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Kadınlarda Kronik Ağrı ve Ruh Sağlığı: Toplumsal Cinsiyet Duyarlı Sağlık Hizmeti Nasıl Olmalı?

Yıl 2025, Cilt: 34 Sayı: 1, 61 - 68, 18.03.2025

Öz

Bu makalede, kadınların kronik ağrı deneyimlerinin ve bu deneyimlerin kadın ruh sağlığıyla ilişkisinin sağlık hizmetine erişim bağlamında toplumsal cinsiyet duyarlı bir biçimde değerlendirilmesi ve sağlık hizmetine erişimde karşılaşılan sorunlara yönelik toplumsal cinsiyet dönüştürücü çözüm önerilerine dair örnekler verilmesi amaçlanmaktadır. Kadınlar, kronik ağrılardan erkeklere göre daha sık etkilenmekte, daha şiddetli ağrı bildirmekte ve daha sık farklı vücut bölgelerinde eş zamanlı ağrı tariflemektedir. Ancak kadınların, ifade ettikleri ağrılar daha az ciddiye alınmakta ve bu da tedavi süreçlerinde zaman kaybına neden olmaktadır. Ağrı deneyimleyen kadınlara daha hafif ve daha az etkili tedaviler uygulanmaktadır. Kadınların kronik ağrı deneyimleri, sadece fiziksel sağlıklarını değil, aynı zamanda ruh sağlıklarını da derinden etkilemektedir. Sürekli ağrı, kadınların yaşam kalitesini olumsuz yönde etkileyerek depresyon, anksiyete ve stres gibi ruh sağlığı sorunlarına yol açabilmektedir. Dolayısıyla, kadınların kronik ağrıyla başa çıkarken aynı zamanda ruh sağlıklarına yönelik etkili destek ve tedavi stratejilerine erişimleri önemlidir. Kronik ağrıyla başa çıkma stratejileri ve tedavi edici yaklaşımlar, bireylerin güçlenmesini destekleyerek, kadınların yaşadığı zorluklarla baş etmelerine yardımcı olabilir. Sağlık hizmetlerinde toplumsal cinsiyet temelli eşitsizliklere karşı farkındalık artırılmalı, doktor-hasta ilişkilerinde adil bir tutum benimsenmeli ve tedavi süreçlerinde duyarlılık gösterilmelidir.

Kaynakça

  • Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain. 2020;161(9):1976-82.
  • Ellis B, Ly, M., Steinberger, S. Chronic pain in England: Unseen, unequal, unfair. Versus Arthritis. 2021:1-51
  • Mantyselka P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, et al. Pain as a reason to visit the doctor: A study in Finnish primary health care. Pain. 2001;89(2-3):175-80.
  • Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-7.
  • Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19-27.
  • NICE. Chronic pain (primary and secondary) in over 16s: Assessment of all chronic pain and management of chronic primary pain. 2021.
  • Reinert M, Adams T, Fritze D, Nguyen T. Early, equitable and trauma responsive care for chronic pain. Mental Health America; 2020.
  • IASP. Definitions of chronic pain syndromes. MG30 Chronic pain. [Available from: https://www.iasp-pain.org/advocacy/definitions-of-chronic-pain-syndromes/.
  • Eti Aslan F, Çınar, F. Prevalence of pain in adult population in Türkiye. Agri. 2023;35(2):83-95.
  • Paksoy Erbaydar N, Çilingiroğlu, N. Chronic pain and depression: A descriptive survey among adult primary health centre patients. Turkish Journal of Medical Sciences. 2010;40(5):707-14.
  • Public Health England. Chronic pain in adults 2017. Health Survey for England; 2020:1-41
  • Skuladottir H, Halldorsdottir S. Women in chronic pain: Sense of control and encounters with health professionals. Qual Health Res. 2008;18(7):891-901.
  • Vearrier L. A feminist perspective on gender justice in the treatment of chronic pain. Archives of Medicine. 2016;8(3):5.
