This explorative study examined the influence of chronic lower back pain on the motives for occupational performance. A narrative interview was conducted with seven Dutch clients. Three phases in the process of living with lower back pain were identified in which the self, the pain, and the environment were seen as interrelated elements that influence the creation of motives. In the first phase, clients wanted to meet social and personal expectations, which led to their ignoring the lower back pain. In the second phase, the pain took control and the clients withdrew from social participation, which led to “emotional pain.” In the third phase, clients became more conscious of the dynamics and dilemmas between the self, the pain, and the environment. Analysis of study results suggests that clients' narratives can help occupational therapists gain a deeper understanding of clients' experiences of dealing with chronic pain.
AnderssonG. B. J. (1997). The epidemiology of spinal disorders. In FrymorerJ. W. (Ed.), The adult spine: Principles and practice (2nd ed., pp. 93–141). Philadelphia: Lippincott-Raven Publishers.
2.
BogdanR. C.BiklenS. K. (1998). Qualitative research for education: An introduction to theory and methods (3rd ed.). Boston: Allyn and Bacon.
3.
ClarkF.CarlsonM.PolkinghorneD. (1997). The legitimacy of life history and narrative approaches in the study of occupation. American Journal of Occupational Therapy, 51, 313–317.
4.
DePoyE.GitlinL. N. (1998). Introduction to research: Understanding and applying multiple strategies. St. Louis, MO: Mosby.
5.
DeversK. J. (1999). How will we know “good” qualitative research when we see it? Beginning the dialogue in health services research. Health Services Research, 34, 1153–1188.
6.
GamsaA. (1990). Is emotional disturbance a precipitator or a consequence of chronic pain?Pain, 42, 183–195.
7.
GoossensM. E. J. B.van TulderM. W. (2000). Epidemiologie van rugklachten [Epidemiology of backpain]. In VlaeyenJ. W. S.HeutsP. H. T. G.Gedragsgeorienteerde behandel-ingsstrategieën bij rugpijn [Behavioral strategies for backpain] (pp. 1–14). Houten, the Netherlands: Bohn Stafleu Van Loghum.
8.
HelfrichC.KielhofnerG.MattinglyC. (1994). Volition as narrative: Understanding motivation in chronic illness. American Journal of Occupational Therapy, 48, 311–317.
9.
HendrikssonC. (1995). Living with fibromyalgia: A study on the consequences for daily activities. Linkoping, Sweden: Linkoping University.
10.
HonkasaloM. L. (2001). Vicissitudes of pain and suffering: Chronic pain and liminality. Medical Anthropology, 19, 319–353.
11.
JonssonH. (2000). Anticipating, experiencing and valuing the transition from worker to retiree: A longitudinal study of retirement as an occupational transition. Unpublished dissertation, Karolinska Institutet, Stockholm, Sweden.
12.
KielhofnerG. (1997). Conceptual foundations of occupational therapy (2nd ed.). Philadelphia: F. A. Davis Company.
13.
KleinmanA. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books Inc.
14.
KvaleS. (1996). InterViews: An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage Publications.
15.
LarsonE. A.FanchiangS. P. C. (1996). Life history and narrative research: Generating a humanistic knowledge base for occupational therapy. American Journal of Occupational Therapy, 50, 247–250.
16.
LintonS. J. (1985). The relationship between activity and chronic back pain. Pain, 21, 289–294.
17.
LintonS. J. (1998). The socioeconomic impact of chronic back pain: Is anyone benefiting?Pain, 75, 163–168.
18.
MelzackR.WallP. D. (1982). The challenge of pain. Harmondsworth, England: Penguin Books.
19.
MerskeyH. (1986). Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms. Pain, 24, 1–211.
20.
OsterweisM.KleinmanA.MechanicD. (1987). Pain and disability: Clinical, behavioral, and public policy perspectives. Washington, DC: National Academy Press.
21.
PeolssonM.HydenL. C.LarsonSatterlund U. (2000). Living with chronic pain: A dynamic learning process. Scandinavian Journal of Occupational Therapy, 7, 114–125.
22.
PolkinghorneD. E. (1995). Narrative configuration in qualitative analysis. Qualitative Studies in Education, 8, 5–23.
23.
PolkinghorneD. E. (1996). Transformative narratives: From victimic to agentic plots. American Journal of Occupational Therapy, 50, 299–305.
SchepersR. M. J.NievaardA. C. (1997). Ziekte en zorg: Inleiding in de medische sociologie [Disease and care: Introduction in medical sociology]. Houten, the Netherlands: Educatieve Partners Nederland B.V.
26.
SchkadeJ. K.SchultzS. (1992). Occupational adaptation: Toward a holistic approach for contemporary practice, Part 1. American Journal of Occupational Therapy, 46, 829–837.
27.
ShorterE. (1992). From paralysis to fatigue: A history of psychosomatic illness in the modern era. New York: Free Press.
28.
StrongJ. (1996). Chronic pain: The occupational therapist's perspective. New York: Churchill Livingstone.
29.
StrongJ.AshtonR.ChantD.CramondT. (1994). An investigation of the dimensions of chronic low back pain: The patients' perspectives. British Journal of Occupational Therapy, 57, 204–208.
30.
van TulderM. W.KoesB. W.BouterL. M. (1995). A cost-of-illness study of back pain in the Netherlands. Pain, 62, 233–240.
31.
VlaeyenJ. W. S.HeutsP. H. T. S.van AkkerveekenP. E. (1998). Rugpijn [Back pain]. In PasschierJ.TrijsburgR. W.de WitR.Eerdmans-DubbeltS. L. C. (Eds.), Psychologie van onbegrepen chronische pijn [Psychology of uncomprehended pain] (pp. 148–166). Assen, the Netherlands: van Gorcum.
32.
WaddellG. (1998). The back pain revolution. Edinburgh, Scotland: Churchill Livingstone.
33.
WilcockA. A. (1998). An occupational perspective of health. Thorofare, NJ: SLACK Incorporated.
