Cultural influences on the assessment of children’s pain

Culture is commonly regarded as a factor in pain behaviour and experience, but the meaning of the term is often unclear. There is little evidence that pain perception is modified by cultural or ethnic factors, but pain expression by children and interpretation by caregivers may be affected by the culture of the patient or the caregiver. The present paper examines some of the research regarding cultural influences on children’s pain assessment, and addresses directions for future research. A focus on cultural influences should not distract clinicians from the need to be sensitive to individual beliefs and attitudes

My child you must have patience and Kreng Jai : Thai parents and child pain

Purpose: To elicit the experiences of parents in providing care for their hospitalized child’s acute pain needs. Design: Phenomenology, using in-depth interviews with 45 parents whose children were being cared for in five hospitals in Northeastern (Isan) Thailand. Findings: The findings address Thai cultural beliefs regarding the experience of pain and the role societal expectations have on parental behavior in trying to meet their child’s acute pain needs. Two themes emerged– “Understanding my child’s pain: it’s karma” and “Maintaining Kreng Jai”– which identify parent beliefs toward pain and pain treatment, as well as perceived barriers in securing pain management for their children. Together these two themes describe the essence of this study as parents experienced an “inner struggle in providing pain care.” Pain was perceived as an inescapable part of life, and participants identified a preference for traditional remedies. Parents experienced a tension as they wanted to provide and secure pain care for their child but at the same time were reticent to approach staff with concerns about their child’s care. Conclusions: Thai parents viewed pain as a normal consequence of life, and one had to use traditional remedies in addition to medicine to successfully treat pain. Societal behavioral expectations required children to have patience. Nevertheless, parents wanted professionals to show more empathy and provide more effective pain care. Clinical Relevance: Improvements in pediatric pain care must formally include parents. Culturally sensitive approaches that do not stereotype parents and children are needed to ensure that evidence-informed pain care is available for all children

Children's pain assessment in Northeastern Thailand : perspectives of health professionals

Deficiencies in pain care within the developing world are starting to be realized. Children, in particular, are vulnerable, as preliminary studies suggest that these children receive less pain treatment because of health professionals’ attitudes and beliefs. This article reports on some of the findings of the first study in a larger program of research aimed at improving pediatric pain care in Thailand. Improvements in practice are not simply the result of providing evidenced-based knowledge, but a complex process that includes the context of care. Given that little is known about the pain management experiences of Thai health professionals, including the challenges they face, we used focus groups to capture their stories. Data revealed a need for both updating pain knowledge and for supporting an increased use of appropriate practices. In this article, we focus on the issues concerning the assessment of pain resulting from underrecognizing children’s pain and complex issues in communicating findings of children’s pain

Living with Difference: Exploring the Social Self of Adolescents with Chronic Pain

BACKGROUND: Chronic pain negatively affects an adolescent’s life; however, little is known about the social impact of chronic pain for adolescents. More is known about the general peer relationships of adolescents with chronic pain than their close friendships. Close friendships begin to take on more importance during adolescence as these relationships facilitate the development of an adolescent’s sense of personal identity and increasing independence from family influences. Thus, chronic pain may create friendship challenges for adolescents beyond those typically experienced during this developmental trajectory, which may negatively impact their abilities to secure social support.OBJECTIVES: To better understand the challenges adolescents with chronic pain face with regard to their friendships.METHODS: An interpretative phenomenological study using individual interviews was conducted.RESULTS: Two themes emerged. ‘Rethinking the self with pain’ describes the intrusive nature of chronic pain, challenging the participants to rethink the way they view themselves and their place within their social network. ‘Rethinking friendships’ describes the interpretation of their friends’ reactions to their chronic pain condition, which led to these adolescents spending more time by themselves, and feeling misunderstood and unsupported.CONCLUSIONS: The impact of chronic pain on the adolescent as an individual as well as the responses of close friends and others within their social network resulted in the development of new friendship needs. However, the adolescents were not always able to secure these new friendship needs. Their experiences suggest factors within friendships that may be ameliorated by interventions, thus maintaining and strengthening their close friendships.Peer Reviewe

Living with Difference: Exploring the Social Self of Adolescents with Chronic Pain

BACKGROUND: Chronic pain negatively affects an adolescent’s life; however, little is known about the social impact of chronic pain for adolescents. More is known about the general peer relationships of adolescents with chronic pain than their close friendships. Close friendships begin to take on more importance during adolescence as these relationships facilitate the development of an adolescent’s sense of personal identity and increasing independence from family influences. Thus, chronic pain may create friendship challenges for adolescents beyond those typically experienced during this developmental trajectory, which may negatively impact their abilities to secure social support

Social Functioning and Peer Relationships in Children and Adolescents with Chronic Pain: A Systematic Review

BACKGROUND: Peer relationships during childhood and adolescence are acknowledged to be negatively impacted by chronic pain; however, to date there has been no synthesis of this literature