Background Pain is a complex and multifactorial experience shaped by biopsychosocial and contextual factors. Communication gaps between healthcare professionals and people living with pain persist as a major barrier to effective and patient-centered care. Supporting the education of healthcare professionals is essential to improving patient satisfaction and the overall experience of care for both healthcare professionals and people living with pain.Aims To address this gap in pain care communication, this paper aims to describe the CARING in Action project, a patient-oriented approach to co-developing resource materials and a dissemination strategy to enhance knowledge mobilization and implementation.Methods This project employed a participatory co-creation design informed by Canada’s Strategy for Patient-Oriented Research. Patient partners contributed across all stages, from idea conceptualization, to planning and dissemination. We identified communication gaps, adapted evidence to context, and held iterative virtual and in-person workshops with people with lived experience, healthcare professionals, researchers, and trainees. Prototype materials were refined through three cycles of iteration, resulting in an evidence-informed, educational tool shaped by diverse interest holder perspectives and strengthened by a process prioritizing consensus-building, inclusivity, and validation.Results The final eight-module is a self-directed online educational resource for licensed and trainee healthcare professionals, to strengthen effective communications with people living with pain.Discussion This initiative generated concrete knowledge products that support culturally attuned communication and relational approaches to pain management. Together, these outputs provide practical resources for healthcare professionals and trainees across pre-licensure and post-licensure education, supporting the implementation of patient-centered communication practices in pain care.
Background Iron deficiency (ID), a common cause of anemia, disproportionately affects women of reproductive age and is characterized by symptoms such as fatigue, cognitive fog, migraines, restless‑leg syndrome, and musculoskeletal pain. Some of these are also common to chronic pain syndromes. Iron is essential for the synthesis of multiple neurotransmitters, suggesting a mechanistic link between ID and pain perception.Methods This single‑center cross-sectional study assessed the prevalence of risk factors for iron deficiency among 81 women attending the Michael G. DeGroote Pain Clinic. Participants completed a validated questionnaire adapted from Dr. Toby Richards’ Iron Clinic, which evaluated risk factors including heavy menstrual bleeding, prior iron‑deficiency status, and supplementation history. Patients were defined as being at high risk for ID if they endorsed two or more positive symptoms within Question 14 (menstrual‑bleeding characteristics).Results Overall, 54% of participants were identified as high risk for iron deficiency. 46% reported having restless‑leg syndrome, 47% reported a history of anemia or ID, 41% had taken oral iron supplements, and 15% were receiving iron‑infusion therapy. These results indicate that a substantial proportion of women with chronic pain may also have unrecognized ID.Discussion Since iron’s role in neurotransmitter metabolism provides a plausible biological mechanism for some symptomatology, and there is overlap of the symptoms of ID and chronic pain conditions, routine screening for ID, along with patient education, dietary optimization, oral iron supplementation, and intravenous iron therapy, should be considered as part of integrative pain‑management strategies. Cost-effectiveness analyses support ferritin screening as a feasible approach in this population, highlighting the potential for improved patient outcomes.
Background Chronic non-cancer pain (CNCP) is widespread in Canada, with Family Physicians (FPs) playing a crucial role in patient care and opioid stewardship amidst high prescribing rates. Two national surveys conducted in 2010 and 2018 revealed notable knowledge gaps and poor adherence to safe opioid prescribing practices among Canadian FPs.Aims To provide an update on Canadian FPs’ knowledge, attitudes, and behavior regarding opioid prescribing for CNCP.Methods This study is the third national cross-sectional online survey of Canadian FPs. The results are presented narratively, and only descriptive statistics are offered.Results A total of 529 responses were collected from July 2023 to June 2024, primarily from female participants (52%) and Ontario (50%). Eighteen percent of respondents did not prescribe opioids for CNCP, and 17% prescribed only weak opioids. Wait time for a pain specialist and for a non-urgent referral to an addiction specialist were less than one month among 23% and 25% of respondents, respectively. Only 27% of respondents were able to correctly identify the minimum daily dose of morphine equivalents to start prescribing a transdermal fentanyl patch. Respondents’ adherence to recommended practices before starting opioids varied from 16% for “providing written information about opioid therapy” to 93% for “explaining potential harms of long-term opioid therapy.”Conclusion Several knowledge gaps and a lack of adherence to certain guideline-recommended practices were observed among respondents, along with reduced wait times for consultations with pain specialists.
