A systematic review of the impact of chronic pain on adolescents' school functioning and school personnel responses to managing pain in the schools

Abstract

Aims: To critically synthesize empirical studies on the impact of chronic pain on adolescents' school functioning and school personnel responses to managing pain in schools. Design: Mixed method systematic review. Data sources: Medline, CINAHL, PsycINFO, ERIC, ScienLO, Cochrane Library, and EMBASE were searched for published articles from inception to December 2018. Review methods: Fourteen studies met the inclusion criteria. Data from the qualitative and quantitative studies were synthesized using parallel-results convergent integrated design. The Critical Appraisal Skills Programme and Mixed Methods Appraisal Tool version 2018 were used for assessing the quality of included studies. Results: Chronic pain appears to have a significant negative influence on adolescents' school attendance, academic performance/achievement, academic competence, physical activities, and social functioning. However, other studies indicated that adolescents with chronic pain had better academic performance and competence than healthy peers and that chronic pain did not affect older adolescents' social functioning. There is limited guidelines and resources for how school personnel can help adolescents to manage pain in schools. Conclusion: This review supports the need for future research on the impact of adolescents' chronic pain on the full dimensions of school functioning and to identify the effective responses of school personnel to managing adolescents' pain in schools. Impact: Although findings are somewhat conflicting, overall adolescent's chronic pain appears to have a negative influence on school functioning. Yet limited guidelines exist for how school personnel should respond effectively to manage adolescents' pain in schools. The review indicates the importance of written policies to guide teachers on how to facilitate optimal pain management in schools. It also highlights the significance of clear communication between healthcare professionals and school personnel, adolescents with chronic pain and their parents to support optimal school functioning.