Mothers' appraisals of injustice in the context of their child's chronic pain: An interpretative phenomenological analysis.

Background: In line with research highlighting the role of observer appraisals in understanding individuals' pain experience, recent work has demonstrated the effects of parental child- and self-oriented injustice appraisals on child pain-related outcomes. However, research on parental injustice appraisals is in its infancy and lacks a valid and context-specific operationalization of what parental injustice appraisals of child pain precisely entail. The current study presents an in-depth qualitative analysis of parental child- and self-oriented appraisals of injustice in the context of their child's chronic pain.

Methods: Twenty-one mothers of children living with chronic pain participated in one of five focus group interviews conducted in Ghent (Belgium), Glasgow (Scotland) and Indianapolis (USA).

Results: The interviews were subjected to interpretative phenomenological analysis, which revealed three key justice-related themes, labelled 'You shouldn't be in this much pain', 'The problem's probably with the mother' and 'At least it's not cancer'. Maternal injustice appraisals focused mainly on the child rather than the self and reflected various perceived barriers to their efforts to provide quality of life for their child. A fourth theme labelled 'Not everybody gets a healthy child' reflected maternal strategies to effectively cope with the child's condition and the associated appraisals of injustice.

Conclusions: The current findings attest to the relevance of (child- and self-oriented) injustice in the parental experience of caring for a child with chronic pain and provides insight into the specific content and scope of these appraisals. As such, this study provides valuable insights to further research in this area.

Significance: The current study presents an in-depth qualitative analysis of parental appraisals of injustice in the context of their child's chronic pain condition. The findings provide valuable insights into the phenomenology of this construct and may inform future research and assessment methods. Furthermore, the themes reported in this study may contribute to clinical practice, as they may raise awareness of parental concerns regarding their child's pain management.