Pathways to CAM: A qualitative analysis of pediatric pain patient narratives

Adult chronic pain is strongly associated with lower quality of life, including lost productivity and depression. Thus, the benefits to public health of helping children and adolescents overcome or manage chronic pain are huge. The UCLA Pediatric Pain Research Project (PPRP) is a multi-disciplinary, mixed methods investigation into the effectiveness and mechanisms of an integrative approach to treating and managing pediatric pain. In this presentation, I report the results of a grounded theory analysis of baseline and follow-up, semi-structured interviews, conducted with 72 pediatric patients (10-18 years old), as part of the UCLA PPRP. This analysis finds a dominant narrative emerging from these interviews. In this narrative, multiple negative experiences with conventional medicine lead to both a negative self image and a loss of faith in biomedical providers and treatments and an interest in trying complementary and alternative medicine(CAM). In contrast, positive experiences with UCLA pain clinic providers and CAM practitioners are described as helping pediatric pain sufferers develop positive self image, trust, and self efficacy, as well as lessen and manage their pain. Patients express a preference for modalities such as yoga, hypnosis, and biofeedback, which empower patients by giving them tools for self-management of their pain. In conclusion, both push and pull factors are involved in pediatric patients' decisions to try and use CAM: negative experiences with conventional medicine push patients to look for alternatives; and positive experiences with CAM, especially those involving self-efficacy and construction of a positive self image, pull patients to continue using these modalities.