Pain as social representation: a study with Italian health professionals involved in the 'Hospital and District without Pain' project.

Pain is a complex issue with many different aspects concerning both sensorial and emotional experience. In recent years, the Health Promoting Hospitals (HPH) network has been encouraging a new vision in health structures, with the aim of reducing any form of pain wherever possible. Following the social representation approach, we explore the concept of 'pain' as it is continuously redefined, constructed and shared among health professionals involved in an HPH project named 'Hospital and District without Pain'. Three hundred and eighty-three professionals (doctors, nurses and local general practitioners referring to the hospital of Rovigo, Italy) were involved in a free association task with the aim of exploring the social representation of pain. Contents were further investigated by means of four focus group discussions. Results suggest that the representation of pain is strongly connected to medical knowledge and to functional aspects of the health practice. Other forms of pain-more relational, psychological or emotional-which do not fall within the aetiopathogenetic system of diagnosis, cannot be managed with the traditional tools of the health practice, and are not perceived to be handled with the professionals' competence. Results will be discussed in relation to general health promotion principles and to a specific initiative on the issue of pain carried out by the HPH-Veneto network.