Literature has shown that culture does influence the coping strategies used to cope with different types of stressors. It is predictable that religion also influences the type of coping strategies used by people. Does culture and religion influence the association between coping and adjustment to chronic pain?
A recent study from our group has shown that it is possible that differences in the role of psychosocial factors and coping in particular between USA chronic pain patients and Portuguese patients might be potencially explained by cultural differences. We do suggest in our study that religion and spiritual beliefs might influence the way people cope with pain, and its association with measures of physical and psychological adjustment. Nevertheless, further examination of these hypothesis is needed, and inputs of other researchers of this field are warrant.
Coping is a important matter for the approach of any chronic diseases. In my opinion, any measure that requires deep changes in life style is very hard to be adopted. Life time Health Education is essential. In this sense, religion may be of great help.
Dear Alexandra
I read the article about your study which I found very interesting and inspiring. What I found most intriguing is that the association between belief in task persistence (or shall I say confidence in one’s own efficacy?) on the one hand and pain on the other is not the same in the States and in Portugal.
I wondered that you do not underline and explicate one question that seems rather important to me: are pain patients of the two groups in the same situation referring to insurance payments respective work relief?
Referring to your question about influence of culture or religion. For me it is much more the socio-economic status of the surveyed population that counts (and that is lived as “culture”). The mentioned result of Portuguese pain patients not improving by their ability to perform efficiently in their everyday tasks and work reminded me a previous study of Swiss social anthropologist Christian Giordano (1992. Die Betrogenen der Geschichte: Überlagerungsmentalität und Überlagerungsrationalität in mediterranen Gesellschaften. Frankfurt: Campus). The author deals with clientelism and patronage in Mediterranean societies, explaining the special relationship to state and government that seems to be typical for these “cultures”. (I am not aware how far these considerations are still valid given that socio-structural changed a lot in the Mediterrean country as consequence of their integration into the EU. Latest incidences and the crisis of national depts, economy and banks therefore rather suggest, that there is still some truth in Giordano’s findings). I would like to offer an explanation that is not far from your’s but puts a stronger emphasis on these asymmetrical relationships: Could it be that the absence of confidence in democracy and participation in the government weakens the successful performance’s influence to the state of health in the surveyed population? Another problem that goes together with this is the authoritarianism, making subjects conform to other-directed tasks and not giving likelihood of self-realization.
The client’s relationship to the patron is one of big dependence, the client has always to be aware of how he can turn the patron’s interest in the “correct” direction, a direction that turns damage away from him and his family and which presumably will serve his interest. The tendency to see relationship as asymmetrical surely plays a role in the doctor-patient relationship as well.
I ask myself if this characteristic relationship also plays a role in the second mentioned result, the different outcome of the factor “seeks help of others”. This is not entirely clear for me because I do not fully understand what is meant with this factor. I understood that you put it at the side of dysfunctional coping strategies. In the light of attachment theory and psychoanalysis meanwhile, the tendency to ask for help could be considered as positive sign of a secure attachment, or am I wrong?
Another slightly critical comment is about your study’s counting “Portuguese” and “Americans” as ethnic groups with homogenous culture, proper norms and religions. In order to understand the effect of health and illness in general, as well as pain and relief of pain in particular we cannot rely on an idea of culture like this. We have to make more precise distinctions. So, in order to include my considerations about patron-client-relationship it would have been essential to indicate the socio-economic level of the surveyed patients. Other distinctions which are crucial are urban-versus agrarian, religious sub-groups etc.
Please correct me, if I misunderstood your results, Greetings Vera
Article Associations Between Psychosocial Factors and Pain Intensity...
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