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Un quart de la population est confronté à une douleur chronique à un moment ou à un autre de son existence et une partie en sera durablement et fortement affectée. Dans ces situations complexes, considérer la douleur uniquement sous l'angle d'un symptôme n'est pas suffisant. Un regard qui intègre tout ce que la douleur vient bousculer dans le quotidien est indispensable. Les points de fragilisation peuvent en effet être nombreux : déconditionnement physique, peur de la douleur, ancrage social déstructuré, difficultés socioprofessionnelles, troubles du sommeil, ruminations mentales, perturbations émotionnelles et cognitives... La douleur chronique pose différents défis aux soignants : conjuguer leur savoir avec le vécu du patient, mais aussi s'ouvrir à leur propre vécu. La prise en compte de la singularité de l'expérience du patient et de celle du soignant est une des conditions de la remise en mouvement de la personne figée dans son existence par la douleur. Ce livre propose ainsi un angle d'approche inédit : les connaissances scientifiques s'y articulent autour de la pièce maîtresse du travail clinique, la rencontre avec le patient. Cet ouvrage donne des repères et ouvre des pistes pour enrichir la réflexion de tout soignant, quelle que soit sa discipline.
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Although pain is one of the most fundamental and unique experiences we undergo in everyday life, it also constitutes one of the most enigmatic and frustrating subjects for many scientists. This book provides a detailed analysis of why this issue is grounded in the nature of pain itself. It also offers a philosophically driven solution of how we may still approach pain in a theoretically compelling and practically useful manner. Two main theses are defended: (i) Pain seems inscrutable because there exists no property that is commonly shared by all types of pain and that is at the same time particular to pain, setting it apart from other bodily sensations. This applies irrespective of whether we consider the psychological dimensions, neural networks, causal relations or biological functions of pain. Consequently, it is impossible to refer to ideal far-reaching and ideal distinct generalizations on the matter of pain. (ii) Despite this challenge, by focusing on the resemblance relations that hold across pains, we can generate scientific progress in explaining, predicting and treating pain. In doing so, the book aims to provide a clear conceptual basis for interdisciplinary communication and a useful heuristic for future research.
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Chronic pain is a part of the human condition, despite immense advancements in pain treatment and management. In many societies, easy access to opioids has created a drug abuse crisis. Unfortunately, we seem to have forgotten many techniques that have been used in the past with great success. Some of these techniques continue to be useful, particularly in areas of the globe where resources are limited. This book attempts to remind those of us in the medical profession about the existence of some of these techniques and their ongoing utility. We need to master them or keep them in our armamentarium for the good of our patients.
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