Self-Management for Persistent Pain by Karen Rodham

Author:Karen Rodham
Language: eng
Format: epub
ISBN: 9783030489694
Publisher: Springer International Publishing

The (Perhaps Underrated) Importance of Language

In the previous section, Kool and colleagues (2009) reported that people living with fibromyalgia felt that they were perceived as being ‘whiners’. A pejorative term which according to my concise Oxford Dictionary means someone who makes petty complaints. Many studies have been conducted exploring how the way we talk about something affects how it is viewed. If we think further afield, the advertising industry has mastered this skill beautifully and estate agents have in the recent past been called into line for their overenthusiastic (exaggerated) claims made when selling property (their Code of Practice for Residential Estate Agents (2011, updated in 2019) makes for interesting reading!). In the pain field, it is common to read about participants in studies who have been deemed to be ‘non-compliant’. Other phrases abound: ‘patient engagement’, ‘appropriate decisions’, ‘good’, ‘bad’ and ‘resistant’ patients. For example, Koekkoek et al. (2011: 505) note that difficult patients are those that do not seem to do their best to get better, they miss appointments, fail to comply “even to the most modest of lifestyle suggestions”. Even those who do try hard, but who relapse may be seen as difficult. The authors chose their words carefully, presumably to avoid blaming, but the phrase “even the most modest” is laden with judgement. Who decides what is modest? Modest for whom? If a health professional is stating this is modest, are they properly conversant with the patient’s life context? What a health professional may deem as modest, may, for a patient who has social, financial, cultural and environmental constraints, be a gargantuan task.

To further pick up on the importance of language, I turn now to the work of Dariusz Galasinski. He is a Professor of Discourse and Cultural Studies at Wolverhampton University and he has written widely on the impact and importance of language. In a blog piece fizzing with indignation he wrote a response to articles by Chesanow (2015) and Davies (2013) that had been written about ‘difficult’ or ‘challenging’ patients. In his blog piece, he points out that patients are often described in the literature as being ‘hostile’, ‘demanding’, ‘disruptive’. They are thought to have ‘unrealistic expectations’ and to be “unwilling to take responsibility for their health”. Yet health professionals are in Davies’ (2013) article described as being ‘hungry, angry, late or tired’. In other words, personal factors are accounted for to explain doctors behaviour but not for patients. As Galasinski (2017) puts it “patients are nasty, doctors are overworked” and this state of affairs quite rightly irks him.

I have already mentioned that many of the studies reported by De Ruddere and colleagues have shown that how health professionals view their patients can impact on the way in which patients are subsequently treated. In another example, Sointu (2017) reported on a longitudinal study of American medical students. Sointu was interested in the issue of inequality and explored this through the way in which students described ‘good’ and ‘bad’ patients. She found that ‘good’ patients were seen as actively taking part in their healthcare.

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