MANUCU: A Case Study of Pain Experience Among Elderly as Gout Arthritis Sufferer in Tomohon City
Abstract
Gout Arthritis is a degenerative disease caused by the deposit of monosodium urate crystals in joints and triggered acute inflammation. One of the most dramatic events occurring to GA sufferers is a flare, a severe condition that rises quickly and lasts for one or two weeks. The pain's intensity and subjective experience vary between individuals and could be among groups. Therefore, identifying how the sufferer expresses pain is essential to understanding the phenomenon. Objective: This study aimed to explore the pain experience of GA Sufferers. Methods: A single case study was applied to conduct this qualitative research. This research was located in Tomohon City and occurred in September 2024. In-dept interviews were done with three adults who are GA sufferers. A narrative analysis of each participant was used to describe the result. Results: Participants are polyarticular tophaceous gout sufferers. Participant 1 (P1) expresses his pain as "ba’-nyut-nyut" or "manucu" (the pain was excruciating, like being stabbed with a needle), burns, and even makes him cannot wake up from bed due to the painful feeling and the foot tophi. Meanwhile, P2 says the Manucu experience usually happens during cold temperatures and makes him totofore (trembling). Last, the third participant says it feels like being stabbed, "ba-cucuk," and very painful. Conclusions: Pain is a subjective experience of the sufferer and has impact in his/her quality of life however, pain is also expressed in a commonality based on the sufferer cultural background like the word "manucu" exists as a characteristic of the pain in the community.
References
Abbott, F. V., Gray-Donald, K., Sewitch, M. J., Johnston, C. C., Edgar, L., & Jeans, M. E. (1992). The prevalence of pain in hospitalized patients and resolution over six months. Pain, 50(1), 15-28.
Ahmad SJ, Khurshid S. (2013). Polyarticulartophaceous gouty arthritis: a case report. Int J Case Rep Imag. 4:554-8. 10.5348/ijcri-2013-10-378-CR-7
Broom, D. M. (2001). Evolution of pain. Vlaams Diergeneeskundig Tijdschrift, 70(1), 17-21
Broom, D.M. (1986). Indicators of poor welfare. British Veterinary Journal 142, 524-526.
Cottrell E, Crabtree V, Edwards JJ, Roddy E. (2013). Improvement in the management of gout is vital and overdue: an audit from a UK primary care medical practice. BMC Fam Pract 14:170. https://doi.org/10.1186/1471-2296-14-170
Darmawan, J., Valkenburg, HA., Muirden, KD., & Wigley, RD. (1992). The epidemiology of gout and hyperuricemia in a rural population of java. The Journal of Rheumatology, 19, 1595–1599.
Darmawan, J., Johannes, J, R., Hendri, N. (2003). The effect of control and self-medication of chronic gout in a developing country. Outcome after 10 years. The Journal of Rheumatology, 30 (11), 2437-2443
Gafforov Xudoyor Xudoyberdiyevich, Khusainova Munira Alisherovna, Toirov Doston Rustamovich, Kamolova Diyora Djamshedovna. (2023). QUALITY OF LIFE IN PATIENTS WITH GOUT. Spectrum Journal of Innovation, Reforms and Development, 12, 156–164. Retrieved from https://sjird.journalspark.org/index.php/sjird/article/view/552
Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012 Aug;13(8):715-24. doi: 10.1016/j.jpain.2012.03.009. Epub 2012 May 16. PMID: 22607834.
Gooberman-Hill R. Ethnographies of pain: culture, context and complexity. Br J Pain. 2015 Feb;9(1):32-5. doi: 10.1177/2049463714555439. PMID: 26516554; PMCID: PMC4616991.
Hamijoyo, L. (2010). Kenali Gout. Retrieved 11 10, 2021, from Reumatologi.or.id: http://reumatologi.or.id/reuarttail?id=27
Hanago GA, Siebeck M, Dira SJ, Tadesse T, Irnich D. Perception of Pain Expression Among Surgical Patients and Families from Three Ethnic Groups of a Nation: A Multicenter Qualitative Study. J Pain Res. 2024 Jan 16;17:241-251. doi: 10.2147/JPR.S447676. PMID: 38249567; PMCID: PMC10799569.
