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ObjectiveSocial challenges are a common experience for adolescents with chronic pain. Group peer support for these adolescents could be a promising intervention; however, no studies have focused exclusively on the peer support needs of this population. The present study addressed this gap in the literature.MethodsAdolescents with chronic pain between 12 and 17 years of age completed a virtual interview and demographics questionnaire. Interviews were analyzed using inductive reflexive thematic analysis.ResultsFourteen adolescents (Mage: 15.21 years; 9 females; 3 males, 1 nonbinary, 1 gender questioning) with chronic pain participated. Three themes were generated: “Being Misunderstood,” “They Would Understand Me,” and “Moving Forward Together in Our Pain Journeys.” Adolescents with chronic pain feel misunderstood and under supported by their peers without pain leading to feeling “othered” by having to explain their pain, yet not feeling free to talk about their pain with friends. Adolescents with chronic pain expressed that peer support would provide the forms of social support they are missing amongst their friends without pain as well as companionship and a sense of belonging due to shared knowledge and experiences.ConclusionsAdolescents with chronic pain desire peer support from others like themselves, highlighting the challenges in their everyday friendships as the impetus for this support, as well as their anticipated short- and long-term benefits, including learning from their peers and developing new friendships. Findings indicate that adolescents with chronic pain may benefit from group peer support. Findings will inform the development of a peer support intervention for this population.

Patient engagement (PE) in research refers to partnering with people with lived experience (e.g., patients, caregivers, family) as collaborators in the research process. Although PE is increasingly being recognized as an important aspect of health research, the current state of PE among pain research trainees in Canada is unclear.The aims of this study were to describe perspectives about and experiences with PE among trainees conducting pain research in Canada, to identify perceived barriers and facilitators, and to describe recommendations to improve its implementation.A cross-sectional web-based survey (English and French) was administered to trainees at any level conducting pain research at any Canadian academic institution.A total of 128 responses were received; 115 responses were complete and included in the final analysis. The majority of respondents identified as women (90/115; 78.3%), in graduate school (83/115; 72.2%), and conducting clinical pain research (83/115; 72.2%). Most respondents (103/115; 89.6%) indicated that PE is "very" or "extremely" important. Despite this, only a minority of respondents (23/111; 20.7%) indicated that they "often" or "always" implement PE within their own research. The most common barrier identified was lack of knowledge regarding the practical implementation of PE, and understanding its positive value was the most commonly reported facilitator. Recommendations for improving the implementation of PE were diverse.Despite viewing PE as important in research, a minority of pain research trainees regularly implement PE. Results highlight perceived barriers and facilitators to PE and provide insight to inform the development of future training and other enabling initiatives.

Purpose Involvement in sport is common among prospective medical students and may serve as a foundation for the psychological wellbeing of future physicians. This study examined the relationship between medical students’ sport background and their tolerance of ambiguity and uncertainty, an established factor in physician wellbeing and a key component in quality patient care. Method Sixty-one 3rd year medical students (50% females) at a large Canadian university responded to a web-based survey (62% response rate). The survey included the 29-item TAMSAD (Tolerance of Ambiguity in Medical Students and Doctors) scale and sport background measures (sport type and level of involvement). Analysis of variance and correlational analysis were performed. Results Analysis of variance indicated a significant mean difference in students’ TAMSAD scores based on sport type. Individual sport participants reported on average higher tolerance of ambiguity and uncertainty than team sport participants. However, in team sport participants, their tolerance of ambiguity and uncertainty tended to increase with an increase in sport involvement (from recreational to competitive). Discussion The gained insights are valuable as involvement in dedicated, extracurricular activities such as sport has not been studied in relation to ambiguity and uncertainty tolerance in medical students. The findings have implications for medical education and professional practice. Medical students and physicians could draw on the attributes and skills developed in sport when responding to ambiguity and uncertainty in clinical settings. Those without a sport background could learn and apply some of the strategies athletes use to tackle setbacks and uncertainty in high-stakes situations. Medical school admissions, curriculum designers, and educators could use the knowledge in developing interview questions, designing educational innovations, and selecting instructional strategies for teaching clinical reasoning and decision making. Future research should include qualitative studies to provide in-depth explanations for the relationships observed in this study.

