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Accepted Paper:

The self management of chronic musculoskeletal pain in a Bengali community: the pain program paradox  
Paula Bronson (UCL)

Paper short abstract:

Interviews with participants from groups that teach strategies for living with chronic pain were analyzed using a narrative phenomenological lens. Insights gained from experiences within the patient-centered approach groups were used to understand the place of such programs within biomedical discourse.

Paper long abstract:

According to the National Pain Audit compiled by the British Pain Society (BPS) from 2010 through 2012, 7.8 million in the UK suffer with chronic pain (BPS 2012). This qualitative study was conducted to better understand the role of self -management in BPS guideline recommended group chronic pain programs as delivered within a Bengali community in East London. Drawing on Mattingly's (2010) notion of the paradox of hope as practice created by families with chronically ill children, I place the experience of living with chronic pain and the cultivation of self management concepts within biomedical discourse in the Bengali pain management program as a comparable paradox. I argue that in a similar manner, participants in the program seek medical attention to remove or reduce their pain. However, in contrast to their expectations they may be told that the pain cannot be further pharmacologically or surgically managed entirely and they can then learn to self manage, often with evidence based medical guidelines not particular to their community and experience. Therefore, the lived experience of illness and healing as transformative is paradoxical to the chronic pain patient. The understanding of concepts of self-efficacy, acceptance, and empowerment that are promoted in the programs may not be readily accessible and understood. Rather , day-to-day life is an unavoidable need to escape pain rather than transform as encouraged in the program. Further questions are posed for patient centered care and how this Bengali community may begin to construct meaning towards healing.

Panel P038
The self-management of chronic disease: critical perspectives [MAN]
  Session 1