Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV, USA.
Matern Child Health J. 2024 Jul;28(7):1210-1218. doi: 10.1007/s10995-024-03915-5. Epub 2024 Feb 24.
We aimed to understand connections between pain, caregiving, physical and behavioral health treatment needs, and motivations for prescription opioid use among child caregiving women with chronic pain.
We conducted in-depth, semi-structured interviews with 12 women (average age 48 years; 58% Black) in child caregiving roles, including women who were pregnant or trying to become pregnant and were caring for children or grandchildren < 18 years, and who received treatment at an outpatient pain management clinic. We used thematic text analysis to identify qualitative themes related to caregiving, pain, treatment, substance use, coping strategies, and sources of support.
A diverse sample of women reported high levels of stress and pain, substance use, interpersonal violence, depression, and financial strain. Most described difficulties at work, interacting with children or grandchildren, and engaging routine, daily activities due to their pain. Most indicated that they spent less time with family and friends due to their pain and had limited sources of support to help them navigate both caregiving and pain. Many described barriers to receiving appropriate healthcare, including prescription opioids, due to stigma or logistics, though most also reported positive healthcare experiences. Women also reported added daily-life, physical, mental health, and interpersonal stressors and difficulty navigating the healthcare system to receive needed care.
For women with chronic pain in child caregiver roles, results highlight the importance of care tailored to the physical needs of child caregiving and of trauma-informed approaches given the prevalence of comorbid conditions and trauma.
我们旨在了解慢性疼痛的育儿女性的疼痛、照护、身体和行为健康治疗需求以及处方类阿片使用动机之间的联系。
我们对 12 名处于育儿角色中的女性(平均年龄 48 岁;58%为黑人)进行了深入的半结构化访谈,包括正在怀孕或试图怀孕并照顾 18 岁以下儿童或孙辈的女性,以及在门诊疼痛管理诊所接受治疗的女性。我们使用主题文本分析来确定与照护、疼痛、治疗、药物使用、应对策略和支持来源相关的定性主题。
一个多样化的女性样本报告了高水平的压力和疼痛、药物使用、人际暴力、抑郁和经济紧张。大多数人表示由于疼痛,她们在工作、与儿童或孙辈互动以及从事日常例行活动方面存在困难。大多数人表示由于疼痛,她们与家人和朋友的相处时间减少,而且帮助她们照顾孩子和缓解疼痛的支持来源有限。许多人表示由于耻辱感或后勤问题,她们在获得适当的医疗保健方面存在障碍,包括处方类阿片,但大多数人也报告了积极的医疗保健体验。女性还报告了日常生活、身体、心理健康和人际关系方面的额外压力源,以及在医疗保健系统中难以获得所需护理的困难。
对于处于育儿角色且患有慢性疼痛的女性,研究结果强调了需要根据儿童照护的身体需求量身定制护理,并采用创伤知情方法的重要性,因为存在多种合并症和创伤。