My child you must have patience and Kreng Jai : Thai parents and child pain

Purpose: To elicit the experiences of parents in providing care for their hospitalized child’s acute pain needs. Design: Phenomenology, using in-depth interviews with 45 parents whose children were being cared for in five hospitals in Northeastern (Isan) Thailand. Findings: The findings address Thai cultural beliefs regarding the experience of pain and the role societal expectations have on parental behavior in trying to meet their child’s acute pain needs. Two themes emerged– “Understanding my child’s pain: it’s karma” and “Maintaining Kreng Jai”– which identify parent beliefs toward pain and pain treatment, as well as perceived barriers in securing pain management for their children. Together these two themes describe the essence of this study as parents experienced an “inner struggle in providing pain care.” Pain was perceived as an inescapable part of life, and participants identified a preference for traditional remedies. Parents experienced a tension as they wanted to provide and secure pain care for their child but at the same time were reticent to approach staff with concerns about their child’s care. Conclusions: Thai parents viewed pain as a normal consequence of life, and one had to use traditional remedies in addition to medicine to successfully treat pain. Societal behavioral expectations required children to have patience. Nevertheless, parents wanted professionals to show more empathy and provide more effective pain care. Clinical Relevance: Improvements in pediatric pain care must formally include parents. Culturally sensitive approaches that do not stereotype parents and children are needed to ensure that evidence-informed pain care is available for all children