Background Opioid prescribing guidelines for chronic noncancer pain (CNCP) aim to reduce opioid volume and dosage while addressing risks such as misuse, poisoning, and death. However, these guidelines may have spillover effects on patient populations beyond the intended scope. Aims This study aims to summarize the impact of prescribing guidelines on opioid use prevalence, incidence, and dosage across multiple jurisdictions and patient populations. Methods In October 2025, we systematically searched MEDLINE, Scopus, Web of Science, and PsycInfo for studies on the effects of opioid prescribing guidelines in adult populations. Primary outcomes included opioid use prevalence, incidence, dosage, and duration. We calculated study-level effect estimates using interrupted time series analyses and conducted meta-analyses with random effects models to estimate the pooled effect of the guidelines on the aforesaid outcomes. Results Of 190 records, 71 studies met inclusion criteria for meta-analysis. After guideline implementation, morphine milligram equivalent (MME) dosage per person and prescription duration decreased annually by 10.4% (95% confidence interval [CI] -19.2% to -0.6%) and 5.6% (95% CI -8.1% to -3.0%), respectively, among patients with CNCP. In the general population, MME dosage per person decreased annually by 7.6% (95% CI -11.3% to -3.7%), whereas duration remained stable over time (-1.4%; 95% CI -6.5% to 4.0%). Following guideline implementation, declines in prevalence, dosage, and duration were also observed in patients living with cancer or treated for acute pain. Conclusion Guidelines reduced opioid prescribing for CNCP. Future research is needed to examine whether and to what extent similar changes occurred among other patient populations.
Background:Pain Rehabilitation Virtual Reality (PR-VR) is a novel tool designed to engage youth with chronic pain in exercise as a part of physiotherapy. PR-VR has been evaluated in day-treatment and outpatient settings, but not for at home use. Aims:To evaluate the feasibility, acceptability and safety of PR-VR at home for youth with chronic pain. An exploratory aim evaluated the preliminary effectiveness of PR-VR on pain and disability. Methods:This was a 3-arm pilot randomized controlled trial (registration #NCT04912817). Each study arm included four 60-min physiotherapy sessions via Zoom (1: commercially available VR; 2: custom-developed PR-VR; 3: standard physiotherapy care). Feasibility metrics included enrollment, accrual, and drop-out rates. Acceptability was measured via satisfaction surveys and qualitative interviews. Pain and disability were measured via self-report, physical performance, and actigraphy. Results:Thirty-seven of 70 eligible patients approached were enrolled and randomized (53% enrollment rate, 100% accrual rate), including 28 females (76%) aged 10-17 years. Twenty-eight participants completed the study (33% drop-out rate; reasons include pain resolution, medical complexity, dissatisfaction with assignment to control). Ten minor adverse events were reported across study arms. Participants and physiotherapists expressed high levels of VR acceptability. Of the participants who completed arms 1 and 2 (n = 17), 94% were satisfied/very satisfied with VR and 100% rated VR as easy/very easy to use. Conclusions:Results from this study demonstrate the safety and acceptability of VR in pediatric pain rehabilitation. These feasibility results will inform the design of future large-scale trials, including consideration of a wait-list control group. Trial Registration:ClinicalTrials.gov, NCT04912817.
