Clinician perspectives concerning the treatment of adolescents with co-occurring chronic pain and mental health symptoms

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-05-16 DOI:10.1016/j.jpain.2025.105436

Dr Sharon Bateman , Dr Line Caes , Dr Melanie Noel , Dr Jeremy Gauntlett-Gilbert , Dr Abigail Jones , Dr Abbie Jordan

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引用次数: 0

Abstract

Pain and mental health symptoms frequently co-occur in adolescents, often posing physical, social, and emotional challenges. While previous research has focused on clinician perspectives on chronic pain in isolation, limited knowledge exists on the potential unique challenges these co-occurring symptoms’ present to clinicians in providing appropriate support to adolescents. This study examined clinician perspectives on the challenges and barriers to treating adolescents who experience co-occurring pain and mental health symptoms. Using a cross-sectional qualitative online vignette survey, responses were collected from 40 clinicians, including psychologists, physiotherapists, and doctors involved in treating adolescents (11–19 years) who experience co-occurring chronic pain and mental health symptoms. Participants, recruited from several countries, were asked about their perceived challenges to treating adolescents with co-occurring chronic pain and mental health symptoms. Vignettes were analyzed using reflexive thematic analysis. The analysis generated two themes. The first, ‘tangled threads’, describes how clinicians perceive mistrust from the adolescents based on previous negative clinician encounters and a perceived need to ‘undo’ this anticipated harm. The second theme ‘the difficult-to-pursue integrated approach’ depicts how fragmentation and siloed services for pain and mental health hinder effective treatment for adolescents who experience both symptoms. Co-occurring pain and mental health symptoms in adolescents are often initially mismanaged because they do not fit the mould of the services available to treat them, resulting in a more complex presentation to clinicians. The development of a more integrated clinical approach to treating adolescents with co-occurring pain and mental health symptoms is needed.

Perspective

This study identifies that clinicians perceive they face challenges treating adolescents with co-occurring pain and mental health symptoms, often due to the adolescent’s prior clinical experiences and the limited comprehensive treatment options available to them. An integrated approach is urgently needed to tailor care and reduce harm.

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临床医生对青少年慢性疼痛和心理健康症状共存治疗的看法

疼痛和精神健康症状经常在青少年中同时出现，常常带来身体、社会和情感方面的挑战。虽然以前的研究主要集中在临床医生对慢性疼痛孤立的看法，但对这些共同出现的症状给临床医生提供适当支持的潜在独特挑战的了解有限。本研究考察了临床医生对治疗经历共同发生的疼痛和心理健康症状的青少年的挑战和障碍的看法。通过横断面定性在线小短文调查，收集了40名临床医生的反馈，包括心理学家、物理治疗师和参与治疗同时出现慢性疼痛和心理健康症状的青少年（11-19岁）的医生。从几个国家招募的参与者被问及他们在治疗同时出现慢性疼痛和精神健康症状的青少年方面所面临的挑战。使用反身性主题分析对小插曲进行分析。分析产生了两个主题。第一个，“纠结的线索”，描述了临床医生如何根据之前的负面临床医生遭遇和感知到的“消除”这种预期伤害的需要来感知青少年的不信任。第二个主题“难以实施的综合办法”描述了针对疼痛和精神健康的分散和孤立的服务如何阻碍了对经历这两种症状的青少年的有效治疗。青少年中同时出现的疼痛和精神健康症状最初往往处理不当，因为它们不符合现有治疗服务的模式，导致向临床医生提出更复杂的问题。需要发展一种更加综合的临床方法来治疗同时出现疼痛和精神健康症状的青少年。该研究发现，临床医生认为他们在治疗同时出现疼痛和心理健康症状的青少年时面临挑战，这通常是由于青少年之前的临床经验和他们可用的有限的综合治疗方案。迫切需要一种综合方法来调整护理和减少伤害。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.