  • Osborne NR, Davis KD. Sex and gender differences in pain. Int Rev Neurobiol. 2022;164:277-307.
  • Bimpong K, Thomson K, McNamara CL, Balaj M, Akhter N, Bambra C, et al. The gender pain gap: Gender inequalities in pain across 19 European countries. Scand J Public Health. 2022;50(2):287-94.
  • Jimenez-Trujillo I, Lopez-de-Andres A, Del Barrio JL, Hernandez-Barrera V, Valero-de-Bernabe M, Jimenez-Garcia R. Gender differences in the prevalence and characteristics of pain in Spain: Report from a population-based study. Pain Med. 2019;20(12):2349-59.
  • Türkiye İstatistik Kurumu (TÜİK). Türkiye Sağlık Araştırması, 2022. 2023.
  • Hill JC, Harrell, L.S. Women and chronic pain: Understanding the challenges and empowering for change. Journal of Feminist Family Therapy: An International Forum, 2020;32(3-4):243–62.
  • Pryma J. “Even my sister says I’m acting like a crazy to get a check”: Race, gender, and moral boundary-work in women’s claims of disabling chronic pain. Soc Sci Med. 2017;181:66-73.
  • Skuladottir H, Halldorsdottir S. The quest for well-being: Self-identified needs of women in chronic pain. Scand J Caring Sci. 2011;25(1):81-91.
  • Moretti C, De Luca E, D’Apice C, Artioli G, Sarli L, Bonacaro A. Gender and sex bias in prevention and clinical treatment of women’s chronic pain: Hypotheses of a curriculum development. Front Med (Lausanne). 2023;10:1189126.
  • Samulowitz A, Gremyr I, Eriksson E, Hensing G. “Brave Men” and “Emotional Women”: A theory-guided literature review on gender bias in health care and gendered norms towards patients with chronic pain. Pain Res Manag. 2018;2018:6358624.
  • APA. How endometriosis, a common, painful condirion many women face, can impact mental health 2022 [Available from: https://www.psychiatry.org/news-room/apa-blogs/how-endometriosis-can-impact-mental-health.
  • Grundstrom H, Alehagen S, Kjolhede P, Bertero C. The double-edged experience of healthcare encounters among women with endometriosis: A qualitative study. J Clin Nurs. 2018;27(1-2):205-11.
  • APA. Chronic Pain and Mental Health Often Interconnected 2020 [Available from: https://www.psychiatry.org/news-room/apa-blogs/chronic-pain-and-mental-health-interconnected#:~:text=People%20living%20with%20chronic%20pain,levels%20and%20contribute%20to%20depression.
  • Johnston KJA, Huckins LM. Chronic pain and psychiatric conditions. Complex Psychiatry. 2023;9(1-4):24-43.
  • Gambadauro P, Carli V, Hadlaczky G. Depressive symptoms among women with endometriosis: A systematic review and meta-analysis. Am J Obstet Gynecol. 2019;220(3):230-41.
  • Galvez-Sanchez CM, Duschek S, Reyes Del Paso GA. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag. 2019;12:117-27.
  • Lambert SF. Fibromyalgia in women across the lifespan: A Family feminist therapy approach. Journal of Feminist Family Therapy; An International Forum, 2020;32(3-4):227–42
  • Arman M, Gebhardt A, Hok Nordberg J, Andermo S. Women’s lived experiences of chronic pain: Faces of gendered suffering. Qual Health Res. 2020;30(5):772-82.
  • Bao Y, Sturm R, Croghan TW. A national study of the effect of chronic pain on the use of health care by depressed persons. Psychiatr Serv. 2003;54(5):693-7.
  • Werner A, Malterud K. It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors. Soc Sci Med. 2003;57(8):1409-19.
  • McCracken LM, Vowles KE. Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am Psychol. 2014;69(2):178-87.

