Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 16:8:1281912.
doi: 10.3389/fsoc.2023.1281912. eCollection 2023.

Distress in the care of people with chronic low back pain: insights from an ethnographic study

Miriam Dillon  1   2 , Rebecca E Olson  1 , Stefanie Plage  1 , Maxi Miciak  3 , Peter Window  2 , Matthew Stewart  2 , Anja Christoffersen  4 , Simon Kilner  5 , Natalie Barthel  6 , Jenny Setchell  7   8
Affiliations

Distress in the care of people with chronic low back pain: insights from an ethnographic study

Miriam Dillon et al. Front Sociol. .

Abstract

Introduction: Distress is part of the experiences and care for people with chronic low back pain. However, distress is often pathologised and individualised; it is seen as a problem within the individual in pain and something to be downplayed, avoided, or fixed. To that end, we situate distress as a normal everyday relational experience circulating, affecting, moving in, through, and across bodies. Challenging practices that may amplify distress, we draw on the theorisation of affect as a relational assemblage to analyse physiotherapy clinical encounters in the care of people with chronic low back pain.

Methods: Adopting a critical reflexive ethnographic approach, we analyse data from a qualitative project involving 15 ethnographic observations of patient-physiotherapist interactions and 6 collaborative dialogues between researchers and physiotherapists. We foreground conceptualisations of distress- and what they make (im)possible-to trace embodied assemblage formations and relationality when caring for people with chronic low back pain.

Results: Our findings indicate that conceptualisation matters to the clinical entanglement, particularly how distress is recognised and navigated. Our study highlights how distress is both a lived experience and an affective relation-that both the physiotherapist and people with chronic low back pain experience distress and can be affected by and affect each other within clinical encounters.

Discussion: Situated at the intersection of health sociology, sociology of emotions, and physiotherapy, our study offers a worked example of applying an affective assemblage theoretical framework to understanding emotionally imbued clinical interactions. Viewing physiotherapy care through an affective assemblage lens allows for recognising that life, pain, and distress are emerging, always in flux. Such an approach recognises that clinicians and patients experience distress; they are affected by and affect each other. It demands a more humanistic approach to care and helps move towards reconnecting the inseparable in clinical practice-emotion and reason, body and mind, carer and cared for.

Keywords: affective assemblage; chronic pain; distress; health sociology; low back pain; physiotherapy; sociology of emotions.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer GR declared a past co-authorship with the author MM to the handling editor. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision

References

    1. Ahlsen B., Ottesen A., Askheim C. (2020). Care in physiotherapy - a ghost story. Mobilizing knowledge in physiotherapy critical reflections on foundations and practices.
    1. Ahmed S. (2014). The cultural politics of emotion. 2nd Edn. Edinburgh University Press.
    1. Alodaibi F., Beneciuk J., Holmes R., Kareha S., Hayes D., Fritz J. (2021). The relationship of the therapeutic alliance to patient characteristics and functional outcome during an episode of physical therapy care for patients with low back pain: an observational study. Phys. Ther. 101:1. doi: 10.1093/ptj/pzab026, PMID: - DOI - PubMed
    1. Ashton-James C. E., McNeilage A. G., Avery N. S., Robson L. H. E., Costa D. (2021). Prevalence and predictors of burnout symptoms in multidisciplinary pain clinics: a mixed-methods study. Pain 162, 503–513. doi: 10.1097/j.pain.0000000000002042, PMID: - DOI - PubMed
    1. AVCC (2018). National Statement on ethical conduct in human research. In N. H. a. M. R. Council (Ed.). pp. 116.

LinkOut - more resources