Background:Buprenorphine/naloxone (Suboxone) is an emerging option for chronic noncancer pain (CNCP), but evidence on transitioning patients from full opioid agonists remains limited. At the University of Saskatchewan Chronic Pain Clinic (UCPC) in Saskatchewan, Canada, pharmacists support these transitions within a unique interdisciplinary model. Aim:The aim of this study was to explore patient perspectives on transitioning to and using buprenorphine/naloxone for CNCP. Methods:This qualitative study involved one-on-one semistructured interviews with current and former UCPC patients who had transitioned to buprenorphine/naloxone for CNCP. Participants were invited by email to complete semistructured interviews via Zoom or telephone with a trained facilitator. The interview guide was informed by a literature review and pretested. Recorded interviews were transcribed using an artificial intelligence-supported platform, reviewed for accuracy, and analyzed in NVivo 14 using thematic analysis. Results:Seven participants (five females, two males; average age 57 years) were interviewed. Most had used opioids long term for pain prior to transition. Experiences varied: some transitioned easily, whereas others required more time or experienced discomfort. Buprenorphine/naloxone tablet size and taste were the most common negative experiences. Side effects were mild (e.g. drowsiness, constipation). Some expressed concern about long-term use and desired clearer communication during transitions. Although buprenorphine/naloxone was not uniformly experienced as effective for pain relief, most would recommend buprenorphine/naloxone to others. Conclusion:Patient experiences at UCPC suggest that though buprenorphine/naloxone is not a universal solution for CNCP, it may be an effective option for carefully selected individuals. Side effects were tolerable, and most would recommend the treatment. Improved communication during transitions may enhance patient experiences.
Background:Parental responses to an adolescent's pain impact pain-related variables, yet limited research has focused on parent-adolescent pain communication. Additionally, patterns have rarely been examined through comparisons of dyads where the adolescent has chronic pain versus those without. Aims:To examine the impact of parental validation and invalidation on adolescent pain-related variables (i.e. functional disability, pain catastrophizing, pain intensity). Methods:Parent-adolescent dyads, including adolescents with chronic pain (CP; n = 32) and with no chronic pain (NCP; n = 61), completed questionnaires and two discussion tasks: a worry discussion and a pain discussion. Parental responses were coded using the Validating and Invalidating Behaviors Coding Scale. Results:Parental invalidation was significantly greater in the worry task compared to the pain task (F(1, 91) = 4.16, p =.04). In the pain task, greater parental validation predicted higher adolescent functional disability (β = 0.32, p =.02), with significantly stronger effects in the CP group. Validation also predicted adolescent pain catastrophizing (worry: β =.35, p =.02; pain: β = 0.30, p =.03), with significantly greater effects in the CP group. In the worry task, validation showed both linear (β = -0.34, p =.03) and curvilinear (β = -0.25, p =.005) relationships with changes in adolescent pain intensity. Conclusions:Chronic pain status and discussion content are associated with adolescent-reported variables during parent-adolescent interactions. Greater attention to intra- and interpersonal variables is needed to understand how pain communication unfolds between parents and adolescents.
Background Chronic pain has many deleterious effects on the lives of those living with it. Though understanding the needs of people living with chronic pain is crucial to providing patient-centered care, current knowledge remains limited regarding the needs of this population in relation to the physiotherapy services they regularly use.Aims This study aimed to understand the perceived needs of people living with chronic pain regarding physiotherapy services in Quebec, Canada.Methods This qualitative study followed an interpretative description methodology. Semistructured individual interviews were conducted with adults living with chronic pain who had used physiotherapy services in any type of setting. Transcripts were analyzed using reflexive thematic analysis following an inductive approach with the constant comparative method.Results Among the 27 participants, the majority were White women living in urban areas who were highly educated. They mainly used physiotherapy services in private clinics for musculoskeletal chronic pain. Four overarching themes related to patients’ perceived physiotherapyrelated needs were identified: (1) being respected in an empathetic human-to-human relationship; (2) obtaining the care you need; (3) desiring a warm, welcoming, and tailored environment; and (4) feeling the organization practices and policies are adapted to persons living with chronic pain.Conclusion Our findings show that the needs of people living with chronic pain are multiple, deeply interconnected, and shaped by organizational and systemic contexts. Improving the responsiveness of physiotherapy services therefore requires moving beyond individual-level strategies to address these broader forces. A comprehensive, systemwide approach is essential to meaningfully meet patients’ needs.
