Adolescent chronic pain: the influence of autonomy on functional outcomes

Abstract

Background: The existing literature suggests an influence of family factors on pain functional disability. However, as of yet, little attention has been given to developmental aspects of adolescents who suffer from chronic pain. Those aspects are strongly related to family factors, which influence functional outcomes. The purpose of the present study is to investigate the relation between adolescents’ and parents’ fear of pain and adolescents’ feelings of being supported in their need of autonomy. Methods: This research uses a mixed methodology. 100 patients between the ages of 12 and 17 referred to pain centers in Switzerland completed measures of autonomy support, fear of pain and functional disability. At least one parent of each adolescent completed the parent versions of the above questionnaires. Twenty of these adolescents participated in semi-structured interviews, where the management of developmental tasks was discussed. Those adolescents also participated in a video task with one of their parents. The interviews were analyzed following interpretative phenomenological analysis. Videos were coded following an interactive code design. Findings The results of the interviews and videos underscore how ressources and difficulties in managing pain belong together with developmental aspects. As expected, our first results show that being supported in his own values and norms help the adolescent and his family to manage the pain. Discussion: The meeting of developmental theories and the usual models in pain highlight that adolescents with chronic pain remain adolescents. The developmental tasks influence and are influenced by the pain and impact functional outcomes.