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Smith NL, Gibson N, Bear N, Thornton AL, Imms C, Smith MG, Harvey AR. Measurement properties and feasibility of chronic pain assessment tools for use with children and young people with cerebral palsy. Disabil Rehabil 2024:1-15. [PMID: 38856092 DOI: 10.1080/09638288.2024.2362398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/25/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE Chronic pain assessment tools exist for children, but may not be valid, reliable, and feasible for populations with functional, cognitive or communication limitations, for example, cerebral palsy (CP). This study aimed to (i) identify chronic pain assessment tools used with children and young people and rate their measurement properties; (ii) develop a CP specific feasibility rating tool to assess the feasibility of tools in CP; and (iii) categorise tools according to reporting method. MATERIALS AND METHODS Assessment tools were identified by literature review. Their measurement properties were rated using the COnsensus based standards for the Selection of health Measurement INstruments. The CP specific Feasibility Rating Tool was developed and used to rate the tools. RESULTS Fifty-seven chronic pain assessment tools were identified. Six have content validity for CP, four of these use proxy-report. Forty-two tools were considered feasible for people with CP; 24 self report and 18 observational/proxy-report. Only the Paediatric Pain Profile has content validity and feasibility for people with CP unable to self-report. CONCLUSIONS There are few valid, reliable and feasible tools to assess chronic pain in CP. Further research is required to modify tools to enable people with cognitive limitations and/or complex communication to self-report pain.
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Affiliation(s)
- Nadine L Smith
- Kids Rehab WA, Perth Children's Hospital, Nedlands, WA, Australia
- Department of Physiotherapy, Perth Children's Hospital, Nedlands, WA, Australia
- Division of Paediatrics, Medical School, The University of Western Australia, Crawley, WA, Australia
| | - Noula Gibson
- Kids Rehab WA, Perth Children's Hospital, Nedlands, WA, Australia
- Department of Physiotherapy, Perth Children's Hospital, Nedlands, WA, Australia
| | - Natasha Bear
- Institute for Health Research, Notre Dame University, Perth, WA, Australia
| | - Ashleigh L Thornton
- Kids Rehab WA, Perth Children's Hospital, Nedlands, WA, Australia
- Division of Paediatrics, Medical School, The University of Western Australia, Crawley, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Christine Imms
- The University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Meredith G Smith
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, SA, Australia
- Novita Disability Services, Adelaide, SA, Australia
| | - Adrienne R Harvey
- The University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
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2
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Pavlova M, Mueri K, Peterson C, Graham SA, Noel M. Mother– and Father–Child Reminiscing About Past Events Involving Pain, Fear, and Sadness: Observational Cohort Study. J Pediatr Psychol 2022; 47:840-849. [DOI: 10.1093/jpepsy/jsac012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Pain in childhood is prevalent and is associated with fear, particularly in the context of injuries or procedural pain, and negative emotions (e.g., sadness). Pain and fear share a bidirectional relationship, wherein fear exacerbates the experience of pain and pain increases subsequent anticipatory fear. The existing research has focused primarily on children’s immediate experience of pain and fear. Research on how children remember or talk about past painful, fearful, or sad events is lacking. Parent–child reminiscing about past pain has been demonstrated to differ from reminiscing about other past negative emotional events (i.e., those involving sadness, but not fear). The present study aimed to examine differences in how parent–child dyads reminisce about past pain, fear, and sadness.
Methods
One hundred and three 4-year-old children (55% girls) and their parents (52% fathers) engaged in a narrative elicitation task in which they reminisced about unique past events involving pain, fear, and sadness. Parent–child narratives were coded using established coding schemes based on the developmental psychology literature.
Results
Parent–child narratives about pain were characterized by fewer emotion-laden words and explanations, as well as more pain-related words compared to sadness or fearful narratives. Mothers and fathers reminisced with sons and daughters in a similar way across all types of events.
Conclusions
Parent–children reminiscing about past painful events differs from reminiscing about other types of distressing events (e.g., involving sadness or fear). This highlights a possibility of differential socialization of pain versus fear. Potential clinical implications of the findings are discussed.