Background/Aims Chronic pain affects approximately 8 million Canadians annually and is defined by persistent pain lasting over 3 months. Ketamine is an anesthetic drug used to treat chronic neuropathic pain, a subset of chronic pain. To better understand ketamine’s therapeutic benefits and feasibility as a treatment for chronic neuropathic pain, it is important to characterize patient experiences and perspectives with ketamine, as well as barriers and facilitators to accessing this treatment.Methods Thirteen participants were recruited from the chronic pain ketamine infusion program at St. Michael’s Hospital in Toronto, Canada. Each participant completed a survey that captured demographic information and chronic pain features, followed by a semistructured interview. Interview data were analyzed, and themes were generated using content analysis.Results All participants described decreased pain intensity and increased functionality after receiving ketamine treatment. Barriers to ketamine treatment included fragmented health systems and long wait times, along with a struggle for pain validation by health care providers. Facilitators of ketamine treatment included support from individual health care providers and the provision of a supportive treatment environment.Conclusions Although pain experiences differed among participants, all participants reported decreased pain with ketamine infusions. Addressing the stigma associated with ketamine infusions, further research around augmenting durability of ketamine, and providing a safe treatment environment can all improve ketamine’s benefit for chronic neuropathic pain. Understanding the barriers and facilitators, as well as implementing participant suggestions, will not only help inform our ketamine program but can improve access to pain management and facilitate future research in this field.
Background Postpartum depression (PPD) develops within the first few weeks or months following delivery and causes severe emotional and psychological problems. Pain has been closely linked to the occurrence of depression. Observational studies have suggested that effective pain relief during childbirth can reduce the incidence of PPD. However, these studies are fraught with numerous confounding factor. Combined spinal-epidural analgesia (CSEA) is a commonly used pain relief method during childbirth. It is currently unclear whether a causal relationship exists between CSEA and PPD.Methods An analysis was conducted using five methods in Mendelian randomization (MR) to study the use of CSEA during childbirth and PPD. The data were obtained from the United Kingdom Biobank database for CSEA and from FinnGen for PPD. The analysis included MR-Egger, weighted median, inverse variance weighted (IVW), simple mode, and weighted mode. We then conducted exposure heterogeneity testing using Cochran’s Q statistics and assessed the pleiotropy of exposure single nucleotide polymorphisms (SNPs) using MR-Egger.Results IVW odds ratio (OR) = 0.978; 95% confidence interval (CI) 0.407, 1.031; P = 0.408. The results of the weighted median (OR = 1.035; 95% CI 0.995; 1.118, P = 0.377), simple mode (OR = 0.929; 95% CI 0.773, 1.116; P = 0.435), and weighted mode (OR = 0.995; 95% CI 0.930, 1.065; P = 0.888) suggest that there is no significant link between CSEA and PPD.Conclusion We have concluded that there is no causal link between CSEA and PPD. This information can assist clinical professionals in gaining a better understanding of this condition.
Aims To support the implementation of parent-led infant pain care by identifying barriers and facilitators during acute procedures.Methods We conducted a qualitative descriptive study guided by the Theoretical Domains Framework (TDF) and COM-B Model. We completed individual, virtual, semi-structured interviews with health system participants (hospital and community-based health care providers, clinical leaders, and administrators; n = 10) and parent participants (who had used hospital or community-based perinatal services in the last 12 months; n = 14) and analyzed the data using deductive-inductive qualitative content analysis.Results Thirty-two themes were identified across the capability (9 themes), opportunity (13 themes), and motivation (10 themes) domains of the COM-B Model. Participants emphasized the influence of environmental context, resources, and social factors on the use of breastfeeding and skin-to-skin contact to manage infant pain across rural acute and community care settings. Health system and parent participants described similar barriers and facilitators, highlighting the inconsistent implementation of parent-led infant pain care.Conclusions The barriers and facilitators identified in this study will inform the development of theory-informed, contextually relevant implementation interventions to support the use of best practice infant pain care in rural contexts.
