Social Connectedness and Pain.

Research suggests that social interactions and connections consistently play a pivotal role in pain perception and coping (Karayannis et al., 2019Karayannis, N. V., Baumann, I., Sturgeon, J. A., Melloh, M., & Mackey, S. C. (2019). The Impact of Social Isolation on Pain Interference: A Longitudinal Study. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 53(1), 65–74. https://doi.org/10.1093/abm/kay017Google Scholar). Individuals with higher social connectedness tend to feel close with others, identify with them, and readily engage in social activities and groups (Baumgartner, Haupt and Case, 2023Baumgartner, J., Haupt, M., & Case, L.. (2023). Chronic pain patients low in social connectedness report higher pain and need deeper pressure for pain relief. 10.1037/emo0001228.Google Scholar). Moreover, high-quality social connections are essential to our mental health, physical health, overall sense of well-being, and longevity (Halcomb et al., 2022Halcomb E. Thompson C. Tillott S. Robinson K. Lucas E. Exploring social connectedness in older Australians with chronic conditions: Results of a descriptive survey.Collegian. 2022; 29: 860-866https://doi.org/10.1016/j.colegn.2022.05.011Abstract Full Text Full Text PDF Scopus (3) Google Scholar). On the other hand, socially disconnected individuals tend to perceive themselves as outsiders, feel misunderstood by others, and experience difficulty engaging in social interactions (Lee, Draper and Lee, 2001Lee R.M. Draper M. Lee S. Social connectedness, dysfunctional interpersonal behaviors and psychological distress: Testing a mediator model.Journal of counseling psychology. 2001; 48: 310-318Crossref Scopus (415) Google Scholar; Lee and Robbins, 1995Lee R.M. Robbins S.B. Measuring belongingness: The Social Connectedness and the Social Assurance scales.Journal of Counseling Psychology. 1995; 42: 232-241https://doi.org/10.1037/0022-0167.42.2.232Crossref Scopus (626) Google Scholar) which influence their response to pain and therapeutic pain interventions (Karayannis et al., 2019Karayannis, N. V., Baumann, I., Sturgeon, J. A., Melloh, M., & Mackey, S. C. (2019). The Impact of Social Isolation on Pain Interference: A Longitudinal Study. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 53(1), 65–74. https://doi.org/10.1093/abm/kay017Google Scholar). Even before COVID-19, an international survey revealed two in ten individuals in the United States and United Kingdom and one in ten in Japan reported social isolation or loneliness (Bianca, et al., 2018). Interestingly, these findings are not just among older adults, but many individuals under the age of 50. Given the increasing prevalence of social isolation and loneliness, the The United Nations Decade of Healthy Ageing (2021–2030) 2021The United Nations Decade of Healthy Ageing (2021–2030) https://www.who.int/initiatives/decade-of-healthy-ageing, 2021.Google Scholar views this as a global priority. When the COVID-19 pandemic occurred, social connectedness dramatically changed for many influencing how individuals (patients, families, health care providers) could connect and communicate on health issues such as pain assessment as well as management. The literature reveals that the relationship between social connectedness and pain is complex. Hennen and Morrisey (2015) found, for instance, many women with persistent pain feel less connected and able to respond emotionally to those closest to them affecting not only themselves, but also their network of family and friends. This finding highlights the importance of health care providers recognizing how persistent pain, the intensity of pain, and resultant psychological distress affect relationships. Baumgartner, Haupt and Case, 2023Baumgartner, J., Haupt, M., & Case, L.. (2023). Chronic pain patients low in social connectedness report higher pain and need deeper pressure for pain relief. 10.1037/emo0001228.Google Scholar also discovered that greater levels of social connectedness were associated with lower anxiety, which in turn, predicted lower pain. In another study, Karayannis et al., 2019Karayannis, N. V., Baumann, I., Sturgeon, J. A., Melloh, M., & Mackey, S. C. (2019). The Impact of Social Isolation on Pain Interference: A Longitudinal Study. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 53(1), 65–74. https://doi.org/10.1093/abm/kay017Google Scholar, found that patients with greater feelings of isolation, loneliness or disconnection with others view pain as more problematic than those with relatively lower levels of social isolation. They identified the importance of social isolation as a factor in pain-related appraisal, coping and the need to include social context in every comprehensive pain assessment. As a result of their findings, Karayannis et al., 2019Karayannis, N. V., Baumann, I., Sturgeon, J. A., Melloh, M., & Mackey, S. C. (2019). The Impact of Social Isolation on Pain Interference: A Longitudinal Study. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 53(1), 65–74. https://doi.org/10.1093/abm/kay017Google Scholar recommend therapeutic pain interventions aimed at increasing the social connection with patients, families, and health care providers. Sturgeon and Zautra, 2016Sturgeon J.A. Zautra A.J. Social pain and physical pain: shared paths to resilience.Pain management. 2016; 6: 63-74https://doi.org/10.2217/pmt.15.56Crossref PubMed Scopus (90) Google Scholar further emphasize that positive interactions among the providers and patients is crucial. When providers do not believe the legitimacy of the pain, social isolation and unwillingness of patients to seek treatment occurs. Within this issue, several articles examine how different factors can influence social connectedness and pain management. In a research study framed within a pediatric hospital, Mahon, Aiiken, Veiga and Poitras, 2023Mahon P. Aiiken C. Veiga M. Poitras S. Time for action: Understanding health care professionals’ views on pain and pain management in a pediatric hospital.Pain Management Nursing. 2023; 24Google Scholar examines perceptions of health care professionals about pediatric pain and pain management. Their findings reveal how cultural diversity of patients, their families, and health care professionals must be considered during pain assessment and achieving shared views of optimal pain management. When working with patients who have cancer, Almasri and McDonald, 2023Almasri B.M. McDonald Barriers and Facilitators of Pain Self-Management Among Patients with Cancer: An Integrative Review.Pain Management Nursing. 2023; 24: 2Google Scholar, found that a supportive environment with good communication among patients, their families/friends, and health care providers facilitated quality pain self-management and active participation in developing and monitoring outcomes. In addition, consideration of patient characteristics such as age, gender, race, marital status, educational level, level of pain and presence of comorbidities are essential to incorporating different strategies to overcome barriers and maximize facilitators to achieve successful pain management. It is apparent that social connectedness and pain have a complex relationship and the science is still unfolding. When working with patients experiencing pain, some points to consider:1Socially disconnected individuals tend to perceive themselves as outsiders, often feel misunderstood by others, and experience difficulty engaging in social interactions that can significantly affect optimal pain management.2Diversity issues such as age, gender, race, ethnicity and culture affect social connections, the quality of pain assessment, as well as the development of feasible treatment plans and outcomes.3When dealing with or managing pain, it is important to design interventions that include the patient, primary family caregivers, and health care providers in the assessment process and recommended actions.4Continually assess the quality of interactions among patient, primary family caregivers, and health care providers to determine if they are all working together and have shared common perceptions of the pain situation and its management.