Interpersonal relationships in adolescent chronic pain: A qualitative synthesis.

Numerous qualitative studies suggest that adolescents with chronic pain experience disruptions to their interpersonal relationships. A synthesis of this research has not yet been conducted. Using a qualitative metasynthesis approach, we collated, interpreted and (re)presented what is known about how adolescents with chronic pain and their significant others describe their interpersonal relationships. A systematic search strategy was developed to identify and retrieve all primary studies focused on exploring social relationships of adolescents with chronic pain and their significant others using qualitative methodology published by December 31, 2016. Searches identified 1,309 articles, with 8 articles meeting inclusion criteria. Included articles were reviewed for quality and thematic content. Overall, these articles included 127 participants, comprising adolescents with pain, parents, siblings, and peers. Data was characterized by two themes: restriction and tensions. Findings highlighted the complex and typically deleterious impact of chronic pain on relationships held by adolescents with chronic pain and significant others (e.g., parents). Data illustrated tensions between adolescents' and others' perceptions of pain on everyday life in addition to a sense of pain restricting adolescent and parental relationships through processes of isolation and difference. Findings also identified the strengthening of relationships due to challenges associated with living with adolescent chronic pain. Study results highlight the importance of assessing the impact of pain on interpersonal relationships. Second, findings illustrate the need to develop and test treatment approaches to enable adolescents and their family members to maintain and strengthen positive interpersonal relationships and to develop more adaptive social functioning.