Abstract
Parental behaviour appears to influence the adjustment of children with chronic pain. However, research in this area has failed to produce consistent evidence. Studies have tended to rely on self-report measures derived from adult pain populations. This qualitative, observational research provides descriptive data of parental behaviour in a clinical environment. A qualitative observational study was made of parents and adolescents in a physically stressful setting. Modified grounded theory was used to analyse verbal and non-verbal behaviours. Eight parent-adolescent dyads seeking treatment for chronic pain were videoed during physical exercise sessions. Verbal and non-verbal behaviours were recorded and transcribed. Four overarching categories emerged: 'monitoring', 'protecting', 'encouraging' and 'instructing'. These often had both verbal and non-verbal aspects. Within these categories, more precise behavioural groups were also identified. This research identifies categories of parental behaviour that were derived directly from observation, rather than imposed on the basis of results from different populations. Four categories of behaviour were derived, which clarify and extend dimensions used in existing self-report instruments. Careful description of parental behaviours showed features that past research has neglected, and highlighted potential drawbacks of apparently positive parental actions.
Highlights
Chronic pain can be distressing and can impact on many important areas of child and adolescent development (Gauntlett-Gilbert and Eccleston, 2007; Roth-Isigkeit, Thyen, Stöven, Schwarzenberger & Schmucker, 2005)
Research suggests that there is a relationship between the functioning of children and adolescents with chronic pain and certain environmental and social factors
Whilst some research has found a link between parental behaviour and child outcomes using such measures (e.g. Claar, Guite, Kaczynski & Logan 2010; Logan & Scharff 2005; Peterson & Palermo 2004; Walker et al, 2006) the findings are not consistent
Summary
Chronic pain can be distressing and can impact on many important areas of child and adolescent development (Gauntlett-Gilbert and Eccleston, 2007; Roth-Isigkeit, Thyen, Stöven, Schwarzenberger & Schmucker, 2005). The Adult Responses to Child Symptoms (ARCS; Van Slyke & Walker, 2006) measures parent behaviour on three dimensions; ‘Protect’, ‘Minimise’ and ‘Encourage and Monitor’, whilst the Pain-related Parent Behaviour Inventory (PPBI; Hermann, Zohsel, Hohmeister & Flor, 2008) records parent behaviour as Solicitous, Distracting and Discouraging / Ignoring. Whilst some research has found a link between parental behaviour and child outcomes using such measures (e.g. Claar, Guite, Kaczynski & Logan 2010; Logan & Scharff 2005; Peterson & Palermo 2004; Walker et al, 2006) the findings are not consistent. Other research has failed to find a link between parent behaviour and the functional outcomes of children and adolescents Other research has failed to find a link between parent behaviour and the functional outcomes of children and adolescents (e.g. Reid, McGrath & Lang, 2005; Logan, Guite, Sherry & Rose 2006; Peterson & Palermo 2004). Palermo and Chambers (2005) reviewed the existing research on parent behaviour and concluded that findings were inconsistent and failed to capture the complexity of the parent-child relationship
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