title: [Patient careers in the orthopedic pain treatment. Sociological studies on pain behavior].
abstract: BACKGROUND
  Based on case histories the following study raises the question why some pain patients remain permanently on the path of specialist pain treatment after initial treatment whereas other patients with similar pain reports do not.
  
  
  METHODS
  In this study 134 qualitative interviews were conducted in order to research patient career paths. The study population included patients with back pain recruited from different orthopedic care settings and included persons with back pain from a general population not involved in specialized pain treatment.
  
  
  RESULTS
  Patient career paths within medical care settings are effective in socializing and transforming the subjects. In the course of medical treatment patients learn their rights and obligations and subsequently acquire habits of typical pain behavior both in medical and domestic arrangements. Patients learn to formulate and preserve their interests and learn to align the different expectations which results in increasing identification with the career path.
  
  
  CONCLUSIONS
  Conceptions of pain and pain behavior are formed in the course of patient careers while this is not necessarily a conscious or reflected process. As an unintended consequence it evolves into pain acting within the patient that integrates patients into distinct care milieus and holds them tight in the respective pain care. In these cases pain patients and their doctors fall so to say into a pain trap.
authors.affiliation: Fachbereich Humanwissenschaften, Universität Kassel, Arnold-Bode-Straße 10, 34109, Kassel, Deutschland, gg@uni-kassel.de.
authors.forename: G
authors.initials: G
authors.lastname: Göckenjan
authors.forename: S
authors.initials: S
authors.lastname: Dreßke
authors.forename: O
authors.initials: O
authors.lastname: Pfankuch
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000523:psychology* / Q000628:therapy*; D003299:Cooperative Behavior; D004185:Disability Evaluation; D006801:Humans; D033183:Interdisciplinary Communication; D007405:Intervertebral Disc Displacement / Q000523:psychology / Q000601:surgery; D008297:Male; D008306:Malingering / Q000523:psychology; D019637:Orthopedic Procedures / Q000523:psychology*; D059408:Pain Management / Q000379:methods* / Q000523:psychology*; D010147:Pain Measurement / Q000523:psychology; D010149:Postoperative Pain / Q000523:psychology / Q000628:therapy; D036301:Qualitative Research; D012017:Referral and Consultation; D012803:Sick Role
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