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The meaning and consequences of amputation and mastectomy from the perspective of pain and suffering

Overview of attention for article published in Scandinavian Journal of Pain, January 2017
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Title
The meaning and consequences of amputation and mastectomy from the perspective of pain and suffering
Published in
Scandinavian Journal of Pain, January 2017
DOI 10.1016/j.sjpain.2016.09.012
Pubmed ID
Authors

Berit Björkman, Iréne Lund, Staffan Arnér, Lars-Christer Hydén

Abstract

The concepts 'pain' and 'suffering' are frequently treated as synonymous. However, they are clearly distinct phenomena. Phantom phenomena including pain and sensory disturbances are still recognized as long-lasting problems after limb amputation and after mastectomy. The complex nature of phantom phenomena makes the interpretation of its results ambiguous, regarding the prevalence of pain, sensory disturbances and the accompanying suffering. There is clinical experience that suffering is a great burden for the individual but there is a lack of systematic studies of patients' own evaluations of the suffering caused by their phantom phenomena. The overall aim of this study was to identify and describe patients' suffering related to, and as a part, of their post-amputation situation. The present study constitutes a part of a prospective, two-year follow up project investigating interviews of 28 men and women in different ages and who have undergone a limb amputation or mastectomy. The reason for amputation or mastectomy varied among the patients and included vascular diseases, cancer (sarcoma and breast-cancer) and trauma. Our ambition was to extract as much variations as possible in different, individualized aspects of the actual pain and suffering producing situation. The participants were, here, invited to open-ended, narrative-oriented interviews one month after the surgery. The interviews were transcribed verbatim and analyzed within qualitative methodology: thematic content analysis. Twenty-two of 28 interviewees experienced phantom pain and phantom sensations. The two surgical processes amputation and mastectomy meant for a majority of the interviewees a critical event with threatening consequences for everyday life such as loss of function and personal integrity. Nine interviewees felt even stigmatized as a result of their lost body part. Numerous inter-related factors following the amputation/mastectomy, which can inflict severe suffering on the amputee, were uncovered. The context in which the interviewees were informed about the decision to amputate proved to be one such critical and important factor. To understand potential suffering in relation to phantom phenomena, it will never be enough merely to have knowledge of the underlying physiological or neurological mechanisms and/or the intensity of phantom pain and phantom sensations. Rather, it is necessary to find out how the loss of the body part and its everyday consequences are experienced by patients. It is important to create time for real dialogue with the patients both during pre-operative preparation and post-operative rehabilitation in order to clarify and verbalize elements that constitute the patients individual suffering. Hopefully this strategy can alleviate future chronic pain problems, severe psycho-social distress and suffering. Such an approach ought to have impact also for perceived suffering after other types of surgery or different invasive treatments.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 115 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 115 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 25 22%
Student > Master 13 11%
Student > Ph. D. Student 10 9%
Student > Doctoral Student 7 6%
Student > Postgraduate 6 5%
Other 21 18%
Unknown 33 29%
Readers by discipline Count As %
Nursing and Health Professions 27 23%
Medicine and Dentistry 16 14%
Psychology 14 12%
Unspecified 3 3%
Social Sciences 3 3%
Other 14 12%
Unknown 38 33%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 June 2023.
All research outputs
#16,721,717
of 25,374,647 outputs
Outputs from Scandinavian Journal of Pain
#387
of 652 outputs
Outputs of similar age
#255,077
of 421,653 outputs
Outputs of similar age from Scandinavian Journal of Pain
#7
of 13 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 652 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.1. This one is in the 37th percentile – i.e., 37% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 421,653 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 36th percentile – i.e., 36% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.