Department of Psychology, University of Calgary, Calgary, Canada.
Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford.
Clin J Pain. 2024 Oct 1;40(10):588-600. doi: 10.1097/AJP.0000000000001238.
This study was the first to apply a socio-narratology framework to the narratives about child pain as told by youth with chronic pain and their parents, all of whom experience chronic headaches.
Storytelling is a powerful social transaction that occurs within systems (eg, families, clinical encounters) and is both shaped by, and can shape, the pain experience. Narrative can be harnessed as a clinical tool to aid in the ability to listen, understand, and improve clinical encounters.
Twenty-six youth (aged 11 to 18 y) and their mothers, both with chronic headaches, recruited from a tertiary level pediatric pain clinic separately completed in-depth interviews about children's pain journey narratives. Data were analyzed using narrative analysis, which incorporated elements of socio-narratology to compare similarities and differences between and within dyads' narratives.
Five narrative types were generated: (1) The trauma origin story-parents, but not youth, positing traumatic events as the causal link to children's pain; (2) mistreated by the medical system-neglect, harm, and broken promises resulting in learned hopelessness or relying on the family system; (3) the invalidated-invalidation of pain permeated youth's lives, with mothers as empathic buffers; (4) washed away by the pain-challenges perceived as insurmountable and letting the pain take over; and (5) taking power back from pain-youth's ability to live life and accomplish goals despite the pain.
Findings support the clinical utility of narrative in pediatric pain, including both parents' and youths' narrative accounts to improve clinical encounters and cocreate more youth-centred, empowering narratives.
本研究首次将社会叙事学框架应用于患有慢性头痛的青少年及其父母所讲述的儿童疼痛叙事，他们均经历慢性头痛。
讲故事是一种强大的社会交流，发生在系统（如家庭、临床接触）中，受疼痛体验的影响，并能塑造疼痛体验。叙事可以作为一种临床工具，帮助倾听、理解和改善临床接触。
从一家三级儿科疼痛诊所招募了 26 名青少年（年龄 11 至 18 岁）及其母亲，她们均患有慢性头痛，分别完成了关于儿童疼痛经历叙事的深入访谈。使用叙事分析对数据进行分析，该分析纳入了社会叙事学的元素，以比较亲子叙事的相似点和差异。
生成了五种叙事类型：（1）创伤起源故事——父母而非青少年将创伤性事件作为儿童疼痛的因果关系；（2）被医疗系统虐待——忽视、伤害和违背诺言导致习得性绝望或依赖家庭系统；（3）被否定——否定疼痛充斥着青少年的生活，母亲作为共情的缓冲；（4）被疼痛淹没——感知到无法克服的挑战，让疼痛占据主导地位；（5）从疼痛中夺回力量——青少年有能力在疼痛中生活和实现目标。
研究结果支持叙事在儿科疼痛中的临床应用，包括父母和青少年的叙事描述，以改善临床接触并共同创造更多以青少年为中心、赋权的叙事。
