The influence of pain-related beliefs and parental responses on occupational engagement and self-management among adolescents living with chronic pain
Chronic pain has been described as ‘the silent epidemic’ in the UK and its prevalence continues to present as a major public health concern. Chronic pain can affect every sphere of a person’s life, going beyond the physical sensation to affect many aspects of an individual. Occupational therapists are skilled professionals in ensuring that all facets of the pain experience are acknowledged. Through an holistic and occupational focused approach, they can enable individuals to live well, irrespective of their condition. Therefore, the recognition of the occupational therapy profession is fundamental, and the valuable, person-centred contribution that occupational therapists can make should be more widely acknowledged. The core standards for pain management services in the UK (2015) stress that occupational therapists are ideally placed to make a unique contribution to pain prevention and pain management programmes. Critical to this is the ambition of Scotland’s Strategic 2020 Vision, which focuses on prevention and supported self-management to alleviate some of the significant challenges faced by Scotland’s healthcare system and to better equip individuals to manage their own health and well-being. However, there is a general lack of knowledge about chronic pain and the management options available in Scotland. While there is an expanding body of research on chronic pain available within the occupational therapy literature, the use of self-management as a comprehensive approach for adolescents living with chronic pain is an under-researched area in occupational therapy specific literature. This is particularly concerning for young adolescents as they are at a greater risk of continuing into adulthood with chronic pain if it is not addressed appropriately. The premise behind undertaking this literature review is to explore the barriers to occupational therapy participation experienced among adolescents living with chronic pain. Recurrent themes appearing in the literature are parental involvement and how parents’ responses to an adolescent’s pain inadvertently reinforce occupational inactivity and avoidance behaviours. Furthermore, the influence of self and intrapersonal factors experienced by adolescents often acts as a driving force for disengagement and withdrawal. This reveals a pressing need for future research to explore the influence of self and parental involvement among adolescents living with chronic pain and whether this inhibits meaningful occupational participation and self-management.