An evolving theory on “women's sense of control while in chronic pain and the results of the quality of their encounters with health professionals” is introduced in this article. According to the theory, the main challenge of women in chronic pain is to maintain a sense of control of self and the pain to avoid demoralization, which is seen as a potential threat for all women in chronic pain. To retain a sense of control, women are challenged to learn to live with the pain and cope with the unpredictability and incurability of the pain. They are challenged to find meaning in their suffering, to create personal space, and to be self-protective as well as to keep a positive self-image and self-esteem while trying to live a “normal” life in dignity in spite of the pain and warding off isolation and demoralization. Health professionals are seen as potentially powerful people in the lives of women in chronic pain. Empowerment or disempowerment from them greatly influences whether women in chronic pain are demoralized or not.
Andersson, H.I. (1994). The epidemiology of chronic pain in a Swedish rural area. Quality of Life Research, 3(1), 19-26.
2.
Åsbring, P., & Närvänen, A.L. (2002). Women's experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia. Qualitative Health Research, 12, 148-160.
3.
Battenfield, B.L. (1984). Suffering-A conceptual description and content analysis of an operational schema. Image: The Journal of Nursing Scholarship, 16(2), 36-41.
4.
Belenky, M., Clinchy, B., Goldberger, N., & Tarule, J. (1996). Women's ways of knowing: The development of self, voice, and mind (10-year anniversary ed.). New York: Basic Books.
5.
Blyth, F.M., March, L.M., Brnabic, A.J., Jorm, L.R., Williamson, M., & Cousins, M.J. (2001). Chronic pain in Australia: A prevalence study . Pain, 89, 127-134.
6.
Bradley, L.A., & Alarcón, G.S. (2000). Sex-related influences in fibromyalgia. In R. B. Fillingim (Ed.), Sex, gender and pain (pp. 281-308). Seattle, WA: IASP Press.
7.
Butt, F.S., & Chesla, C. (2007). Relational patterns of couples living with chronic pelvic pain from endometriosis. Qualitative Health Research , 17, 571-585.
8.
Dionne, C.E. (1999). Low back pain. In I. K. Crombie, P. R. Croft, S. J. Linton, L. LeResche , & M. Von Korff (Eds.), Epidemiology of pain (pp. 283-297). Seattle, WA: IASP Press.
9.
Dysvik, E., Lindstrom, T.C., Eikeland, O.-J., & Natvig, G.K. (2004). Health-related quality of life and pain beliefs among people suffering from chronic pain. Pain Management Nursing, 5(2), 66-74.
10.
Elliott, A.M., Smith, B.H., Penny, K.I., Smith, W.C., & Chambers, W.A. (1999). The epidemiology of chronic pain in the community. Lancet, 354, 1248-1252.
Evans, P., Hucklebridge, F., & Clow, A. (2000). Mind, immunity and health: The science of psychoneuroimmunology . London: Free Association Books .
13.
Frank, A.W. (2000). The standpoint of storyteller. Qualitative Health Research, 10, 354-365.
14.
Gilligan, C. (1978). The reproduction of mothering. Berkeley: University of California Press.
15.
Gilligan, C. (1982). In a different voice: Women's conceptions of self and morality. Harvard Educational Review, 47(4), 481-517.
16.
Gilligan, C. (1993). In a different voice: Psychological theory and women's development. Cambridge, MA: Harvard University Press.
17.
Halldorsdottir, S. (1996). Caring and uncaring encounters in nursing and health care: Developing a theory (Linköping University Medical Dissertations No. 493). Unpublished doctoral dissertation, Department of Caring Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
18.
Halldorsdottir, S. (1999). Suffering-reflection-caring. International Journal for Human Caring, 3(2), 15-20.
19.
Halldorsdottir, S. (2000). Feeling empowered: A phenomenological case study of the lived experience of health. In B. Fridlund & C. Hildingh (Eds.), Qualitative methods in the service of health (pp. 82-96). Lund , Sweden: Studentlitteratur.
20.
Hamberg, K. (1998). Begränsade möjligheter-anpassade strategier. En studie i primärvården av kvinnor med värk [Limited opportunities-adjusted strategies. A study from primary care of women with pain]. Unpublished doctoral dissertation, University of Umeå, Umeå, Sweden.
21.
Hamberg, K., Johansson, E.E., Lindgren, G., & Westman, G. (1997). The impact of marital relationship on the rehabilitation process in a group of women with long-term musculoskeletal disorders. Scandinavian Journal of Social Medicine, 25(1), 17-25.
22.
Jensen, A.L., & Harder, I. (2004). The osteoporotic pain experience. Osteoporosis International, 15(3), 204-208.
23.
Johansson, E. (1998). Beyond frustration: Understanding women with undefined musculoskeletal pain who consult primary care. Unpublished doctoral dissertation , University of Umeå, Umeå, Sweden.
24.
Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.
25.
LeResche, L. (2000). Epidemiologic perspective on sex differences in pain. In R. B. Fillingim (Ed.), Sex, gender and pain: Progress in pain research and management (pp. 233-249). Seattle, WA: IASP Press.
26.
Malterud, K. (1998). Understanding women in pain. New pathways suggested by Umea researchers: Qualitative research and feminist perspectives. Scandinavian Journal of Primary Health Care, 16, 195-198.
