What factors do children and young people and their parents perceive to impact therapeutic interactions when receiving healthcare for chronic pain: A qualitative evidence synthesis

Citation

Norton JG, France EF, Newton-John T, Alcock M, Fechner R, Lawrence E, Lawrence K & Pate JW (2026) What factors do children and young people and their parents perceive to impact therapeutic interactions when receiving healthcare for chronic pain: A qualitative evidence synthesis. The Journal of Pain, Art. No.: 106424. https://doi.org/10.1016/j.jpain.2026.106424

Abstract
In a prospectively registered qualitative evidence synthesis (PROSPERO CRD42023461067), we explored child and parent perceptions and experiences of working with health professionals during healthcare for chronic pain, focusing on the factors impacting therapeutic interactions, with the aim to enhance provision of healthcare. Inclusion criteria: studies using qualitative methods; children and young people experiencing chronic pain aged 0–18 years and/or their parents/guardians; explored experiences or perceptions of therapeutic interactions when receiving healthcare. Five databases were searched (inception to July 2026), study quality was assessed, data were extracted and thematically synthesised, and GRADE-CERQual was used to assess confidence in findings. 22 studies were included, reporting the experiences of 292 children (6–18 years) and 194 parents (84% mothers). One overarching theme was identified, with six sub-themes (underpinned by discrete review findings), presented in a novel conceptual framework to guide clinicians in nurturing therapeutic interactions. Across the 14 review findings, 5 (36%) were graded as moderate confidence, 8 (57%) as low confidence, and 1 (7%) as very low confidence. Most studies were found to be of reasonable-good methodological quality. Child and family pain healthcare experiences influence how they engage and interact with health professionals in the future, creating an ongoing cycle that shapes therapeutic interactions in healthcare both positively and negatively. The presented conceptual framework aims to encourage and guide proactive nurturing of therapeutic interactions by health professionals, to improve healthcare experiences and outcomes for children experiencing chronic pain and their families.

Keywords
Children; Parents; Chronic pain; Therapeutic interactions; Qualitative evidence synthesis

Journal
The Journal of Pain

• Published Version