Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: a qualitative systematic review and thematic synthesis

BMC Musculoskeletal Disorders

Sonia Khanom¹  John McBeth¹  Janet E. McDonagh²  Ebru Bakir³  Michelle Briggs³ 

[1] Centre for Epidemiology Versus Arthritis , School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 2.706 Stopford Building, Oxford Road, M13 9PT, Manchester, UK;Centre for Epidemiology Versus Arthritis , School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 2.706 Stopford Building, Oxford Road, M13 9PT, Manchester, UK;NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK;Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK;

关键词: Adolescence;    Juvenile arthritis;    Chronic pain;    Patient experience;    Qualitative research;   

DOI  :  10.1186/s12891-020-03627-1

来源: Springer

【 摘 要 】

BackgroundAdolescents with chronic musculoskeletal pain experience daily fluctuations in pain. Although not all fluctuations are bothersome, pain flares are a distinct type of symptom fluctuation with greater impact. Since literature on the experience of pain flares is non-existent, the aim of this review was to (i) synthesise the qualitative literature on adolescents’ experiences of fluctuating pain in musculoskeletal disorders in order to (ii) identify knowledge gaps to inform future research on pain flares.MethodsElectronic databases (CINAHL, MEDLINE, EMBASE, PsycINFO), grey literature and reference lists were searched from inception to June 2018 for qualitative studies reporting adolescents’ experiences of pain. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research. Studies were analysed using thematic synthesis.ResultsOf the 3787 records identified, 32 studies (n = 536) were included. Principal findings were synthesised under three key themes: 1) symptom experience, 2) disruption and loss, and 3) regaining control. The first theme (symptom experience) describes adolescent’s perception and interpretation of pain fluctuations. The second theme (disruption and loss) describes the physical, social and emotional constraints faced as a result of changes in pain. The third theme (regaining control) describes coping strategies used to resist and accommodate unpredictable phases of pain. Each theme was experienced differently depending on adolescents’ characteristics such as their developmental status, pain condition, and the duration of the pain experience.ConclusionsAdolescents with chronic musculoskeletal pain live with a daily background level of symptoms which frequently fluctuate and are associated with functional and emotional difficulties. It was not clear whether these symptoms and challenges were experienced as part of ‘typical’ fluctuations in pain, or whether they reflect symptom exacerbations classified as ‘flares’. Further research is needed to explore the frequency and characteristics of pain flares, and how they differ from their typical fluctuations in pain. The review also highlights areas relating to the pain experience, symptom management and health service provision that require further exploration to support more personalised, tailored care for adolescents with chronic musculoskeletal pain.

【 授权许可】

CC BY