Kementerian Kesehatan Republik Indonesia. (2019). Riset Kesehatan Dasar Daerah. Lembaga Penerbit Balitbangkes.
Lee SJ, Nam KI, Jin HM, et al. Bone destruction by receptor activator of nuclear factor kB ligand-expressing T cells in chronic gouty arthritis. Arthritis Res Ther, 2011, 13: R164.
Li-Yu J, Clayburne G, Sieck M, et al. Treatment of chronic gout. Can we determine when urate stores are depleted enough to prevent attacks of gout? JRheumatol, 2001, 28: 577–580.
Mandell BF. Clinical manifestations of hyperuricemia and gout. Cleve Clin J Med, 2008, 75 (Suppl 5): S5–S8.
Mandell BF. Clinical manifestations of hyperuricemia and gout. Cleve Clin J Med. 2008 Jul;75 Suppl 5:S5-8. doi: 10.3949/ccjm.75.suppl_5.s5. PMID: 18822469.
Mäntyselkä P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamäki H, Halonen P, Takala J. Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001 Jan;89(2-3):175-80. doi: 10.1016/s0304-3959(00)00361-4. PMID: 11166473.
Morris C, Macdonald L, Stubbe M, Dowell A. "It's complicated" - talking about gout medicines in primary care consultations: a qualitative study. BMC Fam Pract. 2016 Aug 19;17(1):114. doi: 10.1186/s12875-016-0515-y. PMID: 27542754; PMCID: PMC4992199.
Padang C, Muirden KD, Schumacher HR, Darmawan J, Nasution AR. Characteristics of chronic gout in Northern Sulawesi, Indonesia. J Rheumatol. 2006 Sep;33(9):1813-7. PMID: 16960942.
Perez-Ruiz, F., Perez-Herrero, N., Richette, P. et al. High Rate of Adherence to Urate-Lowering Treatment in Patients with Gout: Who’s to Blame?. Rheumatol Ther 7, 1011–1019 (2020). https://doi.org/10.1007/s40744-020-00249-w
Perhimpunan Reumatologi Indonesia. (2018). Pedoman Diagnosis dan Pengelolaan Gout. Jakarta
Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Song XJ, Stevens B, Sullivan MD, Tutelman PR, Ushida T, Vader K. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020 Sep 1;161(9):1976-1982. doi: 10.1097/j.pain.0000000000001939. PMID: 32694387; PMCID: PMC7680716.
Rashid N, Coburn BW, Wu YL, Cheetham TC, Curtis JR, Saag KG, Mikuls TR. (2015). Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system. J Rheumatol 42(3):504–512. https://doi.org/10.3899/jrheum.140588
Ritschl, V., Stamm, T. A., Aletaha, D., Bijlsma, J. W., Böhm, P., Dragoi, R., ... & De Thurah, A. (2020). Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews Informing the 2020 EULAR points to consider. RMD open, 6(3), e001432.
Sarawate CA, Brewer KK, Yang W, Patel PA, Schumacher HR, Saag KG, Bakst AW. (2006). Gout medication treatment patterns and adherence to standards of care from a managed care perspective. Mayo Clin Proc 81(7):925–934. https://doi.org/10.4065/81.7.925
Scheepers, L. E., van Onna, M., Stehouwer, C. D., Singh, J. A., Arts, I. C., & Boonen, A. (2018, April). Medication adherence among patients with gout: a systematic review and meta-analysis. In Seminars in arthritis and rheumatism (Vol. 47, No. 5, pp. 689-702). WB Saunders.
Singh, R. (2017). The Pain: How Does Anthropology Look at it? Suffering of Body and Mind. Ethnologia Actualis, 17, 123 - 139.
Singh JA, Hodges JS, Toscano JP, Asch SM. (2007). Quality of care for gout in the US needs improvement. Arthritis Rheum 57(5):822–829. https://doi.org/10.1002/art.22767
Schwartz, S. A. (2006). Disease of distinction. Explore, 2(6), 515-519.
Tosun HB, Serbest S, Baloglu M, Inanmaz ME, Kose KC: Tophaceous gout with atypical localization without hyperuricemia or an inflammatory gout attack. Turk J Rheumatol. 2013, 28:136-40. 10.5606/tjr.2013.2857.
Copyright (c) 2024 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