The Strategy for Patient-Oriented Research Chronic Pain Network was founded in 2016 and is a patient-oriented research network funded by the Canadian Institutes of Health Research. The Network incorporates patient partners throughout its governance and operations meaning that patient partners may contribute to research projects in ways that warrant scientific authorship as defined by the International Committee of Medical Journal Editors. The Network did a brief informal review of guidance on patient authorship in 2019, but could not find any practical documentation to guide its members on this topic. Note the term patient partner here refers to a patient (or caregiver or other person with lived experience) who is a partner or collaborator on a research team. This guidance does not address patients as participants in a research study. This guidance has been co-written by a group of researchers and patient partners of the Chronic Pain Network in an effort to address this gap. It is intended for both researchers and patient partner audiences. This guidance is meant to facilitate conversations between researchers and patient partners about authorship and/or acknowledgement regarding research projects on which they collaborate. While the overall principles of academic authorship and acknowledgement remain unchanged, nuances for interpreting these principles through the lens of patient engagement or patient-oriented research is provided. Teams that carry out patient-oriented research projects will require different preparation to empower all team members (researchers and patient partners) to discuss authorship and acknowledgement. To facilitate these conversations, we have included an overview of the scientific publishing process, explanation of some common terms, and sets of considerations are provided for both patient partners and researchers in determining the range of team member contribution from acknowledgement to authorship. Conversations about authorship can be difficult, even for established research teams. This guidance, and the resources discussed within it, are provided with the intention of making these conversations easier and more thoughtful.

The purpose of writing this article is to describe what added challenges people like us who are living with chronic pain are experiencing during the COVID-19 pandemic. We explore what this challenging time means to us and how it affects our lives, along with providing insight into our experiences. This is not a research study, but instead an article that shares perspectives from people with lived experience of chronic pain. Our narratives are presented to create an awareness of the plight for people already living with challenging health conditions and how the COVID-19 pandemic has added additional layers of vulnerability. While these stories offer brief accounts of some of the challenges we face, they also provide glimmers of hope that others with similar challenges can look to for inspiration. We also hope that our stories and reflections provide discussion points and perhaps even case studies for clinicians and policymakers who are working to strengthen clinical care and health systems for people with chronic conditions during pandemics such as COVID-19. Sharing our lived experiences with chronic pain during this global crisis may also spark critical conversations among all chronic pain stakeholders to ensure that we could continue to provide excellent care, strong self-management support and optimal health policy-making as this pandemic continues to unfold and for consideration for future health emergencies. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens.

This study evaluated the relationship between parental autonomy support and preschool-aged children’s display of autonomy. Specifically, we examined if mothers’ and fathers’ use of positive guidance, negative control, and responsiveness during parent-child interactions predicted children’s autonomous behavior. One hundred families comprised of mothers, fathers, and their children participated. Parent-child dyads were filmed engaging in an unstructured play task and interactions were coded using the Parent-Child Interaction System. Mothers’ use of negative control and father’s use of positive guidance, negative control, and responsiveness predicted children’s displays of autonomy, whereas mothers’ positive guidance and responsiveness did not. The results offer insight into how parents play unique roles in promoting their children’s autonomy, which has implications for practitioners and researchers who work with families. Our findings provide examples of behaviors that parents can employ to promote their children’s autonomy.

Introduction: Poor tolerance of ambiguity is consequential in clinical practice, and has been linked to avoidance of family medicine, in which there is inherently more ambiguity. This study aimed to investigate the relationship between tolerance of ambiguity and prospective specialty choice of medical students in their third year of medical school. This stage of medical training is of particular importance as students develop clinical reasoning skills and encounter clinical ambiguity. Methods: This was a cross-sectional study using an online survey. Sixty-one third-year medical students (62% response rate) from a large Canadian university completed the survey with a validated measure of ambiguity tolerance (the 29-item Tolerance of Ambiguity in Medical Students and Doctors scale) and their top three specialty choices. Specialty choices were subsequently grouped into two categories: family medicine (FM) and non-family medicine (non-FM) specialties. Results: There was no significant mean difference in tolerance of ambiguity between students who reported interest in FM and students interested in non-FM specialties. Similarly, we observed no significant difference in tolerance of ambiguity between female and male students. Older students reported higher levels of ambiguity tolerance. Older students were also more likely to report FM as one of their top three specialty choices. Conclusion: Qualitative studies are needed to explore possible reasons for the observed results, including the effects of digital information resources and clinical decision-making tools on medical students’ ambiguity tolerance. Medical educators should be aware that some students may require explicit training in how to respond to ambiguity.