Chronic Pain and Mental Health in Women: What Should Gender-Sensitive Healthcare Look Like?

Yıl 2025, Cilt: 34 Sayı: 1, 61 - 68, 18.03.2025

Öz

This article aims to evaluate women's experiences of chronic pain and the relationship of these experiences with women's mental health in a gender-sensitive manner within the context of healthcare access. It also aims to present gender-transformative solutions to the problems encountered in accessing healthcare. Women are more frequently affected by chronic pain compared to men, report more severe pain, and often describe simultaneous pain in different parts of their bodies. However, women face difficulties in being taken seriously regarding their pain expressions and experience delays in their treatment processes. Women experiencing pain are often provided with milder and less effective treatments. Women's chronic pain experiences deeply affect not only their physical health but also their mental health. Persistent pain negatively impacts women's quality of life, leading to mental health issues such as depression, anxiety, and stress. Therefore, it is important for women to have access to effective support and treatment strategies that address both their chronic pain and its impacts on mental health. Strategies for coping with chronic pain and therapeutic approaches that empower individuals can help women manage the challenges they face. Awareness of gender-based inequalities in healthcare should be increased, an equitable attitude should be adopted in doctor-patient relationships, and gender-sensitive treatment processes should be followed.

Kaynakça

  • Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain. 2020;161(9):1976-82.
  • Ellis B, Ly, M., Steinberger, S. Chronic pain in England: Unseen, unequal, unfair. Versus Arthritis. 2021:1-51
  • Mantyselka P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamaki H, et al. Pain as a reason to visit the doctor: A study in Finnish primary health care. Pain. 2001;89(2-3):175-80.
  • Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-7.
  • Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19-27.
  • NICE. Chronic pain (primary and secondary) in over 16s: Assessment of all chronic pain and management of chronic primary pain. 2021.
  • Reinert M, Adams T, Fritze D, Nguyen T. Early, equitable and trauma responsive care for chronic pain. Mental Health America; 2020.
  • IASP. Definitions of chronic pain syndromes. MG30 Chronic pain. [Available from: https://www.iasp-pain.org/advocacy/definitions-of-chronic-pain-syndromes/.
  • Eti Aslan F, Çınar, F. Prevalence of pain in adult population in Türkiye. Agri. 2023;35(2):83-95.
  • Paksoy Erbaydar N, Çilingiroğlu, N. Chronic pain and depression: A descriptive survey among adult primary health centre patients. Turkish Journal of Medical Sciences. 2010;40(5):707-14.
  • Public Health England. Chronic pain in adults 2017. Health Survey for England; 2020:1-41
  • Skuladottir H, Halldorsdottir S. Women in chronic pain: Sense of control and encounters with health professionals. Qual Health Res. 2008;18(7):891-901.
  • Vearrier L. A feminist perspective on gender justice in the treatment of chronic pain. Archives of Medicine. 2016;8(3):5.
  • Osborne NR, Davis KD. Sex and gender differences in pain. Int Rev Neurobiol. 2022;164:277-307.
  • Bimpong K, Thomson K, McNamara CL, Balaj M, Akhter N, Bambra C, et al. The gender pain gap: Gender inequalities in pain across 19 European countries. Scand J Public Health. 2022;50(2):287-94.
  • Jimenez-Trujillo I, Lopez-de-Andres A, Del Barrio JL, Hernandez-Barrera V, Valero-de-Bernabe M, Jimenez-Garcia R. Gender differences in the prevalence and characteristics of pain in Spain: Report from a population-based study. Pain Med. 2019;20(12):2349-59.
  • Türkiye İstatistik Kurumu (TÜİK). Türkiye Sağlık Araştırması, 2022. 2023.
  • Hill JC, Harrell, L.S. Women and chronic pain: Understanding the challenges and empowering for change. Journal of Feminist Family Therapy: An International Forum, 2020;32(3-4):243–62.
  • Pryma J. “Even my sister says I’m acting like a crazy to get a check”: Race, gender, and moral boundary-work in women’s claims of disabling chronic pain. Soc Sci Med. 2017;181:66-73.
  • Skuladottir H, Halldorsdottir S. The quest for well-being: Self-identified needs of women in chronic pain. Scand J Caring Sci. 2011;25(1):81-91.
  • Moretti C, De Luca E, D’Apice C, Artioli G, Sarli L, Bonacaro A. Gender and sex bias in prevention and clinical treatment of women’s chronic pain: Hypotheses of a curriculum development. Front Med (Lausanne). 2023;10:1189126.
  • Samulowitz A, Gremyr I, Eriksson E, Hensing G. “Brave Men” and “Emotional Women”: A theory-guided literature review on gender bias in health care and gendered norms towards patients with chronic pain. Pain Res Manag. 2018;2018:6358624.
  • APA. How endometriosis, a common, painful condirion many women face, can impact mental health 2022 [Available from: https://www.psychiatry.org/news-room/apa-blogs/how-endometriosis-can-impact-mental-health.
  • Grundstrom H, Alehagen S, Kjolhede P, Bertero C. The double-edged experience of healthcare encounters among women with endometriosis: A qualitative study. J Clin Nurs. 2018;27(1-2):205-11.
  • APA. Chronic Pain and Mental Health Often Interconnected 2020 [Available from: https://www.psychiatry.org/news-room/apa-blogs/chronic-pain-and-mental-health-interconnected#:~:text=People%20living%20with%20chronic%20pain,levels%20and%20contribute%20to%20depression.
  • Johnston KJA, Huckins LM. Chronic pain and psychiatric conditions. Complex Psychiatry. 2023;9(1-4):24-43.
  • Gambadauro P, Carli V, Hadlaczky G. Depressive symptoms among women with endometriosis: A systematic review and meta-analysis. Am J Obstet Gynecol. 2019;220(3):230-41.
  • Galvez-Sanchez CM, Duschek S, Reyes Del Paso GA. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag. 2019;12:117-27.
  • Lambert SF. Fibromyalgia in women across the lifespan: A Family feminist therapy approach. Journal of Feminist Family Therapy; An International Forum, 2020;32(3-4):227–42
  • Arman M, Gebhardt A, Hok Nordberg J, Andermo S. Women’s lived experiences of chronic pain: Faces of gendered suffering. Qual Health Res. 2020;30(5):772-82.
  • Bao Y, Sturm R, Croghan TW. A national study of the effect of chronic pain on the use of health care by depressed persons. Psychiatr Serv. 2003;54(5):693-7.
  • Werner A, Malterud K. It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors. Soc Sci Med. 2003;57(8):1409-19.
  • McCracken LM, Vowles KE. Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am Psychol. 2014;69(2):178-87.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlığın Sosyal Belirleyicileri, Sağlıkta Hakkaniyet, Birinci Basamak Sağlık Hizmetleri, Ruh Sağlığı Hizmetleri, Sağlık ve Toplum Hizmetleri
Bölüm Derleme
Yazarlar

İrem Şevik 0000-0001-6536-1665

Meltem Çiçeklioğlu 0000-0002-7059-7573

Yayımlanma Tarihi 18 Mart 2025
Gönderilme Tarihi 7 Ağustos 2024
Kabul Tarihi 17 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 34 Sayı: 1

Kaynak Göster

Vancouver Şevik İ, Çiçeklioğlu M. Kadınlarda Kronik Ağrı ve Ruh Sağlığı: Toplumsal Cinsiyet Duyarlı Sağlık Hizmeti Nasıl Olmalı?. STED. 2025;34(1):61-8.