Mothers’ appraisals of injustice in the context of their child’s chronic pain: An interpretative phenomenological analysis

Abstract

Background: In line with research highlighting the role of observer appraisals in understanding individuals' pain experience, recent work has demonstrated the effects of parental child-and self-oriented injustice appraisals on child pain-related outcomes. However, research on parental injustice appraisals is in its infancy and lacks a valid and context-specific operationalization of what parental injustice appraisals of child pain precisely entail. The current study presents an in-depth qualitative analysis of parental child-and self-oriented appraisals of injustice in the context of their child's chronic pain. Methods: Twenty-one mothers of children living with chronic pain participated in one of five focus group interviews conducted in Ghent (Belgium), Glasgow (Scotland) and Indianapolis (USA). Results: The interviews were subjected to interpretative phenomenological analysis, which revealed three key justice-related themes, labelled 'You shouldn't be in this much pain', 'The problem's probably with the mother' and 'At least it's not cancer'. Maternal injustice appraisals focused mainly on the child rather than the self and reflected various perceived barriers to their efforts to provide quality of life for their child. A fourth theme labelled 'Not everybody gets a healthy child' reflected maternal strategies to effectively cope with the child's condition and the associated appraisals of injustice. Conclusions: The current findings attest to the relevance of (child-and self-oriented) injustice in the parental experience of caring for a child with chronic pain and provides insight into the specific content and scope of these appraisals. As such, this study provides valuable insights to further research in this area. Significance: The current study presents an in-depth qualitative analysis of parental appraisals of injustice in the context of their child's chronic pain condition. The findings provide valuable insights into the phenomenology of this construct and may inform future research and assessment methods. Furthermore, the themes reported in this study may contribute to clinical practice, as they may raise awareness of parental concerns regarding their child's pain management. | 1933 BAERT ET Al. 1 | INTRODUCTION The experience of pain is common in childhood and is usually temporary. However, a considerable proportion of children report chronic, long-term pain that has a significant impact on their everyday lives (e.g. impaired functioning, school absence and general distress) (

Being a parent of a child with Down’s arthritis: an interpretative phenomenological analysis

“…Research has shown that higher levels of parental injustice appraisals are associated with increased parental stress and burden [31]. This may hinder parents' ability to effectively care for their child [32], highlighting the importance of healthcare professionals listening to parents and taking their experiences and expertise on board. As one participant stated, "nobody knows our child to the extent that we do" (Emma).…”

Child pain‐related injustice appraisals mediate the relationship between just‐world beliefs and pain‐related functioning

“…Parental tension and stress, which often occurs in the context of chronic or persistent child pain (Campo et al., 2007; Eccleston et al., 2004), may affect this. Furthermore, recent focus group research has demonstrated that mothers of children with chronic pain tend to frame the world as unfair; such framing may affect the way parents talk to their children about pain and further shape children's appraisal of pain (Baert et al., 2020).…”

Child appraisals of injustice in the context of acute and chronic pain: An interpretative phenomenological analysis

“…Specifically, IPA is a bottom‐up‐oriented approach allowing the experiences of participants to speak for themselves, rather than fitting them into a predetermined categorical system (Pietkiewicz & Smith, 2014). IPA has been used successfully in the past to examine both lived chronic pain experiences (Osborn & Smith, 1998; Smith & Osborn, 2007) as well as the phenomenology of pain‐related injustice appraisals in adults (Baert et al, 2020; McParland, Eccleston, et al, 2011).…”

“…Furthermore, as mentioned above, guidelines for recurrence were adopted to ensure the themes to reflect shared understandings. Rigor of the analyses was established further as the secondary author of the manuscript (FB), who has previous experience with conducting IPA (Baert et al, 2020), independently coded the first 10 pages of each of the focus group transcripts, serving as a check of the credibility of the analyses performed by the first author. Establishing that the coding by the primary author (FD) lined up with the coding of the initial sections by the secondary author, served as a form of quality control of the qualitative analyses.…”

“…Specifically, there is evidence that the IEQ may not capture all domains of injustice that may be relevant to the everyday experience of pain among different populations. In particular, phenomenological studies of pain‐related injustice among adults with chronic pain (Karos, 2017; Karos et al, 2018; Kugelmann, 1999; McParland, Eccleston, et al, 2011; McParland, Hezseltine, et al, 2011; Wernicke et al, 2017) as well as parents of children with chronic pain (Baert et al, 2020; Jordan et al, 2007) have highlighted the importance of interpersonal injustice, that is the perceived unfair treatment by others due to pain, to which the IEQ makes only limited reference. Such interpersonal dimensions are noted to be particularly important in children, as children with chronic pain often experience victimization and isolation from peers (Forgeron et al, 2010; Jordan et al, 2017).…”