Background:The relationship between substance use and chronic pain is bidirectional. Although chronic pain and polysubstance use are highly prevalent among people who inject drugs (PWID), few studies have examined how the frequency of use of different substances relates to chronic pain. Aims:The aim of this study was to examine associations between substance use frequency and chronic pain in a sample of PWID. Methods:A cross-sectional analysis was conducted among PWID participating in a community-based cohort in Montreal, Canada. Chronic pain measures were introduced in the interviewer-administered questionnaire in February 2017. The first questionnaire was used for analyses, which covers data up to November 2022. Logistic regression analyses were conducted to examine associations between alcohol, stimulants, opioid and cannabis frequency and chronic pain. Results:Six hundred and eight participants were included; 84% were men and mean age was 44.7 years old. Prevalence of chronic pain was 48%. Age (adjusted odds ratio [aOR] = 1.38, 95% confidence interval [CI] 1.15-1.65) and regular alcohol consumption in the past month (aOR = 1.76, 95% CI 1.13-2.75) were associated with chronic pain in univariable and multivariable logistic regression models. The frequency of use for all other substances was not found to be significantly associated with chronic pain. Conclusion:The prevalence of chronic pain in our sample was high. The positive association between high frequency of alcohol use and chronic pain could be explained by alterations of pain pathways by heavy use and withdrawal episodes, potentially increasing hyperalgesia. This study underscores the importance of addressing alcohol use along with other substances among PWID.
Background:Regular viewing of dim green light has been shown to reduce the pain associated with migraine, fibromyalgia, and post-surgery. Aim:The present study examined whether visual exposure to ambient green light could also alleviate osteoarthritis (OA) pain. Methods:Nineteen patients diagnosed with moderate to severe knee OA pain were exposed to dim white light (6.57 ± 1.00 lux) for 1-2 hours per day for 10 weeks. Following a 2-week wash-out period, patients then received green light treatment (wavelength = 525 nm, 6.82 ± 0.78 lux) for 1-2 hours per day for a further 10 weeks. The primary outcome measure was changes in arthritis disability score as measured by the Western Ontario and McMaster University Arthritis Index (WOMAC) questionnaire. Secondary outcomes included patient-reported changes in pain intensity, pain disability, and patient global satisfaction. Results:With green light therapy (GLT), average WOMAC scores decreased from 44.1 ± 17.5 at baseline to 32.5 ± 16.2 whereas white light therapy (WLT) had no significant effect on arthritis disability scores (39.6 ± 15.3). While both WLT and GLT reduced pain intensity, the analgesic effect of green light was significantly greater. Pain interference scores were lower following GLT whereas WLT had no effect on this parameter. The Patient's Global Impression of Change was significantly improved over baseline with both WLT and GLT. Conclusion:Daily exposure to ambient green light had a beneficial effect on OA knee pain. The neural pathways between the visual system and central pain modulation regions requires further investigation.
