Chronic pain, meaning, and spirituality: A qualitative study of the healing process in relation to the role of meaning and spirituality

This qualitative study explores experiences of individuals with chronic pain in their attempt to find meaning in the presence of continual pain. Fifteen participants at Loma Linda University Behavioral Medicine Center were interviewed. Emerging themes from this study show that (1) meaning is initially defined as the ability to engage in productive activities and positive relationships; (2) chronic pain is perceived as the factor that removes meaning from the lives of sufferers; (3) medication is used to cope with pain, leading to addiction; (4) addiction results in greater loss of meaning; and (5) rediscovery of meaning takes place through a more complex understanding of the self that embraces suffering and thus is able to explain the interrelation of pain, emotions, and addiction. A change in self-understanding makes the reintegration of meaning possible.     

Negotiating Multiplicity: Adaptive Asymmetries within Second-Generation Turks’ “Society of Mind”

If identities are socially produced, what happens when individuals grow up participating in divergent or conflicting social contexts? This article reports on research with second-generation Turkish adolescents in London. Using the concept of the dialogical self, the research examines the dialogical structure of these young Turks’ selves. The analysis is Bakhtinian and seeks to identify the different discourses through which these young Turks talk about themselves. Three distinct discourses, or I-positions, are identified. These are then related to the sociocultural context within which these youth live, and specific attention is given to the constraints on these youth in expressing aspects of their identity. We demonstrate that the asymmetries and tensions within these adolescents’ dialogical selves are adaptive to the fractured and asymmetrical social contexts in which they are embedded.     

Mediating between international knowledge and local knowledge: The critical role of local field officers in an HIV prevention intervention

The outcomes of health interventions are co‐constructed through negotiation between the competing knowledges of different stakeholders. In such a context, local implementing partners – who mediate between international donors/programme managers and local beneficiary communities – have a critical ‘knowledge brokering’ role to play. With appropriate support, they can facilitate integration of internationally established knowledge with local beliefs and practices in ways that support health‐enhancing behaviour change. This paper focuses on the local field officers of an HIV prevention programme with Cambodian military couples. The paper asks: (1) what are the outcomes of knowledge encounters between international organizations and local field officers, as expressed in field officers' interpretation of programme goals, strategies and messages? (2) To what extent does the intervention context support the field officers' knowledge brokering efforts? Data collected includes semi‐structured interviews, observations of programme meetings and activities, and textual materials. The findings demonstrate that field officers privilege international knowledge, particularly in interactions with international manager–partners. However, in the field, they both hybridize programme messages and struggle to resolve dilemmas provoked by conflicting international and local knowledges. Material and symbolic asymmetries within the intervention context are shown to undermine their knowledge brokering efforts, as field officers attempt to claim identities and futures as health development professionals. Implications for programme practices and accountability systems are discussed. Copyright © 2010 John Wiley & Sons, Ltd.