Abstract
BackgroundRecurrent pain is a common complaint among adolescents. Children learn to resolve or cope with pain largely through family dynamics, particularly maternal influences. By adolescence, young people possess an array of pain behaviors, the culmination of multiple opportunities for modeling and reinforcement of attitudes and beliefs about pain. Adolescence is a time of increased autonomy characterized by, among other complex factors, significant increases in peer influence. Although peers are influential in health-risk behavior, little is known how peers impact adolescents' pain experience. The present study explored the role of peers in adolescents' attitudes toward pain, pain behaviors and over-the-counter analgesics.MethodsSixty-minute focus groups were conducted with a sample 24 junior high school students from Halifax, Nova Scotia, Canada (11 male: mean age = 13.45 years, range = 12–15 years; 13 female: mean age = 13.31 years, range = 12–15 years). Participants were randomly assigned to one of five same-gender focus groups designed to explore a wide breadth and depth of information. Sessions were run until theoretical data saturation. Textual data, from transcribed audiotapes, were analyzed with the constant comparative method.ResultsPeer influences were apparent in how adolescents communicate about pain and how those communications effect pain expression. Overt pain responses to injury were primarily contextual and depended on perceived threats to peer-time and pain severity. Adolescents were intolerant of peers' pain behaviors when the cause was perceived as not severe. These attitudes impacted how adolescents responded to their own pain; males were careful not to express embarrassing pain in front of peers, females felt no restrictions on pain talk or pain expression. Evidence for peer influence on attitudes toward OTC analgesics was apparent in perceptions of over-use and ease of access. Findings are discussed within the context of social information-processing and gender role expectations.ConclusionLittle research has addressed how young people experience pain within the context of the psychosocial influences that dominate during adolescence. The findings provide some insight into the role of peer influences via verbal and non-verbal communication, in adolescents' pain experience. This exploratory study is a necessary first step in understanding the socialization of adolescents' pain experiences.
Highlights
Recurrent pain is a common complaint among adolescents
In an extensive critical summary of the research investigating gender variation in children's pain experiences, Unruh and Campbell reported that caregiver responses to children's pain expressions provide the children with information about social display rules and the gender appropriate responses to pain events [9]
Two major thematic categories emerged from the focus group sessions: (1) peer influences on attitudes about pain and pain expression and (2) attitudes toward OTC analgesics
Summary
Recurrent pain is a common complaint among adolescents. Children learn to resolve or cope with pain largely through family dynamics, maternal influences. With repeated incidents of pain episodes, either their own or others', children are provided with opportunities for modeling and reinforcement of attitudes and beliefs about how to experience, cope with and manage pain. In an extensive critical summary of the research investigating gender variation in children's pain experiences, Unruh and Campbell reported that caregiver responses to children's pain expressions provide the children with information about social display rules and the gender appropriate responses to pain events [9]. These social display rules are maintained well beyond childhood. Research reporting significant correlations between the number of pain "models" (e.g. mother, sister, grandmother, aunt) and the frequency of pain among females suggests that social learning via observation may provide females with a supportive outlet for pain expression and numerous opportunities from which to learn socially acceptable pain responses from female peers [10]
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