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Cultural Influences on Parental Responses to Children’s Pain

Kristjansdottir, Olof, RN PhD1; McGrath, Patrick J., PhD2,3; Finley, G. Allen, MD FRCPC FAAP2,3; Kristjansdottir, Gudrun, RN PhD1; Siripul, Pulsuk, RN PhD4; Mackinnon, Sean P., PhD2; Yoshida, Yoko, PhD2

doi: 10.1097/j.pain.0000000000001289
Research Paper: PDF Only

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, specifically, if this process is mediated by caregiver parenting styles and moderated by eco-social context. Based on cross-cultural developmental theories, this study hypothesized that eco-social 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 6-12-year-olds living in Canada (n = 183), Iceland (n = 184), and Thailand (n = 180). Multigroup structural equation modeling showed that eco-social 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 theory development about culture and pediatric pain, but do not provide specific clinical recommendations.

1Faculty of Nursing, University of Iceland, Reykjavík, Iceland

2Dalhousie University and

3IWK Health Centre, Halifax, Canada

4Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand

Corresponding author: Olof Kristjansdottir, Faculty of Nursing, University of Iceland. Currently located in London, Ontario, 1015-675 Winderemer Rd. Telephone: + (519) 858-5411. E-mail:

© 2018 International Association for the Study of Pain
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