Communication Strategies for Children With Chronic Pain Across the Ages: A Qualitative Study of Physiotherapists Using Vignette-Based Focus Groups.

Good communication strategies are essential in the management of chronic pain in children. While physiotherapists play a key role in pain management, there is limited guidance on adapting communication strategies for children of different ages. This study describes the communication approaches physiotherapists consider when working with children experiencing chronic lower limb pain and how they adapt these strategies across developmental stages. This study incorporated a qualitative design with three case vignettes and semi-structured focus groups with 20 physiotherapists with experience in pediatrics (mean 11 years physiotherapy experience, 70% with 80%-100% pediatric caseload). Data were analyzed using thematic analysis. Three key themes were generated: (1) Understanding the child and their needs, tailored to the child's developmental level, interests, and communication style; (2) Reassuring and empowering the child, highlighting strategies to build trust, validate pain experiences, and foster autonomy; and (3) Educating the child and their family, addressing pain-related misconceptions and supporting pain management. Additionally, four communication strategies were described by physiotherapists as methods they employ during consultations to support their approaches. These were (1) visual aids, (2) mirror child's language, (3) storytelling and analogies, and (4) age-appropriate resources. Physiotherapists describe understanding, empowering, and educating children with chronic pain through diverse communication strategies tailored to the child's age. These findings highlight the different approaches that may be helpful for physiotherapists who are new to pediatrics or chronic pain management and may enhance physiotherapy practice and improve outcomes for children with chronic pain.