Pain in children: psychosocial: Maternal influences on adolescents' pain management

Abstract

Adolescents independently medicate for various recurrent pain types (e.g. muscle pain, headache, back pain and menstrual pain). Among this age group over-the-counter analgesic use is high, sometimes inappropriate and knowledge is poor. To date, no known research has addressed how adolescents acquire attitudes about pain and pain management and how attitudes effect pain management practices. A qualitative study was designed to assess maternal influences on adolescents' independent pain management. 20 parent-adolescents dyads, from St. John's Newfoundland, composed of 20 mothers (mean age = 42.72 years; SD = 5.42), 10 male adolescents (mean age = 13.6 years; SD = 1.43) and 10 female adolescents (mean age = 13.4 years; SD = 1.07). Semi-structured interviews. Demographic data were collected using the Pain Assessment Questionnaire. Semi-structured interviews conducted with parents and adolescents yielded rich textual data, reduced to central themes using qualitative content analysis. Results: Pain complaints reported by adolescents were consistent with the pain literature. Attitudes toward OTC analgesics were negative; adolescents and mothers reported using OTCs for pain relief, but typically as a last resort. Although adolescents reported self-medicating for pain, OTC analgesic use was largely mother-assisted. The intergenerational transmission of information about pain and pain management was apparent in dyadic statements. Mothers transmitted information to adolescents' through their (1) attitudes toward pain, (2) pain management practices and (3) knowledge of OTCs. Shared attitudes and pain management strategies underscored the important role of mothers as models for their adolescents' transition toward autonomy in pain management. Mothers emerged as essential facilitators of their children's independent pain management. The mechanisms by which mothers transmitted information to adolescents about pain and pain management were primarily verbal communications and modeling. These findings provide further support for the importance of maternal influences on children's pain expression, as well as the importance of maternal influences on adolescent pain management choices.