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Department of HEALTH CARE SCIENCES Campus Ersta
Main Areas of Research Interest - Psychosomatic theory from a philosophical perspective - Merleau-Ponty’s phenomenology, especially "the lived body" - Existential aspects of care and rehabilitation of persons with chronic pain - The aging body and identity My research is concerned mainly with issues surrounding the theoretical understanding of psychosomatic conditions (mind – body problem) and how the care, treatment and rehabilitation of patients with complicated psychosomatic symptoms and diseases can be improved. My doctoral dissertation from 1999 (published as well in book form) is a systematized philosophical analysis of psychosomatic theories, including a presentation of my own alternative phenomenological theory of psychosomatics inspired by the work of the French phenomenologist Maurice Merleau-Ponty. On-going projects 1. PROJEKTTITEL: Interview study of women with persistent pregnancy – related pelvic girdle pain. Project leader: Annelie Gutke, Med Dr. Linköpings universitet Collaborators: Marie Lundberg , Med Dr. Yrkesortopeden Sahlgrenska Jennifer Bullington, Professor, Ersta Sköndal högskola Back pain is more common in women than in men and 10-20% report debut during pregnancy. Back problems that start during pregnancy are more often of pelvic joint character than coming from the lumbar spine region. In a pregnant population, 2/3 of women with lumbopelvic pain have PGP. Several authors argue for the importance of different treatment strategies for PGP and pain from the lumbar region. It is therefore of great importance to classify lumbopelvic pain patients into subgroups and study the different subgroups. Studies with long-term follow up of PGP are missing and the natural course is therefore unknown. Lumbopelvic pain is often looked upon as a normal consequence of pregnancy that the woman must endure. However, a third of all pregnant women report lumbopelvic pain as a severe problem which interferes with most activities of daily life and compromises their ability to work. For women having persistent lumbopelvic pain after pregnancy, there is a high risk of persistent pain for years with difficulty of going back to work. So far, the research within this field has been viewed from a strict biomedical perspective. Even if complexity of the problem is acknowledged, the influence of psychosocial factors on the course and prognosis of PGP is little investigated. The aim of this study is to explore how women with persistent pregnancy-related pelvic girdle pain experience living with pain through a long-term follow-up of a cohort of women 6-8 years after pregnancy will be undertaken in city Y. All pregnant women during 2 years (86% of all pregnant women in the year of 2001 and 2002 in the community) participated in a previous cohort study. The women of the cohort will answer a questionnaire. Women with any form of lumbopelvic pain will be clinically evaluated. The women who accept participation in the long term follow-up will be asked about participation in the interviews. 2. PROJECT TITEL: Skelelton anchored prosthesis – Importence and cost. (ALF research grant) Projektledare: Professor Björn Rydevik, Sahlgrenska universitetssjukhus Medarbetare: Kerstin Hagberg, Med Dr. Sahlgrenska Universitetssjukhus Marie Lundberg, Med Dr. Yrkesortopeden, Sahlgrenska Jennifer Bullington, Professor, Ersta Sköndal högskola Amputation of an arm or a leg because of trauma, tumor or any other reason usually afflicts younger people who can then expect a long life with a marked physical handicap. Conventional prostheses are casing prostheses. This means a lifelong contact with an orthopedic clinic for adjustment. After years of use the stump is often worn down from the casing, which can make it difficult to fit the prosthesis. One may also develop back problems as well as problems with other joints. Sometimes one needs operative revisions in order to continue with the casing prosthesis, but in some cases it can become impossible to use the prosthesis. During the last 15 years skeleton anchored prostheses have become a realistic alternative to traditional casing prostheses for people with amputation of other causes than reduced peripheral circulation. Treatment has been developed through a joint effort between Sahlgrenska University hospital (SU) and Sahlgrenska Academy, building on the osseointegration method introduced for teeth implants during the 1960’s of Professor P-I Brånemark. Since 1999 this treatment has been given at the Center for Orthopedic Osseointegration (COO) and Orthopedics SU. COO has world leading experience with skeleton anchored prostheses with approximately 130 treated patients. Since 1999 there is a prospective, non-randomized study (Osseointegrated Prostheses for the Rehabilitation of Amputees) with the aim of evaluating the treatment with OI-prostheses for thigh bone amputation generally and specifically HRQL at the 2 year follow-up with regards to higher rate of prosthesis use, better function and less problems. Studies using standardized questionnaires give a limited knowledge as to the importance of the treatment for the patient. We have no studies to date which investigate the costs involved comparing OI- prosthesis with traditional casing prosthesis. Thus, there are no cost-benefit analyses performed on the improved health of these two prostheses. The overall aim of the qualitative study is to investigate at a deeper level what the OI-prosthesis means to the patient and to compare costs comparing OI-prostheses with traditional prostheses. Ten to fifteen patients are strategically selected to be interviewed, in order to cover the phenomenon “living with OI- prosthesis”. Participants are recruited from the orthopedic clinic att SU, where all patients have been given OI- prostheses. Qualitative deep interviews are performed, tape-recorded and analyzed using a phenomenological method of analysis. Interviews are performed by Med. Dr. Mari Lundberg, who has not had previous contact with these particular patients. The analysis is performed by Marie Lundberg and Associate Professor Jennifer Bullington, in collaboration with Med. Dr. Kerstin Hagberg. Some Recent Publications Bullington, J., Nordemar, K., Nordemar, K., Sjöström-Flanagan, C. (2004) Meaning out of Chaos: a way to understand chronic pain, Neuropathic Pain Review Series, Issue 2 (2004) pp. 22-23. Bullington, J., Sjöström-Flanagan, C., Nordemar, K., Nordemar, K., (2005) From pain through chaos towards new meaning: two case studies, The Arts in Psychotherapy, 32/14, pp. 261-274. Lundberg M, Styf J, Bullington J. (2007). Experiences of moving with persistent pain - A qualitative study from a patient perspective. Physiother Theory Pract. 2007 Jul; 23(4):199-209. Bullington, J. (2009) Embodiment and chronic pain: implications for rehabilitation practice, Health Care Analysis, published on-line 29 january, 2009. DOI 10.10728-008-0109-5. Bullington, J. (2009) Being body: the dignity of human embodiment, I Lennart Nordenfelt (red.) Dignity in Care for Older People, Blackwell, pp 54-76 Levy Berg, A., Sandahl, C., Bullington J. (2010) "Patients" perspective of change processes in affect-focused body psychotherapy for generalized anxiety disorder, Journal of Body, Movement and Dance in Psychotherapy, Vol 5, Nr. 2, august 2010, 151-169. Bullington, J. (2010) "Vad är det som läker? Existentiella aspekter på hälsa och sjukdom", i G. Silfverberg (red). Visst längtar jag fortfarande efter något. Om etik och andlighet i vård, psykoterapi och musik, Ersta Sköndal högskola. |
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Ersta Sköndal högskola |
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