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

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.

Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford: a qualitative interview study

BACKGROUND

Pain is a significant problem for many people with advanced disease or a serious illness. Culture and ethnicity can affect the experience and management of pain. However, there is limited research in South Asian communities in the UK on their experiences of pain. The aim of this study is to explore the experiences and attitudes of patients and family carers from South Asian communities about pain and its management within advanced disease or serious illness.

METHODS

Qualitative thematic analysis based on descriptive phenomenology (Sundler et al. 2019). Qualitative semi-structured interviews with patients or family carers from South Asian communities (N = 15). Interviews were recorded, transcribed and analysed using an inductive approach. Public and Patient Involvement representatives from British South Asian communities were consulted for guidance.

RESULTS

There were five key themes from the interviews: The importance of communication about pain with healthcare professionals; Concerns about taking pain medication; Personal resilience, privacy and self-management; Gender, culture and pain; Home pain management as struggle and frustration.

CONCLUSION

To improve pain management for people from South Asian communities with advanced disease or a serious illness, there are a number of important issues for healthcare professionals from palliative and primary care services to address. These include: greater awareness around people's fears and concerns about pain medication; their potential use of alternative pain management strategies; and cultural issues such as resilience, privacy, dignity and gender roles. Effective communication between doctors, patients and family members could be improved by using a 'cultural humility' model; providing clear and accessible pain medication information; understanding and taking account of people with both low, and medium levels, of English language proficiency; and improving patient trust. Additionally, improvements to out of hours services could improve pain management for all patients managing their pain at home.

A dyadic exploration of support in everyday life of persons with RA and their significant others

BACKGROUND

Support from significant others is important for participation in everyday life for persons with rheumatoid arthritis (RA). Meanwhile, significant others also experience limitations.

AIMS

To explore how support is expressed by persons with RA and significant others, and how support relates to participation in everyday life of persons with RA.

MATERIAL AND METHODS

Sixteen persons with RA and their significant others participated in individual semi-structured interviews. The material was analyzed using dyadic analysis.

RESULTS

Persons with RA and significant others reported that RA and support had become natural parts of everyday life, especially emotional support. The reciprocal dynamics of support were also expressed as imperative. Also, support from people outside of the dyads and well-functioning communication facilitated everyday life.

CONCLUSIONS

Significant others and the support they give are prominent factors and facilitators in everyday life of persons with RA. Concurrently, the support persons with RA provide is important, along with support from outside of the dyads.

SIGNIFICANCE

The results indicate that the interaction between persons with RA and the social environment is central to gain insight into how support should be provided for optimal participation in everyday life. Significant others can preferably be more involved in the rehabilitation process.

Friend or Foe? A Thematic Analysis of Adult Friendships and Chronic Pain Adjustment

BACKGROUND

Chronic pain is a worldwide public health challenge. Despite chronic pain having biopsychosocial dimensions, its social contexts are less investigated. Although current evidence shows that chronic pain shapes and is shaped by interactions with romantic partners, research about friendships and chronic pain is scarce, and mostly focused on adolescents.

AIM

Drawing upon theories on friendship and social support, this study aimed to investigate the role of adult friendships on chronic pain adjustment and, the effect of chronic pain on adult friendships.

METHODS

This study drew upon a qualitative descriptive methodology. Sixteen adults with primary or secondary (non-cancer) chronic pain participated in individual semi-structured interviews, conducted using voice over internet protocol applications. Data analysis was guided by Clarke and Brown's guidelines for thematic analysis.

RESULTS

The analysis of participants' (87.5% women; M_age = 43 years) stories revealed two themes. The first captured how friends promote/hinder adjustment to chronic pain by being: (1) (un)available and providing (un)needed support; and (2) (not)accepting and (not)accommodating to support life engagement. The second captured the negative effect of chronic pain on both parties' attitudes and behaviors towards the relationship, leading to smaller and more homogeneous friendship networks.

CONCLUSIONS

This study stresses the relevance of including adult friends in interventions to reduce the negative effect of chronic pain on friendships, harnessing their power to promote chronic pain adjustment. The findings bring new insights on a topic that has rarely been investigated in the pain field, hence pointing out innovative directions for future research and practice.