"My Goal is...to get Through the Day Without Pain": A Qualitative Study on Chronic Pain Experiences and Treatment Needs Among Child Caregiving Women.

Introduction: We aimed to understand connections between pain, caregiving, physical and behavioral health treatment needs, and motivations for prescription opioid use among child caregiving women with chronic pain. Methods: We conducted in-depth, semi-structured interviews with 12 women (average age 48 years; 58% Black) in child caregiving roles, including women who were pregnant or trying to become pregnant and were caring for children or grandchildren < 18 years, and who received treatment at an outpatient pain management clinic. We used thematic text analysis to identify qualitative themes related to caregiving, pain, treatment, substance use, coping strategies, and sources of support. Results: A diverse sample of women reported high levels of stress and pain, substance use, interpersonal violence, depression, and financial strain. Most described difficulties at work, interacting with children or grandchildren, and engaging routine, daily activities due to their pain. Most indicated that they spent less time with family and friends due to their pain and had limited sources of support to help them navigate both caregiving and pain. Many described barriers to receiving appropriate healthcare, including prescription opioids, due to stigma or logistics, though most also reported positive healthcare experiences. Women also reported added daily-life, physical, mental health, and interpersonal stressors and difficulty navigating the healthcare system to receive needed care. Discussion: For women with chronic pain in child caregiver roles, results highlight the importance of care tailored to the physical needs of child caregiving and of trauma-informed approaches given the prevalence of comorbid conditions and trauma. Significance: What is already known on this subject?: There are complex associations between chronic pain, trauma, mental health, and opioid and other substance use which may be exacerbated in the context of child caregiving. What this study adds?: Few studies have obtained women's own perspectives on their experiences and needs in the context of child caregiving and chronic pain which is critical to informing treatment options and intervention priorities. Qualitative interviews revealed unique and combined impacts of child caregiving and chronic pain on mental health, relationship quality, coping capabilities and strategies, prescription opioid misuse and the overlap of traumatic experiences with each of the themes. [ABSTRACT FROM AUTHOR]