There is a scarcity of work examining the relationship between culture and pain-related caregiver behaviors. Moreover, no pediatric pain studies have examined the relationship between caregiver cultural values and pain-related caregiver behaviors nor discern if this process is mediated by caregiver parenting styles and moderated by ecosocial context. Based on cross-cultural developmental theories, this study hypothesized that ecosocial context would moderate the relationship between cultural values, parenting styles, and pain-related caregiver behaviors; and that parenting styles mediate the effect of cultural values on pain-related caregiver behaviors. A cross-cultural survey design was employed using a convenience sample of 547 caregivers of 6 to 12 year olds living in Canada (n = 183), Iceland (n = 184), and Thailand (n = 180). Multigroup structural equation modeling showed that ecosocial context did not affect which cultural model of parenting the caregiver adopted. Parenting styles mediated the relationship between cultural values and pain-related caregiver behavior. Vertical/horizontal individualism, collectivism, and authoritative- and authoritarian-parenting styles positively predicted solicitousness. Vertical individualism and authoritarian-parenting style positively predicted discouraging behavior, whereas other predictors did not. The findings support the sociocommunication model of children's pain by showing that cultural context does affect parents' behaviors. They also corroborate with others' claims of solicitousness universality in a pediatric pain context. However, solicitousness may have different cultural meanings among individuals and may be used in conjunction with discouraging behavior. The findings from this study have implications for the theory development about culture and pediatric pain, but do not provide specific clinical recommendations.
Culture influences pain-related parental behaviors, but not always as expected. Solicitous pain-related parental behavior seems to be a universal response to children in pain.
aFaculty of Nursing, University of Iceland, Reykjavík, Iceland
bDepartments of Psychology, Pediatrics and Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
cDepartments of Anesthesia and Psychology, Dalhousie University, Halifax, Nova Scotia, Canada
dFaculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
eDepartment of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada
fDepartment of Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada
Corresponding author. Address: Faculty of Nursing, University of Iceland, Eirbergi, Eiriksgotu 34, IS-101 Reykjavik, Iceland. E-mail: email@example.com (O. Kristjansdottir).
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Received December 20, 2017
Received in revised form May 07, 2018
Accepted May 17, 2018