Chronic pain in the classroom: teachers' attributions about the causes of chronic pain.
BACKGROUND
School absenteeism and other impairments in school function are significant problems among children with chronic pain syndromes; yet, little is known about how chronic pain is perceived in the school setting. The purpose of this study was to examine teachers' attributions about the causes of chronic pain in adolescent students.


METHODS
Classroom teachers (n = 260) read vignettes describing a hypothetical student with limb pain. They were presented with a list of possible physical and psychological causes for the pain and asked to identify the causes to which they attributed the pain. Vignettes varied by the presence or absence of (1) documented medical evidence for the pain and (2) communication from the medical team. Teachers also responded to questions assessing their responses to the student in terms of support for academic accommodations and sympathy for the student.


RESULTS
Teachers tended to endorse a dualistic (ie, either physical or psychological) model for pain rather than a biopsychosocial model. Documented medical evidence supporting the pain was the most influential factor affecting teachers' attributions about chronic pain. Teachers who attributed the pain to physical causes-either in isolation or in combination with psychological causes-responded more positively toward the student.


CONCLUSIONS
Many teachers lack a biopsychosocial framework through which to understand chronic pain syndromes in students. How chronic pain is described to school personnel may affect how teachers understand the pain and respond to it.
Logan
Deirdre E
DE
Children's Hospital Boston, 333 Longwood Ave., Boston, MA 02115, USA. deirdre.logan@childrens.harvard.edu
Catanese
Sarah P
SP
Coakley
Rachael M
RM
Scharff
Lisa
L
D000293:Adolescent; D001290:Attitude; D001900:Boston; D015984:Causality; D002908:Chronic Disease; D005178:Faculty; D006801:Humans; D016014:Linear Models; D008962:Models, Theoretical; D010146:Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D013334:Students