Ways of Understanding Parental Chronic Pain: A Typology

Exploring communication in families affected by parental chronic pain: An occupational perspective

BACKGROUND

Family communication about pain is an important therapeutic target when a parent lives with chronic pain. Occupational therapy literature about communication in families affected by parental chronic pain is currently lacking.

AIMS/OBJECTIVES

To bring an occupational perspective to communication within families affected by parental chronic pain, to generate insights for practice.

MATERIALS AND METHODS

Five families (total n = 19 family members) were recruited into this collective case study. The gathered data included interviews, observations, and personal documents/artefacts. A cross-case analysis of similarities and differences between families was conducted to distil insights about the relationship between occupation and communication about parental pain.

RESULTS

Each family develops its own style of communicating about a parent's pain. On a day-to-day basis, pain-related communication is prompted by experienced, observed and/or anticipated occupational disruption brought about by parental pain.

CONCLUSIONS

Occupational disruption and occupational responses need to be components of interest, when designing assessments and interventions targeted at communication in families affected by parental chronic pain.

SIGNIFICANCE

The findings from this study point to the importance of communication through occupation in families affected by parental chronic pain and suggest novel targets for occupational therapy intervention.

The experience of chronic pain among adolescents: suffering and attempt to overcome pain?

Background

Chronic pain (CP) among adolescents has received less attention than adultsandthere is limited qualitative studies about it in Iran. This study explored the experience of CP among adolescents.

Methods

This exploratory qualitative study was conducted in April–October 2019. Participants were 14 adolescent students purposively recruited from schools in Shiraz, Iran. Semi-structured interviews were conducted for data collection and data analysis was done through conventional content analysis.

Findings

Adolescents’ experiences of CP came into nine subcategories and three main categories, namely perceived suffering, attempt to overcome pain, and attempt to find sources of support.

Conclusion

Adolescents with CP experience physical and mental suffering and attempt to manage their pain and its associated suffering through different physical and psychological strategies and using different sources of support such as family, peers, healthcare providers, and school staff.

Facilitating open family communication when a parent has chronic pain: A scoping review

BACKGROUND

When a parent has chronic pain, family communication can become strained. Clinicians are encouraged to identify and support families struggling with open communication. Occupational therapists are commonly involved in the provision of pain management services but their role in facilitating open communication in families affected by this condition has not been clearly articulated.

OBJECTIVE

To develop a comprehensive understanding of what is being done and/or thought to be helpful for facilitating open communication in families affected by chronic pain, in order to articulate the role of occupational therapy in this area of care.

METHODS

A scoping review was conducted and 24 items analyzed using qualitative content analysis.

RESULTS

The facilitation of open communication in families affected by parental chronic pain is dependent on a variety of factors, including the skills that members possess and occupations which they perform individually and together. It can also be prompted by relationship tension or a family accessing professional support. Occupational therapy literature on the matter is currently limited and focused on assertiveness training.

CONCLUSION AND SIGNIFICANCE

There is scope for occupational therapist to extend their role beyond assertiveness training and use occupation-centered interventions to facilitate communication within families affected by parental chronic pain.

Offspring of parents with chronic pain: a systematic review and meta-analysis of pain, health, psychological, and family outcomes

Offspring of parents with chronic pain may be at risk for poorer outcomes than offspring of healthy parents. The objective of this research was to provide a comprehensive mixed-methods systematic synthesis of all available research on outcomes in offspring of parents with chronic pain. A systematic search was conducted for published articles in English examining pain, health, psychological, or family outcomes in offspring of parents with chronic pain. Fifty-nine eligible articles were identified (31 population-based, 25 clinical, 3 qualitative), including offspring from birth to adulthood and parents with varying chronic pain diagnoses (eg, mixed pain samples, arthritis). Meta-analysis was used to synthesize the results from population-based and clinical studies, while meta-ethnography was used to synthesize the results of qualitative studies. Increased pain complaints were found in offspring of mothers and of fathers with chronic pain and when both parents had chronic pain. Newborns of mothers with chronic pain were more likely to have adverse birth outcomes, including low birthweight, preterm delivery, caesarian section, intensive care admission, and mortality. Offspring of parents with chronic pain had greater externalizing and internalizing problems and poorer social competence and family outcomes. No significant differences were found on teacher-reported externalizing problems. The meta-ethnography identified 6 key concepts (developing independence, developing compassion, learning about health and coping, missing out, emotional health, and struggles communicating with parents). Across study designs, offspring of parents with chronic pain had poorer outcomes than other offspring, although the meta-ethnography noted some constructive impact of having a parent with chronic pain.

"It didn't kill me. It just made me stronger and wiser": Silver Linings for Children and Adolescents of Parents with Chronic Pain

Chronic non-cancer pain (CNCP) is a disease that affects adults in their child-rearing years and is often incurable and of indefinite duration. Children and adolescents who live with parental CNCP can endure multiple adversities and experience subsequent emotional and somatic difficulties. Resilience is the ability to overcome adversity and even experience growth. This study is a secondary analysis of qualitative data, which sought to gain a deeper understanding of the ways in which children and adolescents rebound and grow from experiences living with parents who suffer with CNCP. Young adult children (N=30) of parents with CNCP were interviewed. Content analysis yielded five ways in which their experiences led to areas of positive growth: (a) expanded ways of understanding; (b) cultivated a strong character; (c) aided in the development of important skills; (d) instilled a commitment to live well, and; (e) nurtured spirituality. Clinicians who work with children and adolescents whose parents are disabled with CNCP can create environments that foster resilience and serve as a guide by helping these youth recognize potentials that have not yet been actualized and promoting positive change and growth over time.

The forgotten ones: challenges and needs of children living with disabling parental chronic pain

A qualitative study explored the challenges and needs of children living with parental chronic pain. Young adult children (n=30) of parents with chronic pain were interviewed. Parents (n=20) with chronic pain participated in four focus groups. Content analysis yielded five categories of child challenges: (a) understanding the big picture; (b) enduring hardships; (c) grieving losses; (d) communicating with parent, and; (e) isolating self from peers. Three categories of child needs emerged: (a) knowledge; (b) skills, and; (c) supervised interaction. Understanding these challenges and needs is a vital step in the process of developing evidence-based interventions for this at-risk group.