Exploring the Experiences of Children with Chronic Pain Returning to School After Inpatient Rehabilitation

Research Objectives: To understand the experiences of children with chronic pain returning to school after inpatient rehabilitation and identify their barriers and facilitators to school reintegration.

Design: Qualitative cross-sectional observation study.

Setting: Participants were recruited from a pediatric health system in New Jersey and interviewed in online focus groups.

Participants: Participants were a subsample of a larger study of school reintegration children with varied healthcare needs (N=40). This study focuses on chronic pain and involved data from five patients (aged 17-21) and three parents of patients who returned to school after inpatient chronic pain rehabilitation, and three rehabilitation professionals (an occupational therapist and two child-life specialists) who supported children’s school transition planning and integration.

Interventions: NA

Main Outcome Measures: School reintegration experience, outcomes, and related facilitators and barriers perceived by the patients, parents, and rehabilitation professionals.

Results: Qualitative analysis identified three main themes. 1) Gaps in transition support: Patients and parents experienced significant challenges returning to school from inpatient rehabilitation. Participants identified several gaps in healthcare and educational services, such as a lack of educational support from school districts, insufficient guidance for school reentry transition planning at discharge, and poor communication and coordination between the hospital and schools. 2) Social and attitudinal barriers: Because pain is invisible, patients and parents often experienced resistance when requesting educational accommodation and advocating for their medical needs. A salient barrier to patients’ social reintegration relates to the school staff and peers’ knowledge and attitudes toward chronic pain and pain medication. 3) Healthcare continuity: Participants emphasized the need for improved care continuity after discharge to support children in managing symptoms and difficulties in social reintegration that emerged at school reentry.

Conclusions: This study highlights the need for improved transition support and post-discharge medical follow-up to promote school reintegration in children with chronic pain.

Author(s) Disclosures: The research is supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (#90IFRE0030).