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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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1877-8879
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Volume 15, Issue 1

Issues

Adolescents’ experience of complex persistent pain

Kari Sørensen
  • Corresponding author
  • Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
  • Lovisenberg Diaconal University College, Olso, Norway
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Bjørg Christiansen
  • Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Postbox 4, St. Olavs pl., N-0130 Oslo, Norway
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-04-01 | DOI: https://doi.org/10.1016/j.sjpain.2017.02.002

Abstract

Background and aims

Persistent (chronic) pain is a common phenomenon in adolescents. When young people are referred to a pain clinic, they usually have amplified pain signals, with pain syndromes of unconfirmed ethology, such as fibromyalgia and complex regional pain syndrome (CRPS). Pain is complex and seems to be related to a combination of illness, injury, psychological distress, and environmental factors. These young people are found to have higher levels of distress, anxiety, sleep disturbance, and lower mood than their peers and may be in danger of entering adulthood with mental and physical problems. In order to understand the complexity of persistent pain in adolescents, there seems to be a need for further qualitative research into their lived experiences. The aim of this study was to explore adolescents’ experiences of complex persistent pain and its impact on everyday life.

Methods

The study has an exploratory design with individual in-depth interviews with six youths aged 12–19, recruited from a pain clinic at a main referral hospital in Norway. A narrative approach allowed the informants to give voice to their experiences concerning complex persistent pain. A hermeneutic analysis was used, where the research question was the basis for a reflective interpretation.

Results

Three main themes were identified: (1) a life with pain and unpleasant bodily expressions; (2) an altered emotional wellbeing; and (3) the struggle to keep up with everyday life.

The pain was experienced as extremely strong, emerging from a minor injury or without any obvious causation, and not always being recognised by healthcare providers. The pain intensity increased as the suffering got worse, and the sensation was hard to describe with words. Parts of their body could change in appearance, and some described having pain-attacks or fainting. The feeling of anxiety was strongly connected to the pain. Despair and uncertainty contributed to physical disability, major sleep problems, school absence, and withdrawal from leisure activities. Their parents were supportive, but sometimes more emotionally affected than themselves. The adolescents described how they strived for normality and to not become an outsider. Being met with necessary facilitation from school was important, as well as keeping up with friends. These adolescents had all been treated by an interdisciplinary pain team, and stated that they had an optimistic view of the future, despite still having some symptoms.

Conclusions

The study provides new insights into adolescents’ own experiences of complex persistent pain occurring unexpectedly, developing dramatically over time, and influencing all parts of their everyday lives. The adolescents entered vicious cycles, with despair and decreased physical and social functioning, with the risk of isolation and role-loss. However, these young people seem to have a strong motivation to strive for normalcy.

Implications

These findings may encourage healthcare providers to perceive adolescents’ persistent pain through the lenses of a biopsychosocial approach. We suggest that further research into adolescents with persistent pain should include longitudinal studies of quality of life and gender perspectives.

Keywords: Adolescents; Persistent pain; Emotions; Everyday life; Identity

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About the article

Oslo universitetssykehus HF, Avdeling for smertebehandling, Postboks 4956 Nydalen, 0424 Oslo, Norway.

kasoer2@hotmail.com


Received: 2016-11-15

Revised: 2017-02-03

Accepted: 2017-02-09

Published Online: 2017-04-01

Published in Print: 2017-04-01


Ethical issues: The Regional Committee of Medical Ethics approved this study. Both the adolescents and their parents gave informed consent. Patient confidentiality is secured from interviews to publication. The youths’ stories were held in confidence from parents or healthcare professionals, and the informants are given fictive names. The participating adolescents’ were informed that they were free to withdraw from the study at any time. This would not influence their standing with the hospital.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of interest: None.


Citation Information: Scandinavian Journal of Pain, Volume 15, Issue 1, Pages 106–112, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.02.002.

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