Understanding communication difficulties in young adults with chronic pain: A Scoping Review Protocol Objective : To scope out the current literature that explores communication in young people with chronic pain. Introduction Chronic pain is a pain lasting for 6 months onwards from an underlying issue, or an injury that has healed (Fisher, 2018), and is a long-term condition which can affect 1 in 5 people in Scotland alone (NHS Inform, 2021).

Pain impacts aspects of a person’s life in multiple respects including employment, sleep hygiene, physical, emotional functioning, and stigma (Goubert and Trompetter, 2017). The invisibility of a chronic condition can affect people’s psychosocial resilience and aptitude in relation to social stigma, being misunderstood, and having to justify perceived pain experiences (Nizza et al., 2017). A key difficulty related to this invisibility of pain is effectively communicating pain experience to others, to gain other people’s full understanding of the impact of this long-term condition. Although many people have experience with acute pain (acute pain is pain lasting less than 3 months, often due to injury or illness), the nuanced experience of chronic pain and its longer- term psychosocial impact on patients is difficult to explain (Angheluta, and Lee, 2011). These communication difficulties and their outcomes are apparent in clinical as well as everyday social settings (Liesch and Elertson, 2018).

Chronic pain is an invisible condition and can therefore be hard to communicate (Nizza, Smith, and Kirkham, 2017). As pain is difficult to perceive by others in the absence of an obvious physical impairment, communication skills are vital for chronic pain patients to share their feelings. Difficulties with communication can contribute to the negative impact that chronic pain has on a young person’s life. Indeed, the daily burden and social stigma of living with an invisible condition can be psychologically and physically debilitating (Scott-Smith, 2017), and have a particular impact on the young person’s self-view.

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These communication difficulties might be particularly prevalent in young people aged 18-30 years of age; hereafter referred to as young adults. Young adults have major life events in example leaving home, moving into adult accommodation, attending University, or gaining employment that often occur during this age range (Forgeron et al., 2013). Thus, a young person goes through key and abundant developmental transitions more than within other periods within a lifetime (Wicks et al., 2019).

A particular transition for young people with a chronic condition, is a transition in medical care. 18 years of age marks the transfer from paediatric care to adult health care, and the associated challenges for their communication patterns, for many young people with chronic pain. Hence, from 18 years onwards parents are no longer responsible for the young person’s healthcare choices, with an effective transition from paediatric to adult care involving a need for careful planning between the clinician, parents, and young person to readjust to a new healthcare setting (Forgeron et al., 2017). Research has shown that young people with chronic pain experience communication challenges which can result in feeling isolated with a sense of a loss of control (Bandura, 1993).

The construction of a sense of self, through life experiences and shared storytelling finds that a young person’s experience of chronic pain also shapes their ability to communicate their experience to others (Wicks et al., 2019). A person’s internal narrative is important in shaping their life experience and in communicating that to themselves and others. Being marked out as different or other in a person’s development can have a negative impact of a person’s self-perception when dealing with their diagnosed and/or undiagnosed chronic pain condition (Wicks et al., 2019). However, in the current literature there is a lack of evidence on young adults, aged 18-30 years of age as they are no longer considered a paediatric sample, but also often excluded from adult samples for research purposes. Despite research often excluding young adults, a study by Fayaz et al. (2016), found that as many as 30% of young adults aged 18-39 live with chronic pain. Consequently, the aim of this review will focus on chronic pain within the specific demographic group of young


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