7 research outputs found
The meaning of acceptance and body awareness for individuals living with long-term pain : implications for rehabilitation
Background: Chronic or long-term pain, usually defined as pain lasting at least
three to six months, is generally understood as a multidimensional phenomenon,
often requiring a multidisciplinary rehabilitation approach. The aetiology of longterm
musculoskeletal pain is considered to be multi-factorial. Although body
awareness treatment approaches and acceptance-based methods are incorporated
in pain rehabilitation, there is still a need for knowledge as to how they contribute
to the process of change in rehabilitation. Both body awareness and acceptance
are multi-dimensional concept.
Aims: The aims of the thesis were to describe how individuals with long-term
musculoskeletal pain experience and relate to (a) their aching body (Study I),
(b) body awareness as a resource in rehabilitation (Study II). A further aim was
to investigate how individuals participating in a multi-professional rehabilitation
programme experience and understand (c) the meaning of acceptance when entering
the rehabilitation programme (Study III) and (d) how this meaning change during
the rehabilitation programme (Study IV).
Methods and results: Three different samples were included, in total 27 women
and 12 men between the ages of 24â72 years with pain duration between 2.5â35
years. In-depth interviews and a phenomenological research approach were chosen
as well as a qualitative longitudinal research design.
In study I, the results indicate that patients with long-term pain can be found
along a spectrum from accepting to rejecting the aching body. Body awareness
and a trust in onesâ body seem to be important on the path towards acceptance of
the body as well as oneâs life situation as whole.
In study II, three constituents were identified as a gradual âmoving forwardâ
process, which was characterized by a shift in attentional focus that concerns the
lived body, the embodied self and the life-world beyond the experience of pain.
In study III, the findings were that patients can hold different understandings of
acceptance when entering a rehabilitation program expressed as; the only way
forward, a possible but challenging way forward and no way forward.
In study IV, four meaning structures that deepened the understanding of
acceptance as well as illustrating key aspects of an embodied learning process
during rehabilitation could be described; acceptance as liberation, acceptance
as acknowledging the need for change, acceptance as tolerating ambivalence
and acceptance as failure. Bodily-existential challenges were highlighted as
well as the importance of social support.
Conclusions: This thesis has shown both the importance of acceptance for rehabilitation
as well as the role of embodied transformative learning. Acceptance
was found to be a multifaceted phenomenon varying from person to person and
over time. Although body awareness approaches are prevalent in some clinical
settings, these studies show from an experiential perspective that body awareness
has an important role to play in the successful rehabilitation of long-term pain.
The findings in this thesis support the person-centred approach in rehabilitation,
weather in group or individual treatment
Perceptions of lymphoedema treatment in patients with breast cancer - a patient perspective
Lymphoedema after breast cancer surgery is a chronic condition. Lymphoedema treatment consists of information/advice, compression, physical exercise, skin care, and manual lymph drainage. Little is known about how patients experience, adapt, and respond to lymphoedema treatment. Thus, the purpose of the study was to investigate and describe women's perceptions of lymphoedema treatment after breast cancer surgery. Sixteen women with breast-cancer-related lymphoedema, recruited from four hospitals and two rehabilitation clinics, participated in the study. Semi-structured interviews were conducted and analysed using a phenomenographic method. Five qualitatively different categories of description could be identified: uncertainty, disappointment, guilt and shame, safety, and autonomy. The categories could be described based on a two-dimensional structure: the patients role (internal vs. external locus of control) and an understanding of lymphoedema as a chronic disease or a burden. The study has provided a deeper understanding of different ways in which patients perceive and respond to lymphoedema treatment. The present findings enable the lymphoedema therapist to individualise treatment and counselling based on each patient's approach to the patient role, ability to take responsibility for treatment, and acceptance of lymphoedema as a chronic disease