Adolescent-Centered Pain Management in School When Adolescents Have Chronic Pain-A Qualitative Study

Chronic pain is common among Swedish adolescents, and stress is an independent factor in the onset and persistence of chronic pain. When Swedish school nurses conduct their health dialogs they have a unique opportunity to find adolescents with chronic pain. The aim of this study was to explore school nurses’ and adolescents’ experiences of factors that influence adolescent-centered pain management in school health care, when adolescents have chronic pain. The study context is schools in Sweden where primary health care is available through school nurses. A total of 15 school nurses and 15 adolescents participated in individual interviews, which were transcribed and analyzed by qualitative conventional content analysis. Bronfenbrenner’s bioecological model was used to explain how these factors are directed at the individual or society. The results demonstrated eight different categories of factors that influenced the pain management. The categories focused mainly on the adolescents’ micro- and mesosystems; few strategies were conducted on an exo- and macrosystem level. On the micro- and mesosystem levels, it was necessary to build trust to be able to influence the adolescents’ behavior in the pain management. Pharmacological strategies were paracetamol and non-steroidal anti-inflammatory drugs; non-pharmacological strategies were physical activities and stress-reducing activities. Research and practice involving a more holistic perspective, studying the possibilities of both change at the organizational level and individual support for adolescents, are essential.