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The role of the patient-provider encounter in the complex interplay between pain, gendered norms and health care

Research project

Short description

Nineteen percent of the adult population in Western societies suffer from long-lasting pain which has negative effects on physical health, mental health, quality of life, work capacity, family relations, household duties and leisure activities. Research has shown differences between men and women, how they perceive, describe and handle pain, and how they are treated in health care. In this research project we want to explore and analyse gender norms about men and women with pain. Further, we want to examine the role of the patient-physician encounter in the constitution and co-constitution of these norms. Deepened knowledge about gender and pain is a prerequisite for equitable health care, more capable of meeting the needs of all patients.

A man suffering from pain
A man suffering from pain
Photo: Simmon Okongo

This thesis will consist of four studies: 

 

“Brave men” and “emotional women”… 

… is the title of a literature review that compiles and analyses gendered norms about men and women with long-lasting pain and gender bias, medically unmotivated differences between men and women, in health care. Seventy-seven included scientific articles describe how men and women with long-lasting pain are expected to be, to express their pain, handle their life and how the pain affected their identity in different ways. As an example, several studies showed that women with pain were dismissed as hysterical. Other studies described how men with pain diagnoses were perceived as feminine and had to struggle with their sense of masculinity. The literature review shows that gendered norm in health care are common. Researchers and clinicians need to be aware of gendered norms and gender bias, to able to provide equitable care based on every patient’s need instead of presumptions about what we believe men and women need.    

  

“Sense of control”… 

… is an interview study. Five women and three men with long-lasting pain described how multimodal pain rehabilitation had affected their everyday life. The participants experienced a better sense of control over their pain and their everyday life after rehabilitation. They described a trustful patient-provider-relationship, based on trust on the providers competence, as necessary for their pain acceptance. Better knowledge, particularly on body function and medication was also important. Research has earlier described social support as an important coping strategy. In this study the participants did not perceive social support as crucial when it comes to handle pain in everyday life. The participants in our study were aware of gendered norms in health care and saw that as a potential obstacle for equity in health care.       

 

Activities in everyday life (planned) 

In this cross-sectional study we are going contact patients with long-lasting pain. We will examine if different kinds of daily life activities have been discussed with men and women with long-lasting pain during the doctors’ visit, and if men and women participate in different kinds of activities in daily life.    

 

Trust, rumination and social support (planned)   

In this cross-sectional study we are going to contact patients with long-lasting pain. We will examine potential associations between trust in the physician, rumination and social support, and if those associations differ between men and women. 

 A woman suffering from pain
A woman suffering from pain
Photo: Simmon Okongo