Background:With the increasing use of medical cannabis (MC), there is growing evidence suggesting that MC may be an effective therapeutic for chronic sleep, pain, and anxiety conditions. However, further evaluation is warranted to evaluate the heterogeneous patient outcomes of authorized cannabis treatment. Aims:To assess the effectiveness of authorized cannabis on pain, sleep duration, anxiety, and depression in patients presenting to clinics over a 6-month time period. Methods:This long-term prospective observational multicenter study utilized data from adult Canadian patients in the Medical Cannabis Real-World Evidence study. With physician guidance, patients were able to choose from Health Canada-verified MC products via a national pharmacy platform. Validated questionnaires were administered at Weeks 0, 6, 12, and 24 to assess pain interference (PROMIS, 6-30), pain score (NPRS, 0-10), sleep duration, anxiety (GAD-7, 0-21), depression (PHQ-9, 0-27), and quality of life (EQ-5D-3 L, 0-10). Outcomes were analyzed using descriptive statistics and generalized estimating equations models as both a per-protocol and intention-to-treat basis. Results:Improvements in pain, anxiety, depression, and QoL were observed from Baseline to Week 24. Decreases were observed in PROMIS Pain Interference - 4.6 (CI - 6.02 to - 3.17, n = 137), Numeric Pain Rating Scale - 1.19 (CI - 1.7 to -0.68, n = 137), General Anxiety Disorder-7 - 2.24 (CI - 3.5 to - 0.99, n = 139), Patient Health Questionnaire-9 depression -2.79 (CI - 4.29 to -1.3, n = 141), and EQ-5D-3 L - 0.56 (CI -0.96 to -0.16, n = 139). Conclusions:At Week 24, outcomes in chronic pain, anxiety, depression, and quality of life improved. Although 85% of patients in our study had an MC indication for pain, no outcomes met their minimal clinically significant thresholds at Week 24. These observations align with existing evidence, yet there remains some discrepancies in the current literature. Our findings highlight the need for future studies to characterize MC administration, dose, and specific product relationships.
Missing value imputation is a routine step in biomedical data analysis, yet techniques are often not tailored to specific datasets. We propose a systematic framework for selecting imputation methods customized for the unique characteristics of cross-sectional numerical data, with a focus on pain-related biomedical research. This approach generates artificial “diagnostic” missing values by randomly removing entries, allowing for direct assessment of reconstruction accuracy across various algorithms. We introduce two novel classes of diagnostic reference methods: pseudo or “poisoned” imputation methods, which intentionally introduce bias into the imputation, and “calibrating” imputations, which inject controlled random noise for objective evaluation. The framework was tested on synthetic datasets and four biomedical datasets, primarily focusing on pain-related data, employing 29 different imputation methods. Quantitative outputs, including root median square deviation (RMSD), median difference (MD), relative bias, and method categorization, facilitate a comprehensive assessment of imputation quality. The framework consistently identifies the most suitable imputation technique for each dataset, revealing that multivariate methods generally outperform univariate approaches. Benchmarking against poisoned and calibrated references establishes quantifiable thresholds for acceptable imputation errors, while also identifying instances where reliable imputations are unattainable. This systematic framework offers practical and reproducible guidelines for imputing missing values in biomedical contexts, particularly in pain research. By empowering researchers to make informed decisions about imputation, the framework enhances data integrity and the robustness of subsequent analyses. Its model-agnostic nature allows for the integration of various imputation methods, with an automated implementation available in the open-source R package “opImputation.”
Background The Pain Education in Physiotherapy (PEP) competency profile provides a structured framework for integrating pain management competencies into Canadian physiotherapy (PT) curricula. Despite widespread endorsement, the integration of pain management competencies into PT curricula remains inconsistent. Identifying the barriers and enablers to implementation is essential for developing strategies that support students in achieving these competencies.Objective This study explored factors influencing the implementation of the PEP competency profile in Canadian PT programs and identified key challenges and opportunities for improving integration.Methods A qualitative description study was conducted using five focus groups with 23 participants, including pain educators and program directors from 13 entry-level PT programs in Canada. Data were analyzed using the Consolidated Framework for Implementation Research to identify multilevel barriers and facilitators.Results Participants recognized the value of the PEP competency profile in enhancing pain education but highlighted three key challenges: (1) a lack of structured guidance for teaching and assessment, (2) an overreliance on faculty champions rather than systemic institutional support, and (3) the absence of rigorous assessment approaches. Participants expressed uncertainty about integrating competencies within existing curricula, emphasizing the need for national collaboration, faculty development, and shared resources. The iterative, decentralized nature of curriculum change further complicated efforts to achieve consistent integration.Conclusion Sustainable implementation of the PEP competencies requires structured guidance, institutional commitment, and adapted assessment strategies. Addressing these barriers through national-level collaboration, accreditation alignment, and faculty support is critical to ensure that PT graduates develop the necessary competencies for high-quality pain management.
