The role of peer communication in the socialization of adolescents' pain experiences: a qualitative investigation.
BACKGROUND
Recurrent pain is a common complaint among adolescents. Children learn to resolve or cope with pain largely through family dynamics, particularly maternal influences. By adolescence, young people possess an array of pain behaviors, the culmination of multiple opportunities for modeling and reinforcement of attitudes and beliefs about pain. Adolescence is a time of increased autonomy characterized by, among other complex factors, significant increases in peer influence. Although peers are influential in health-risk behavior, little is known how peers impact adolescents' pain experience. The present study explored the role of peers in adolescents' attitudes toward pain, pain behaviors and over-the-counter analgesics.


METHODS
Sixty-minute focus groups were conducted with a sample 24 junior high school students from Halifax, Nova Scotia, Canada (11 male: mean age = 13.45 years, range = 12-15 years; 13 female: mean age = 13.31 years, range = 12-15 years). Participants were randomly assigned to one of five same-gender focus groups designed to explore a wide breadth and depth of information. Sessions were run until theoretical data saturation. Textual data, from transcribed audiotapes, were analyzed with the constant comparative method.


RESULTS
Peer influences were apparent in how adolescents communicate about pain and how those communications effect pain expression. Overt pain responses to injury were primarily contextual and depended on perceived threats to peer-time and pain severity. Adolescents were intolerant of peers' pain behaviors when the cause was perceived as not severe. These attitudes impacted how adolescents responded to their own pain; males were careful not to express embarrassing pain in front of peers, females felt no restrictions on pain talk or pain expression. Evidence for peer influence on attitudes toward OTC analgesics was apparent in perceptions of over-use and ease of access. Findings are discussed within the context of social information-processing and gender role expectations.


CONCLUSIONS
Little research has addressed how young people experience pain within the context of the psychosocial influences that dominate during adolescence. The findings provide some insight into the role of peer influences via verbal and non-verbal communication, in adolescents' pain experience. This exploratory study is a necessary first step in understanding the socialization of adolescents' pain experiences.
Hatchette
Jill E
JE
Interdisciplinary Research, IWK Health Centre, Halifax, Nova Scotia, B3K 6R8, Canada. jill.hatchette@iwk.nshealth.ca
McGrath
Patrick J
PJ
Murray
Michael
M
Finley
G Allen
GA
D000293:Adolescent; D000294:Adolescent Behavior; D000700:Analgesics / Q000627:therapeutic use; D001294:Attitude to Health; D002648:Child; D003142:Communication; D005260:Female; D017144:Focus Groups; D005783:Gender Identity; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy / Q000523:psychology*; D010147:Pain Measurement; D010379:Peer Group; D036301:Qualitative Research; D012737:Sex Factors; D012951:Socialization
D000700:Analgesics; D004366:Nonprescription Drugs