The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping

PURPOSE: To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). METHODS: Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. RESULTS: Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. CONCLUSION: This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

When the private becomes public: commodity activism, endorsement, and making meaning in a privatised world

The divide between the public realm and the private realm is a both a moveable and permeable boundary. One of the reasons for this fluidity as to what constitutes these two realms is driven by different political postures. From a neoliberal position, the private—be that private industry, the individual self, the engines of the economy—is better able to produce the Benthamite characterisation of happiness for the greatest number. In contrast, from a socialist to social democratic position, an expanded public disbursement of commonwealth is seen to produce a more equitable, just, and ultimately happy society. Somewhere between these two extremes is a regulated marketplace which more or less describes the organisation of most Western polities.This paper investigates a relatively new form of public activism that, in a sense, emerges from a cultural condition of the ascendancy of the privatisation of politics and culture. Commodity activism, as it is now called by researchers, begins with a politics of the marketplace and turns it into a normative position or posture related to the public sphere. This kind of politics has emerged from consumer movements that have a long history of turning the private into the domain of the public through boycotts, forms of usually negative publicity, and an active engagement of appropriating the key identity of “privatisation,” which is that of the consumer, and re-politicising it into something akin to a form of active citizen. The paper is a study of this changing of the private into the public and how this process relies on the concept of endorsement—particularly high-profile celebrity figures who have gained their power as individuals in this privatised space and now use that form of power for other purposes—in order to gain attention and circulation in this now privatised public sphere.