Experience of Chronic (Non-malignant) Musculoskeletal Pain of French Adolescent and Young Adult: a Qualitative Research With Their Physicians and Non-medical Practitioners
Condition: Chronic (Non-malignant) Musculoskeletal Pain
MeSH terms: Musculoskeletal Pain
Study type: Observational

Summary: 
      The purpose of this study is to explore the perspectives of health professionals on chronic
      (non-malignant) musculoskeletal pain in adolescence and young adulthood. The prevalence of
      this pain symptom is rising for ten years, and most of the time the diagnosis is complex.
      Health professionals have to differentiate between the continuing activity of a somatic
      problem, some painful sequelae, a low threshold for the perception of pain, and psychological
      symptoms with somatic expression. Diagnosis in this case takes time, and is a matter of
      trained specialists. No protocol exists to assess the sub-clinical symptoms which will be
      used to help doing this complex task.

      This qualitative study will elicit the perspectives of trained specialists on this diagnosis:
      how do they deal with these patients? What signs and symptoms helps them? The results will
      present their clinical experiences. The overall goal is to construct the first chronic
      musculoskeletal pain multidimensional scale that will help the practitioners with this
      complex diagnosis.
    

Detailed description: 
      Recent research suggests that musculoskeletal pain may be the most common complaint for which
      children are referred to a pediatric rheumatologist and is present in approximately 50% of
      all new patients. A small percentage of these patients will be diagnosed with a form of
      juvenile idiopathic arthritis (JIA), which is marked by clinically significant pain. A larger
      percentage will be diagnosed with a musculoskeletal pain syndrome, that approximately 25% of
      them are chronic and defined as > = 3 months. The chronic pain symptom is a subjective one
      that professionals have to precise its outlines in term of semiology, nature and efficacity
      of past treatments, medical and family backgrounds. The professional then will have to
      pinpoint a diagnosis, while assessing the consequences of the pain and treating it.

      Most of the time this task is a complex one and professionals have to build their diagnostic
      on a body of clinical, paraclinical and more social, familial and psychological evidences. No
      clear protocol exists to help the professionals with differentiating the continuing activity
      of a somatic problem, some painful sequelae, a low threshold for the perception of pain, and
      psychological symptoms with somatic expression. This diagnostic process is lying on
      sub-clinical symptoms that investigators have to elicit in order to help professionals to
      better support their patients.

      This qualitative study will explore the daily clinical experience of the health professionals
      involved in the care of adolescents suffering from chronic musculoskeletal pain.
      Semi-structured interviews will be analyzed with a phenomenological approach (interpretative
      phenomenological analysis). The rich phenomenological description will be the first step of a
      more ambitious project of constructing a multidimensional scale that will help the
      practitioners with this complex diagnosis.
    

Intervention name(s): semi-structured interviews
Intervention type(s): Other
Intervention description(s): Semi-structured face to face or telephone interviews with an open-ended approach. Duration: about 45 minutes. Audio-recorded. Exploration of the experience of taking care of the suffering adolescents.
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        The study will concern the health professionals who takes care of adolescents suffering
        from chronic (non-malignant) musculoskeletal pain. In France, the medical specialities
        concerned are paediatric medicine, rheumatology, pain medicine, adolescent medicine and
        psychiatry. The investigators also want to include participants from paramedical fields:
        physiotherapists, ergotherapists and psychologists. The participants will be selected in
        the large repository of the professionals working with the French National Reference Center
        in Paediatric Rheumatology and Inflammatory Diseases
      
Keywords: Musculoskeletal pain; Adolescent; Qualitative research; Attitude; Health professionals