Illness-related complaints in women with chronic widespread pain: importance of a contextual approach

摘要

The study, comprising 125 sick-listed women aged 25-64 (m = 46.9 years) with widespread chronic pain, aimed at evaluating biopsychosocial problems as perceived by these women, studying such problems within a contextual framework, relating the findings to sociodemographic and medical data. Musculoskeletal complaints, fatigue, inability to work, sleep disturbances and uncertainty about the future were the problems, other than pain, most frequently reported. The women's written accounts of their musculoskeletal or somatic problems reflected being troubled by their unpaid household work and duties. Their psychological symptoms and social problems generally concerned paid work, unemployment or being on sick leave. The women's biomedical orientation appeared to be a function of their extended pharmaceutical and surgical treatment and their efforts to be recognized, particularly by insurance authorities, as clearly having a somatic disease. The study indicates the importance of a situational approach to gaining an understanding of illnesses in women with widespread pain. It is argued that, in a society accepting only medical grounds for sicklisting, physicians and other health care workers serve to reinforce a biomedical perspective in women suffering from biomedically 'unexplained' somatic symtoms, tending to result in medicalization, surgery and heavy use of pharmaceutical drugs.