Being believed and believing in : the impact of delegitimation on person centred care for people with chronic back pain

Howarth, ML

Abstract

Chronic back pain is an under researched area; the complexities of unseen pain in
particular, present challenges to the sociological assumptions made about the concept
of 'sickness'. The lack of Visible' signs and symptoms means that some people are left
without a diagnosis. If left undiagnosed, their experience of chronic back pain becomes
delegitimized and could result in the erosion of self-esteem, self-identity and
personhood. Undiagnosed chronic back pain can undermine a person's moral self
through disrupting the person's biography and self -esteem. Ultimately, people with
chronic back pain need person centred approaches to care that support the restoration
of the self. The aims of this study were to generate a theory of person-centred care
predicated on the experiences of people who have chronic back pain. The research
design was influenced by a constructivist paradigm, which underpinned a Grounded
Theory methodological approach. A purposive sampling strategy identified 17 people
with chronic back pain and 4 multi-professional teams who were involved in their care.
Semi-structured interviews with people who have chronic back pain, and the multiprofessional
teams captured the experience of person-centred care and explicated
meaning about its key concepts. Data were analysed using a constant comparative
approach through which theoretical sensitivity developed and eleven categories
emerged. The 'conditional partnership' became a core category, which formed a
substantive theory to explain the experience of person-centred care. The key findings
highlight the significance of legitimation on the chronic back pain experience and
exposes the impact that 'delegitimation' has on the individual's ability to mobilise
resources and manage their pain effectively. This thesis presents the conditional
partnership as a theory which explains the relationship needed to support person
centred care. The theory suggests that person centred care for people with chronic back
pain is underpinned by a conditional partnership which is made up of three conditions;
being believed, believing in and non-maleficence which represent the expected
conditions of health care and by health care.

Citation

Howarth, M. Being believed and believing in : the impact of delegitimation on person centred care for people with chronic back pain. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Jul 30, 2021
• Award Date: Feb 1, 2012