There seems to be higher prevalence of ‘’chronic pain with no organic cause’’ in the Turkish speaking middle –aged women in our practice and this is also experienced in the other practices of the City and Hackney clinical commissioning group. Currently most of the GPs refer these women to pain and functionality clinics which recognize the psychological aspect of the pain but falls behind in improving the outcome. This is my very personal opinion based on my observations with my current patients.
I would like to study this group of women by interviewing to collect data about their understanding of the condition and try to elaborate on the shortcomings of the interventions tried. This might be collaborated with the clinic notes and referral letters from pain and function clinics to extend the scope of this analysis to contrast patients unmatched needs to the practitioner’s.
I would interview the women of 18-65 ( a wide range with no rational ) who has been seen more than 3 times by their practitioners in the last year with chronic generalized pain of no serious cause found. I would telephone them to invite directly or send them letters about the study after discussing with their usual doctors.
The questions would be( very much of freely thrown questions at the moment):
-Simple demographics: Ethnicity( Kurdish, Turkish, Cypriot, Bulgarian etc), age, marital status, social status ( employment, network of the relatives, friends, neighbours; English level; general income)
-What is their experience of pain? –this would be very much an open question.
-What do other people think about your pain?
-How much do you believe you are ‘’listened’’ by the health practitioners and your family or friends?
-When did the pain start? Can you remember any social events around the time you have started experiencing pain? How much do you think it effected teh onset of your pain?
-How much does the pain affect your life? What does it permit and what does it prevent you doing now?
-How much does your condition affect your family?
-How much do you think it will affect your future? Is there anything you planned to achieve before and now you feel you are not capable of?
-What do you expect from your doctor and friends/ family?
-What has been tried to help you so far and what is missing in your opinion?
(I think it is very difficult to focus on one aspect of the problem and narrowing the questions down. As GPs our main worry is if we are missing a physical pathology. We then change our focus to psychosocial perspective when the investigations or our knowledge of differentials dry up. What is next in the route of managing these people ? )
