Experiences of a non-clinical set of adolescents and young adults living with persistent pain: a qualitative metasynthesis

Abstract

PurposeAround 15%–30% of adolescents and young adults (AYAs) experience persistent or chronic pain. The purpose of this study was to synthesise evidence from qualitative primary studies on how AYAs in a non-clinical population experience living with persistent pain.MethodA qualitative metasynthesis guided by Sandelowski and Barroso’s guidelines was used. The databases Medline, Embase, Cinahl, PsycINFO, Mednar and ProQuest were searched for studies from 1 January 2005 to 15 February 2021. Inclusion criteria were AYAs aged 13–24 years with first-hand experience of living with persistent, recurrent or episodic non-clinical pain in any body site. Pain associated with a medical diagnosis, malignant diseases, medical procedures or sport activities was excluded.ResultsOf 2618 screened records, data from nine studies conducted in a Western cultural context including 184 participants (127 female and 57 male aged 11–28 years) were analysed into metasummaries and a metasynthesis. Headaches was the most focused pain condition (n=5), while three of the studies did not specify type of pain. The participants’ experiences were characterised by (1) juggling pain with everyday life; (2) exploring sources of information to manage pain; (3) AYAs’ use of medication to find relief and (4) non-pharmacological strategies for pain relief.ConclusionThese AYAs experience of how pain influences everyday life, and their striving to find relief from pain by support from family, friends, professionals and the Internet should be strongly respected. Public health nurses and other healthcare professionals encountering AYAs need to respect their pain experiences, and to support them in healthy coping strategies. Further studies on this issue are needed, especially research focusing on AYAs pain in exposed populations and AYAs from non-Western cultures.

Quality of life in adolescents with chronic non-traumatic knee pain: An analysis of 323 adolescents with Patellofemoral Pain and Osgood-Schlatter Disease

“…The response shift illustrates individual capacity to adapt to their context (i.e., acceptance of pain), shifting focus away from one cannot (for now), to what they can do to exert control of pain in their current situation 43,45 . This aligns with qualitative evidence where some adolescents with CMP ascribe that enhanced knowledge of pain legitimize self-management behaviors that makes it easier to accept limitations, justify actions to other peers, prioritize new life goals and thereby accomplish satisfactory level of perceived QoL 8,14,15,38 . The temporal and adaptive nature of this phenomenon may explain why perceived QoL differs from other outcomes in the long-term 45 .…”

“…Our findings are consistent with a previous study among adolescents diagnosed with either PFP or OSD which showed more than 50% reported their reduced sports participation, due to “pain” , and “ I am afraid to damage my knee” 35 . Adolescents understanding of their pain condition may have a direct impact on how they interpret and manage their pain 8,17,42 . Some adolescents with a lived experience of CMP ascribe positive changes in understanding of pain (i.e., pain as non-threatening) as important contributors towards their recovery 8,15,17 .…”

“…Adolescents understanding of their pain condition may have a direct impact on how they interpret and manage their pain 8,17,42 . Some adolescents with a lived experience of CMP ascribe positive changes in understanding of pain (i.e., pain as non-threatening) as important contributors towards their recovery 8,15,17 . Johansen et al recently showed that the individual perceptions of ‘why do I have pain’ (i.e., functional theories) are strong drivers of behavior in young adults with non-traumatic knee pain underlining that knowledge about their condition is important 14 .…”

“…Chronic musculoskeletal pain (CMP) affects up to one-third of adolescents (age 10-19) 6,9,34 . During this critical period in life, pain may have detrimental impact on a child’s physical, emotional, and social functioning 6,8,17 . Non-traumatic knee pain is the most common pain origin among adolescents, with Patellofemoral Pain (PFP) and Osgood-Schlatter Disease (OSD) having the highest prevalence 34 .…”

How do we explain painful chronic non-traumatic knee conditions to children and adolescents? A multiple-method study to develop credible explanations

“…Chronic non-traumatic knee pain negatively impacts adolescents' quality of life, sleep quality, sports participation, and social interactions [19,25,53]. These non-specific conditions are often viewed as selflimiting by clinicians and pain-dismissing statements, such as "just growing pains" or "it'll go away", have been reported [54,62]; Adolescents living with chronic pain may also experience pain-related stigma from family members, and peers [17,64]. In contrast, recent research shows that about 50% of adolescents with knee pain will continue to have pain after two years [53].…”