27.
McCaffery, M., & Pasero, C. (1999). Pain: Clinical manual (2nd ed.). St. Louis, MO: Mosby.
28.
McCracken, L.M., & Eccleston, C. (2003). Coping or acceptance: What to do about chronic pain. Pain, 105, 197-204.
29.
Meleis, A.I. (2006). Theoretical nursing: Development and progress (4th ed.). Philadelphia: Lippincott, Williams & Wilkins.
30.
Morse, J.M. (2002). Qualitative health research: Challenges for the 21st century. Qualitative Health Research, 12, 116-129.
31.
Morse, J.M., Bottorff, J., Neander, W., & Solberg, S. (1991). Comparative analysis of conceptualizations and theories of caring. IMAGE: The Journal of Nursing Scholarship , 23(2), 119-126.
32.
Robinson, M.E., Riley J. L., & Myers, C.D. (2000). Psychosocial contributions to sex-related differences in pain responses. In R. B. Fillingim (Ed.), Sex, gender and pain: Progress in pain research and management (pp. 41-67). Seattle, WA: IASP Press.
33.
Rousseau, M.A. (2004). Pain at midlife. Journal of Midwifery & Women's Health, 49(6), 529-538.
34.
Rustoen, T., Kopstad Wahl, A., Rokne Hanestad, B., Lerdal, A., Paul, S., & Miaskowski, C. (2004). Gender differences in chronic pain: Findings from a population-based study of Norwegian adults. Pain Management Nursing, 5(3), 105-117.
35.
Skuladottir, H. (2000). Trying to live a "normal" life despite the pain: Women's lived experience of coping with chronic non-malignant pain. Unpublished master's thesis, University of Akureyri/The Royal College of Nursing Institute of Higher Learning, Akureyri , Iceland.
36.
Smith, A.A. (2003). Intimacy and family relationships of women with chronic pain. Pain Management Nursing, 4(3), 134-142.
37.
Smith, B.H., Elliott, A.M., Chambers, W.A., Smith, W.C., Hannaford, P.C., & Penny, K. (2001). The impact of chronic pain in the community. Family Practice, 18(3), 292-299.
38.
Söderberg, S., Lundman, B., & Norberg, A. (1999). Struggling for dignity: The meaning of women's experiences of living with fibromyalgia. Qualitative Health Research, 9, 575-587.
39.
Stones, R.W. (2000). Female genital pain. In R. B. Fillingim (Ed.), Sex, gender and pain: Progress in pain research and management (pp. 355-369). Seattle, WA: IASP Press.
40.
Thorne, S., Paterson, B., Acorn, S., Canam, C., Joachim, G., & Jillings, C. (2002). Chronic illness experience: Insights from a metastudy . Qualitative Health Research, 12, 437-452.
41.
Thorne, S., Paterson, B., & Russell, C. (2003). The structure of everyday self-care decision making in chronic illness. Qualitative Health Research, 13, 1337-1352.
42.
Toombs, K. (1993). The meaning of illness: A phenomenological account of the different perspectives of physician and patient. Dordrecht, the Netherlands: Kluwer Academic.
43.
Turk, D.C., & Okifuji, A. (1998). Treatment of chronic pain patients: Clinical outcomes, cost-effectiveness, and cost-benefits of multidisciplinary pain centers. Critical Reviews in Physical and Rehabilitation Medicine, 10, 181-208.
44.
Van DenKerkhof, E.G., Hopman, W.M., Towhead, T.E., Anastassiades, T.P., & Goldstein, D.H. (2003). The impact of sampling and measurement on the prevalence of self-reported pain in Canada. Pain Research and Management, 8(3), 157-163.
45.
Van Rood, Y.R. (1992). Stress induced changes in immune function in humans. Unpublished doctoral dissertation. UtrectState University , Utrect, Holland.
46.
Walker, L.O., & Avant, K.C. (2005). Strategies for theory construction in nursing (4th ed.). Indianapolis, IN : Prentice Hall.
47.
Wallerstein, N., & Bernstein, E. (1988). Empowerment education: Freire's ideas adapted to health education. Health Education Quarterly, 14(4), 379-394.
48.
Werner, A., & Malterud, K. (2003). It is hard work behaving as a credible patient: Encounters between women with chronic pain and their doctors. Social Science and Medicine, 57(8), 1409-1419.
49.
Werner, A., Steihaug, S., & Malterud, K. (2003). Encountering the continuing challenges for women with chronic pain: Recovery through recognition. Qualitative Health Research, 13, 491-509.
50.
Werner, A., Widding Isaksen, L.W., & Malterud, K. (2004). "I am not the kind of woman who complains of everything": Illness stories on self and shame in women with chronic pain. Social Science & Medicine, 59(5), 1035-1045.
51.
World Health Organization. (2001). Strategic action plan for the health of women in Europe. Copenhagen, Denmark: Author. Available from http://www.euro.who.int
52.
Zola, I.K. (1992). The social construct of suffering. In P. L. Starck & J. P. McGovern (Eds.), The hidden dimension of illness: Human suffering (pp. 11-23). New York: National League for Nursing.
