognostic approach to chronic pain management. Methods: This qualitative case study conducted in-depth semi-structured interviews of Ayurvedic physicians from India (N = 10) and a qualitative inductive content analytic approach. Findings: The diagnostic and interpretational framework of the doshas supports the integration of the individual and the ecological through (a) the circadian and seasonal cycles relating mind-body awareness with diet, lifestyle (e.g., yoga), and breath (e.g., pranayama), and (b) biogeographical and ecosystemic regions relating the biogeographical and the ecological (e.g., desh) with the regulatory principle of pain and its physiological and anatomical perception (vata) in an approach that goes beyond treating pain etiology to a whole person PCC approach. Conclusions: The study highlights how circadian and seasonal cycles and evolutionary spatial-temporal factors of biogeographical and ecological regions are employed in patient assessment and self-management to support patient involvement. Recommendations for PCC in integrative chronic pain management include supporting patient ownership of their care through the dosha framework that relates the individual and the ecological in the patient’s own life-context and supports co-creation of a collaborative plan of care using an ethnomedical framework.

Manageable Self in the Early Hellenistic Era

2010 ◽  
Vol 39 (2) ◽  
pp. 34-36
Author(s):  
Vaia Touna
Keyword(s):  
Social Economic ◽  
Ancient Greece ◽  
The Self ◽  
Hellenistic Period ◽  
Political Conditions ◽  
The Individual

This paper argues that the rise of what is commonly termed "personal religion" during the Classic-Hellenistic period is not the result of an inner need or even quality of the self, as often argued by those who see in ancient Greece foreshadowing of Christianity, but rather was the result of social, economic, and political conditions that made it possible for Hellenistic Greeks to redefine the perception of the individual and its relationship to others.

Monkey on My Back. An Autoethnographic Narrative of a Therapeutic Experience

2020 ◽  
Author(s):  
Adam Wiesner
Keyword(s):  
Personal Experience ◽  
Meaning Making ◽  
The Self ◽  
Symbolic Language ◽  
Discursive Practices ◽  
Therapeutic Experience ◽  
Postmodern Philosophy ◽  
The Moment ◽  
The Individual ◽  
Global Uncertainty

With a conscious attempt to contribute to contemporary discussions in mad/trans/queer/monster studies, the monograph approaches complex postmodern theories and contextualizes them from an autoethnographic methodological perspective. As the self-explanatory subtitle reads, the book introduces several topics as revelatory fields for the author’s self-exploration at the moment of an intense epistemological and ontological crisis. Reflexively written, it does not solely focus on a personal experience, as it also aims at bridging the gap between the individual and the collective in times of global uncertainty. There are no solid outcomes defined; nevertheless, the narrative points to a certain—more fluid—way out. Through introducing alternative ways of hermeneutics and meaning-making, the book offers a synthesis of postmodern philosophy and therapy, evolutionary astrology as a symbolic language, embodied inquiry, and Buddhist thought that together represent a critical attempt to challenge the pathologizing discursive practices of modern disciplines during the neoliberal capitalist era.

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