Stories from doctors of patients with pain. A qualitative research on the physicians' perspective.
OBJECTIVE
The aim of this study was to explore the physicians' internal representation of the doctor-patient relationship in the dramatic field of the patient with pain.


METHODS
Using an open narrative format, 151 physicians were asked to "Tell us about an episode during your professional experience in which you found yourself in difficulty whilst confronting a patient who was in pain". The narrations were examined in accordance with a clinical-interpretive method.


RESULTS
Three "perspectives of observation" were identified, namely: the biological perspective, the professional perspective, and the personal perspective. The biological perspective is about the biological model and the "depersonalization" of pain. In the professional perspective, the narrative concerns the patient as a "person" and the reattribution of the pain to the suffering person. The personal perspective is about the emotional-relational explosion within the meeting between the doctor as human being and the patient as human being. Most of the narrations did not strictly connect to one or another of the perspectives, but each story seemed a journey without peace back and forth among the perspectives.


CONCLUSIONS
The professional perspective seemed to be the only place in which physicians could "stop", a space not extreme in which they seemed to express the need for education about the management of the professional relationship with the other person.
Chair Department of Medical Psychology, School of Medicine, University of Milan, Milan, Italy.
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D003142:Communication; D006801:Humans; D033262:Narration; D010146:Pain; D010817:Physician-Patient Relations; D036301:Qualitative Research