Faculty of Nursing, University of Iceland, Reykjavík, Iceland.
Departments of Psychology, Pediatrics and Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Pain. 2018 Oct;159(10):2035-2049. doi: 10.1097/j.pain.0000000000001289.
There is a scarcity of work examining the relationship between culture and pain-related caregiver behaviors. Moreover, no pediatric pain studies have examined the relationship between caregiver cultural values and pain-related caregiver behaviors nor discern if this process is mediated by caregiver parenting styles and moderated by ecosocial context. Based on cross-cultural developmental theories, this study hypothesized that ecosocial context would moderate the relationship between cultural values, parenting styles, and pain-related caregiver behaviors; and that parenting styles mediate the effect of cultural values on pain-related caregiver behaviors. A cross-cultural survey design was employed using a convenience sample of 547 caregivers of 6 to 12 year olds living in Canada (n = 183), Iceland (n = 184), and Thailand (n = 180). Multigroup structural equation modeling showed that ecosocial context did not affect which cultural model of parenting the caregiver adopted. Parenting styles mediated the relationship between cultural values and pain-related caregiver behavior. Vertical/horizontal individualism, collectivism, and authoritative- and authoritarian-parenting styles positively predicted solicitousness. Vertical individualism and authoritarian-parenting style positively predicted discouraging behavior, whereas other predictors did not. The findings support the sociocommunication model of children's pain by showing that cultural context does affect parents' behaviors. They also corroborate with others' claims of solicitousness universality in a pediatric pain context. However, solicitousness may have different cultural meanings among individuals and may be used in conjunction with discouraging behavior. The findings from this study have implications for the theory development about culture and pediatric pain, but do not provide specific clinical recommendations.
目前，鲜有研究关注文化与疼痛相关照顾者行为之间的关系。此外，也没有儿科疼痛研究调查过照顾者文化价值观与疼痛相关照顾者行为之间的关系，更没有探究这一过程是否受到照顾者养育方式的影响，以及是否受到生态社会环境的调节。基于跨文化发展理论，本研究假设生态社会环境会调节文化价值观、养育方式与疼痛相关照顾者行为之间的关系，同时养育方式会调节文化价值观对疼痛相关照顾者行为的影响。本研究采用跨文化调查设计，使用便利抽样法，选取了生活在加拿大（n = 183）、冰岛（n = 184）和泰国（n = 180）的 6 至 12 岁儿童的 547 位照顾者作为研究对象。多组结构方程模型表明，生态社会环境不会影响照顾者采用的养育模式。养育方式在文化价值观与疼痛相关照顾者行为之间起中介作用。垂直/水平个人主义、集体主义、权威型和专制型养育方式正向预测关怀行为。垂直个人主义和专制型养育方式正向预测抑制行为，而其他预测因素则没有。这些发现支持了儿童疼痛的社会交际模型，表明文化背景确实会影响父母的行为。同时，这些发现也与他人提出的儿科疼痛情境中关怀行为具有普遍性的观点相符。然而，关怀行为在个体之间可能具有不同的文化意义，可能与抑制行为同时使用。本研究的结果对文化与儿科疼痛的理论发展具有重要意义，但没有提供具体的临床建议。