Patients with chronic pain that cannot be explained by tissue abnormality may be accused of symptom amplification and at worst malingering. This is particularly relevant in the medicolegal setting where legal decisions are highly dependent on objective and validated information, conditions mostly lacking in the setting of chronic pain. When evaluations are conducted by assessors less familiar with current knowledge of pain mechanisms, subjective complaints of pain and associated symptoms such as fatigue and cognitive difficulties, are at risk of being misinterpreted leading to bias and stigmatization. In this commentary we will highlight some of the pitfalls that erroneously lead to a biased assessment of pain severity including failure to pay attention to psychological state and sociocultural influences, application of poorly reliable physical maneuvers, and use of neurocognitive testing of intentional cognitive dysfunction as a surrogate for dishonesty in pain and functional impairment report. Concerns about misinterpretation of exaggeration in persons with chronic pain are highlighted by recent report of symptom exaggeration in up to two thirds of those attending for an independent medical evaluation. Directives to help the medical assessor to provide pertinent information that will assist the courts in reaching a fair decision are discussed, with emphasis on need for a comprehensive assessment of biosocial factors, contextual variables and nonphysical evidence.
The incidence of liver disease is projected to increase significantly by 2030, affecting 1.5 billion of the global population and approximately 3 million in Canada. With various etiologies, the progression of liver disease to cirrhosis varies from months, years, or decades. Experiencing pain can severely debilitate a person living with this condition. However, there is limited qualitative evidence to understand the subjective pain experience of individuals with cirrhosis. Understanding this experience with cirrhosis is crucial for providing comprehensive, person-centered care. The aim of this study was to qualitatively explore the multidimensional experience of pain for persons with cirrhosis. A qualitative descriptive approach was used, recruiting participants from a hepatology clinic in Toronto in 2021. Participants completed a Brief Pain Inventory Short Form questionnaire and a semistructured interview. Data analysis was guided by Hsieh and Shannon’s stepwise directed content analysis. Fifteen interviews were conducted with adults (mean age: 54 years, 53% men, 47% women) with cirrhosis, most unable to work, with approximately half married/partnered. Participants reported diverse physical symptoms including visceral and musculoskeletal pain, often described as a constant experience. Psychologically, pain contributed to significant fatigue and emotional distress, affecting self-care and daily activities. Socioculturally, pain disrupted social interactions and financial stability, intensifying reliance on support systems. Participants reported limited effectiveness of pharmacological interventions, reliance on mindfulness and rest, and frustration with unmet pain management needs. These interrelated themes collectively impaired quality of life and independence. Exploring the multidimensionality of pain for persons with cirrhosis provides valuable insights to address the gaps in current pain management strategies.
Background Understanding the experiences of parents of adolescents with chronic pain is crucial in creating a better experience for all involved throughout the adolescent’s chronic pain journey. However, limited qualitative research has explored the experiences of parents of adolescents with chronic pain.Aims This qualitative study explored the lived experiences of parents of adolescents with chronic pain, with a focus on the impact of chronic pain on their child and family life. Methods: We conducted 12 semi-structured interviews with parents of adolescents with chronic pain receiving care through a pain management program. Data were transcribed and analyzed using inductive thematic analysis.Results Seven key themes were generated and divided into two groups: (1) adolescent and (2) family (including both parents and siblings). Groups were determined based on whether the theme referred to the effect of chronic pain on the adolescent or the caregiver or family. The adolescent group included four themes: (1) physical, (2) psychological, (3) social interaction, and (4) school functioning. The family group included three themes: (1) disruption to daily life, (2) emotional, and (3) relationship dynamics.Conclusions This study provides a deeper understanding of the negative effect chronic pain can have on adolescents and family life. Our findings call for interventions to mitigate the physical, psychological, and social impact of chronic pain on adolescents. Family level interventions are also needed to support families of adolescents with chronic pain. More research is needed to explore adolescents’ own views of their experiences with chronic pain.
