| Sažetak | Bol je neugodan i složen doživljaj na kojeg utječu fiziološki, psihološki te sociokulturalni čimbenici. U fiziološkom smislu bol nastaje kao posljedica aktivacije nociceptora koji se aktiviraju pri oštećenju i podraživanja tkiva, dok se u psihološkom, promatra utjecaj emocija, očekivanja, pozornosti, osobina ličnosti i drugih psiholoških čimbenika na bol.
Postoji više vrsta boli koje se mogu podjeliti u određene kategorije.Bol se prema etiologiji djeli na tjelesnu i psihogenu, prema trajanju na akutnu i kroničnu, a prema lokalizaciji na visceralnu i perifernu. Ove tri kategorije predstavljaju osnovnu podjelu. Tjelesna bol predstavlja ozljedu tkiva ili prisutsvo patološkog procesa, dok je psihogena uzrokovana emocionalnim stanjima, a po svojim simptomima je slična tjelesnoj boli. Akutna nastaje iznenada, dobro je lokalizirana te prolazi za kratko vremena, a kronična je stalno prisutna te je otporna na terapiju.
Teorije boli su kroz povijest pokušavale objasniti doživljaj boli, među kojima je najprihvaćenija teorija Ronalda Melzacka i Patricka Walla tj. teorija kontrole prolaza. Za razliku od prethodnih teorija ona uključuje i ulogu središnjeg živčanog sustava osobito psihičkih procesa u nastajanju bolnog doživljaja. Prema ovoj teoriji, stražnji rogovi kralježnične moždine djeluju kao prolaz koji može smanjiti ili povećati prolazak živčanih impulsa koji idu od periferije prema središnjem živčanom sustavu. Teorija kontrole prolaza za razliku od ostalih teorija objašnjava individualne razlike u doživljaju boli. Iako je predstavljala veliki iskorak u odnosu na druge, ova teorija nije uspjela objasniti fantomsku bol.
Sociodemografski te kulturološki čimbenici također utječu na doživljaj boli. Od sociodemografskih čimbenika najprije se misli na dobne i spolne razlike. U dobnom smislu se ne može sa sigurnošću reći da se bolne senzacije povaćavaju sa starosti, ali se svakako može reći da sa starošću dolaze nove boli. Kod spolnih razlika se ipak može reći da su žene te koje su osjetljivije na bol i češće obavještavaju o njenoj prisutnosti. Jedan od razloga je i sigurno to što se muškarce već od djetinjstva uči da nije dolično pokazivati bol na izrazit način. Kod nacionalosti se isto očituju neke razlike pa je tako kroz neka ispitvanja uviđeno da Afroamerikanci pokazuju veću osjetljivost na eksperimentalne bolove u odnosu na osobe Euroameričkog podrijetla. Isto i u ispitivanju akutne i kronične boli utvrđeno je da se kod Afroamerikanaca javlja više popratnih posljedica kao što su depresija, poremećaji spavanja te znakovi jakog stresa. Ostali sociodemografski čimbenici koji utječu su religija, socioekonomski status te čak i vremenske prilike.
U kulturološkom smislu su uočene velike razlike u podnošenju i toleranciji na bol.Tako neke kulture potiču na izražavanje boli, osobito na južnom Mediteranu i na Bliskom Istoku, dok se u nekim dijelovima Indije provode vrlo boli rituali gdje izabrani član u kasnijem dijelu obreda lebdi slobodno viseći na samo na kukama koje su zabodene u leđa. U tom obredu se ni u jednom trenutku ne može zaključiti da osoba trpi bilo kakvu bol već izgleda kao da je u zanosu odnosno transu. U našoj kulturi se najviše ističe porođajna bol, gdje su već od rane dobi djevojke prepadnute pričama o jakim bolovima te komplikacijama prilikom porođaja. Takva očekivanja dovode do pojave intezivnog straha prije samog porođaja, a strah do poveaćne mišićne napetosti što naposljetku i rezultira pojačanim bolovima. |
| Sažetak (engleski) | Pain is an unpleasant and complicated experience on which affect the physiological, psychological and sociocultural factors. In the physiological sense pain occurs as a result of the activation of nociceptors that are activated when impairment and stimulation tissue, while the psychological impact of observed emotions, expectations, attention, personality and other psychological factors on the pain.
There is more than one kind of pain that can be split up into specific categories. The pain according to the etiology share in the physical and psychogenic, according to the duration of the acute and chronic, and according to the localization of the visceral and the peripheral. These three categories are a basic division. Physical pain represents an injury of tissue or presence of a pathological process, while the psychogenic caused emotional states and for it is similar to physical pain. Acute arises suddenly, it is well localized and passing for a short period of time, and the chronic is always present and is resistant to therapy.
The theory of pain throughout history have tried to explain the experience of pain, among which the most stressed the theory of Ronald Melzack and Patrick Wall, gate control theory of pain. Unlike the previous theory, it also includes the role of the central nervous system, especially the mental processes in the making of painful experiences. According to this theory the posterior horns of the spinal cord act as a gateway that can reduce or increase the passage of nerve impulses that go from the periphery to the central nervous system. Control theory of unlike other theory explains the individual differences in the experience of pain. Even though the represented a big step forward in relation to the other, this theory failed to explain the phantom pain.
Sociodemographic and cultural factors also affect the experience of pain. From the socio – demographic factors first thoughts is age-related and sexual differences. In terms of age can not say with certainty that the painful sensations increase with old age, but can certainly say that new pains come with age. At gender differences, however, can be said that women are the ones who are more sensitive to pain and more frequently informed about her presence. One of the reasons is that which is safe and men already since childhood learns that it's not proper to show the pain in a distinct way. With the same, ethnicity manifest some of the differences so that through some observed survey that the African-Americans show greater sensitivity to experimental pain compared to people of Euro-American descent. The same, and in a study of acute and chronic pain it was found that the African-Americans at answering more accompanying consequences such as depression, sleep disorders and signs of strong stress. Other factors that influence sociodemographic are religion, socioeconomic status, and even the weather.
In the cultural sense, have been spotted large differences in submitting and tolerance to pain. So some cultures encourage the expression of pain, especially in the southern Mediterranean and the Middle East, while in some parts of India are conducted very pain rituals where an elected member inthe later part of the rites freely floating hanging on only on hooks, which are stuck into the back. In the ceremony with at no point can’t be concluded that a person suffers any kind of pain already looks like he's in ecstasy or trance. In our culture is the most notable birth pain, where from an early age the girls freaked out stories about strong pain and complications during childbirth. Such expectations lead to the appearance of intense fear before the birth, and the fear to increase muscle tension which finally and results in increased pain. |
