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Chronic Pain in Childhood and the Medical Encounter: Professional Ventriloquism and Hidden Voices
Abstract
This article is a report on the experiences of three children with chronic pain and their families. The children and families experienced numerous encounters with health professionals during their "quest for a diagnosis"for chronic pain. In a high proportion of these encounters, the children/families felt they were judged, disbelieved, and labeled as difficult or dysfunctional, and this compounded the stresses they were already dealing with. The families described situations in which their accounts of pain were reinterpreted through a variety of professional lenses, and the children felt that their voices were muted or ignored. Professional ventriloquism is presented as a means of exploring the way in which the child's words are reinterpreted and mistranslated through professionals' own paradigms of understanding. Professionals need to stand back from what they believe to determine what the children themselves know about their pain.
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“It has been previously highlighted how children with chronic pain often experience negative, judgmental and stressful encounters with clinicians, related to clinicians’ struggles to secure a diagnosis and confidently explain chronic pain; exposing a need to recruit clinicians, including physicians, to remedy this issue [7].”
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Cited by
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Children's Experiences of Hospitalization
Coyne, I. (2006) · Journal of Child Health Care · doi:10.1177/1367493506067884 · Cited by 332
“However, this situation is rapidly changing as researchers are recognizing increasingly the importance of directly recording children’s own perspectives (Carter, 2002; Cohen and Emanuel, 1998; Coyne, 1998; Oldfield and Fowler, 2004).”
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Eccleston, C., Bruce, E., & Carter, B. (2006) · Nursing Children and Young People · doi:10.7748/paed.18.10.30.s21 · Cited by 30
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Revealing the hidden agency of children in a clinical setting
Dedding, C. W. M., Reis, R., Wolf, B. H. M., & Hardon, A. P. (2014) · Health Expectations · doi:10.1111/hex.12180 · Cited by 27
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Robinson, S. (2010) · Journal of Child Health Care · doi:10.1177/1367493510381772 · Cited by 25
“(child) (Carter, 2002: 35) Some children and young people try to avoid communicating with the health professionals.”
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Simons, L. E., Basch, M. C., Chow, E., Logan, D. E., & Schechter, N. L. (2015) · Journal of Pain Research · doi:10.2147/jpr.s55586 · Cited by 26
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“This confirms the findings of a qualitative study on youths with chronic pain and their parents where parents felt that their family was judged as being dysfunctional by HCPs (Carter, 2002).”
Kanstrup, M., Jordan, A., & Kemani, M. K. (2019) · Children · doi:10.3390/children6090101 · Cited by 19
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Wainwright, M., Russell, A., & Yiannakou, Y. (2011) · Qualitative Health Research · doi:10.1177/1049732311416824 · Cited by 12
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“Dismissal and disbelief about chronic pain from friends, family, and health care providers are stigmatizing and can lead to shame, self-blame, and demoralization (Bernhofer et al., 2017; Carter, 2002; Werner & Malterud, 2003).”
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“Factors that might enhance clinicians’ communication with children and their parents has only relatively recently emerged as an issue worthy of research (Carter, 2002; Levetown, 2008).”
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Considering medical assistance in dying for minors: the complexities of children’s voices
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Bruce, M. S. P., Surekha, A., Karnaboopathy, R., Balan, K. U. S., Chavada, V. K., Vedapriya, Boratne, A. V., Bobhate, P. S., & Raja, T. (2025) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1038_24 · Cited by 4
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Group Membership and Social Identities in a Formative Intervention in a Mexican Hospital
Rivera, H. A. B., Alby, F., & Zucchermaglio, C. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.786054 · Cited by 3
“The researcher builds such a discursive structure by means of questions and proposals, using a sort of “ventriloquism” (Carter, 2002), to encourage participants to question themselves on certain issues.”
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“It has been previously highlighted how children with chronic pain often experience negative, judgmental and stressful encounters with clinicians, related to clinicians’ struggles to secure a diagnosis and confidently explain chronic pain; exposing a need to recruit clinicians, including physicians, to remedy this issu…”
BackgroundMeys, A., & Jones, M. (2023) · New Zealand Journal of Physiotherapy · doi:10.15619/nzjp.v51i2.352 · Cited by 1
“A main stressor reported by these parents were the encounters with medical professionals, medical misinterpretations, and lack of diagnosis or treatment plans for their child’s pain (Carter, 2002).”
BackgroundInfluentialThe view from the bridge: bringing a third position to child health
Kraemer, S. (2017) · doi:10.1057/978-1-137-54747-7_5 · Cited by 1
Children’s Right to Health: Theory versus Practice
Simonelli, I. (2021) · Clinical Health Promotion - Research and Best Practice for patients staff and community · doi:10.29102/clinhp.21012 · Cited by 1
The 2010 Annual Conference of the Canadian Pain Society.
(2010) · PubMed Central · Cited by 1
Nursing Care and Management of Children's Perioperative Pain
Carter, B., & Jonas, D. (2009) · doi:10.1002/9781444314625.ch4 · Cited by 1
Logan, D. E. (2003) · Prevention & Treatment · doi:10.1037/1522-3736.6.1.66c · Cited by 1
OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02)
(2003) · Evidence-Based Nursing · doi:10.1136/ebn.6.1.e1 · Cited by 1
5 Management of Pediatric Pain
Forgeron, P. A., & McGrath, P. J. (2008)
The problem of pain : a heuristic and structural existential analysis of unexplained physical pain
Christophy, C. (2017) · Middlesex University Research Repository (Middlesex University Of London)
Self-Care in Young People With Diabetes: A Qualitative Exploration Using a Salutogenic Approach
Green, E. (2018) · UEL Research Repository (University of East London) · doi:10.15123/uel.8887x
Graham-Ray, L. (2020) · Staff Publications Online (The Tavistock and Portman)
Canadian Pain Society Conference May 12 – 15, 2010, Calgary, Alberta
(2010) · Pain Research and Management · doi:10.1155/2010/198368
An Update Proposal for Article 31 of the UN Convention
Simonelli, I. (2022) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-6684-5068-0.ch006
Children First, a Debate on the Restrictions to Tackle COVID-19
Verd, S. (2023) · Children · doi:10.3390/children10020211
“However, many children believe that they have been excluded from decisions affecting their bodies [25].”
Background
Metadata
- Authors
- Carter, B.
- Affiliations
- University of Lancashire (GB)
- Corresponding author
- Carter, Bernie
- ORCID
- Carter, Bernie
- Venue
- Qualitative Health Research
- Publisher
- SAGE Publications
- Published
- 2002-01
- Volume
- 12
- Issue
- 1
- Pages
- 28-41
- ISSN
- 1049-7323 (ISSN-L)
- 1552-7557
- OpenAlex
- W2131865090
- Cited by
- 105
- References
- 48
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 5 · 2016: 2 · 2015: 5 · 2014: 3 · 2013: 4 · 2012: 3
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Qualitative Health Research (publishedVersion)
- PubMed (publishedVersion)
- CLOK (University of Central Lancashire) (submittedVersion)
- Edge Hill University Research Information Repository (Edge Hill University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Social Sciences › Sociology and Political Science › Children's Rights and Participation
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- pediatric chronic pain, healthcare encounters, patient voice, misdiagnosis, family experiences, patient-professional relationship
- MeSH terms
- Adolescent, Psychology, Adolescent, Attitude of Health Personnel, Child, Psychology, Child, Chronic Disease, Communication, Evaluation Studies as Topic, Female, Health Services Research, Humans, Judgment, Male, Medical History Taking, Pain, Physician-Patient Relations, Professional-Family Relations, United States
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