Poster #50 - Everyday pain in children: Parental and child coping strategies in response to physical and social pain

• In Event: Poster Session 06

Abstract

Background. Physical pain is a common occurrence in children, and usually of an everyday nature. Everyday physical pain mostly occurs because of illnesses, injuries, or medical treatment (e.g., Fearon et al., 1996). Social pain, defined as perceptions of potential or real social exclusion (MacDonald & Leary, 2005), occurs frequently as well (e.g., in peer conflicts, Hartup & Moore, 1990, or rejection, Hymel et al., 2002). Maladaptive coping of everyday physical pain in childhood is theorized to contribute to the development of chronic pain (Palermo et al., 2014). Importantly, children do not face their pain alone; it is embedded in a social context (Craig, 2009; Vervoort & Trost, 2018). A child's expression of pain influences the caregiver's appraisal and management of the child’s pain, which in turn influences the child's experience of pain. Thus, after a child expresses his or her pain, parents have an opportunity to alleviate their children’s suffering by reacting in an appropriate way (McMurtry et al., 2006, 2010). Parents’ influence during children’s everyday pain events, however, is underexplored, compared to clinical or experimental pain settings (Chambers et al., 2002; O’Sullivan et al., 2021). In two studies, we explored child and parental coping strategies in response to everyday social or physical pain.

Methods. We conducted semi-structured interviews with N=25 parents (84% mothers, 63% girls, Mage=7.8 years; sample I) and N=36 parent-child pairs (89% mothers, 61% girls, Mage=9 years; sample II) from diverse socioeconomic backgrounds. In study I, we asked parents: “Tell me about a situation within the past 12 months where your child was physically injured or ill/ had to deal with a difficult social situation; what did you do?”. In study II, we presented six vignettes describing common pain events in children’s lives (scraping knee, bee sting, having the flu, needle procedure; being excluded, peer conflict), and asked to rate pain intensity on a 6-point-Likert. Then, various questions were asked about children's and parents’ coping strategies related to each pain situation. Interviews were transcribed and participants’ responses about pain coping strategies were categorized (categories adapted from “Social Support Behavior Code” by Suhr et al., 2004).

Results. Most children and parents reported that children had experienced the situations described in the vignettes at least once in their lives (75%-100%). Participants rated pain intensity overall as medium to strong (Mchildren=2.5, Mparents=2.8, 0=no pain, 5=worst pain). Qualitative content analysis, showed in study I (Figure 1), that parents used emotional strategies for both types of pain, however, they used more cognitive-informational strategies when their child experienced social pain and more instrumental strategies when their child was faced with physical pain (except for social support in social pain). In study II (Figure 2), this pattern of results was mostly replicated for parents’ and child strategies.

Conclusions. Our findings show that children’s everyday pain can reliably be measured with easy-to-administer pain vignettes. Furthermore, findings suggest the use of different strategies for everyday social and physical pain. Implications for our understanding of psychosocial aspects of pediatric pain in real-world settings will be discussed.

Author

• Regula Neuenschwander, University Bern
  Presenting Author