Pain and development of identity in adolescents who frequently use over-the-counter analgesics: a qualitative study
Journal article, Peer reviewed
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Original versionSkarstein S, Lagerløv P, Kvarme LGK, Helseth S. Pain and development of identity in adolescents who frequently use over-the-counter analgesics: a qualitative study. Journal of Clinical Nursing. 2018 http://dx.doi.org/10.1111/jocn.14513
Aims and objectives: This study aims to describe conditions that may influence the development of identity in adolescents frequently using over-the-counter analgesics (OTCAs). Background: Frequent self-medication with analgesics among adolescents is associated with several physical pain points, low self-esteem and low ambitions for the future. Continuous use of OTCAs can keep adolescents from learning healthier coping strategies. Design: Qualitative individual interviews with adolescents and their mothers were conducted and transcribed. Further, they were analyzed as dyads. Setting and participants: Students aged 14–16 years in 9th and 10th grades in 10 Norwegian junior high schools self-reporting at least weekly use of analgesics were asked to participate. Those who wanted to take part took a consent letter to their parents, also inviting the parent to participate. Results: Six girls, two boys and their mothers were included. The teenagers were highly dependent on their mothers. They had often been bullied, lacked good relationships with peers, avoided conflicts and strived to be accepted. Their mothers felt solely responsible for their upbringing and showed great concern for all the pain experienced by their child. A close relationship between mother and child influenced how the adolescent managed their pain, including their use of OTCAs. Three main themes were identified in the stories of mother and child: “Vulnerable adolescents,” “Mother knows best” and “Pain is a shared project.” Conclusions: Pain among adolescents may be amplified by a difficult family situation and insecure relationships with peers. Strategies within the family may sustain pain as a shared project keeping the adolescent and main caregiver close together, and this might be hampering identity development. To help adolescents with pain and high consumption of OTCAs, the adolescents’ relationship with parents must be considered in designing an intervention. Guidance on pain assessment, pain management, including appropriate use of OTCAs, should be included.