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Affiliation(s)
- Maria Pavlova
- Department of Psychology, University of Calgary, Canada
| | - Kendra Mueri
- Department of Psychology, University of Calgary, Canada
| | - Carole Peterson
- Department of Psychology, Memorial University of Newfoundland, Canada
| | - Susan A Graham
- Department of Psychology, University of Calgary and Owerko Centre, Canada
| | - Melanie Noel
- Department of Psychology, Owerko Centre, Alberta Children’s Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Canada
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3
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Mbazzi FB, Nimusiima C, Akellot D, Kawesa E, Abaasa A, Hodges S, Seeley J, Vervoort T. Use of Virtual Reality Distraction to Reduce Child Pain and Fear during Painful Medical Procedures in Children with Physical Disabilities in Uganda: A feasibility study. PAIN MEDICINE 2021; 23:642-654. [PMID: 34185091 DOI: 10.1093/pm/pnab206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study explored the acceptability and feasibility of the use of low-cost virtual reality (VR) glasses, and the Wong-Baker Faces Pain Scale and Children's Fear Scale scales, for pain and fear reduction in children admitted at the septic ward of CoRSU Rehabilitation Hospital in Uganda. METHODS In total 79 children aged 4 to 17 years of age were offered to watch cartoons using VR glasses while undergoing painful dressing procedures. Before and after the procedure children were asked to index current pain; children and their caregivers were asked to rate anticipated fear. Focus group discussions with 13 children, 10 caregivers and 9 nurses explored acceptability and feasibility. Quantitative data were analysed using STATA15, NVIVO12 was used for qualitative data analysis. RESULTS The VR glasses were accepted by 76 (96%) of the children. Children, caregivers, and nurses mentioned the glasses were helpful in distracting children from the medical procedure, and felt the use of the glasses helped reduce child fear and pain. Nurses felt it made their work easier. The Wong-Baker Faces Pain Scale was an acceptable and feasible method to measure pain, whilst the Children's Fear Scale was more difficult to interpret for our study population as they felt the faces on the scale were hard to read and identify with. CONCLUSIONS The use of VR glasses may offer an acceptable and effective pain and fear reduction method in resource-constrained settings and should be further explored in a randomized controlled trial.
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Affiliation(s)
- Femke Bannink Mbazzi
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium.,London School of Hygiene & Tropical Medicine, Global Health & Development, London, United Kingdom
| | - Claire Nimusiima
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | | | - Elizabeth Kawesa
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,CoRSU Rehabilitation Hospital, Kisubi, Uganda
| | - Andrew Abaasa
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | | | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene & Tropical Medicine, Global Health & Development, London, United Kingdom
| | - Tine Vervoort
- Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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4
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Beeckman M, Simons LE, Hughes S, Loeys T, Goubert L. A Network Analysis of Potential Antecedents and Consequences of Pain-Related Activity Avoidance and Activity Engagement in Adolescents. PAIN MEDICINE 2021; 21:e89-e101. [PMID: 31498397 DOI: 10.1093/pm/pnz211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain. METHODS Adolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor. RESULTS Activity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement. CONCLUSIONS This study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.
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Affiliation(s)
- Melanie Beeckman
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Laura E Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sean Hughes
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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5
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Galai T, Yerushalmy-Feler A, Heller NP, Ben-Tov A, Weintraub Y, Amir A, Moran-Lev H, Zac L, Cohen S. Age and pain score before gastrointestinal endoscopies in children are predictors for post procedure pain. BMC Gastroenterol 2020; 20:400. [PMID: 33243150 PMCID: PMC7689973 DOI: 10.1186/s12876-020-01546-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 11/18/2020] [Indexed: 12/31/2022] Open
Abstract
Background Gastrointestinal endoscopy may be associated with pain and anxiety. Predictors for high pain scores after endoscopies in children are not known. The aim of our study was to identify risk factors for prolonged recovery and higher pain scores after gastrointestinal endoscopy in children. Methods All the children that were electively admitted for gastrointestinal endoscopies were included. We retrospectively collected demographic, clinical and endoscopic data as well as information on the recovery process. A numerical rating scale and the Faces, Legs, Activity, Cry, and Consolability Scale were used for pain scoring. Results During the study period (01/2016–10/2016), 284 children (median age 10.7 years, interquartile range 6.7–14.8) were recruited. In a univariate analysis, older age, higher pre-procedure pain scores, longer procedure durations, higher number of biopsies and longer recovery duration were associated with higher post-procedure pain scores. In a multivariate analysis higher pain scores before the procedure (OR 12.42, 95% CI 3.67–42, P < 0.001) and older age (OR 1.016, 95% CI 1.007–1.025, P < 0.001) were associated with higher pain scores after the procedure. Children with a higher pain score before the procedure also had a longer recovery period (OR 5.28, 95% CI (1.93–14.49), P = 0.001). Conclusion Older age and higher pain score before the procedure were identified as predictors for higher pain score after pediatric gastrointestinal endoscopies. Children with these risk factors should be identified before the procedure in order to personalize their post-procedure management.
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Affiliation(s)
- Tut Galai
- Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Yerushalmy-Feler
- Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nathan P Heller
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Ben-Tov
- Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Weintraub
- Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Achiya Amir
- Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadar Moran-Lev
- Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lilach Zac
- Department of Anesthesiology and Critical Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomi Cohen
- Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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6
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McGarrigle L, Wesson C, DeAmicis L, Connoly S, Ferreira N. Psychological mediators in the relationship between paediatric chronic pain and adjustment: An investigation of acceptance, catastrophising and kinesiophobia. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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7
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Abstract
: Effective pain assessment is a necessary component of successful pain management and the pursuit of optimal health outcomes for patients of all ages. In the case of children, accurate pain assessment is particularly important, because children exposed to prolonged or repeated acute pain, including procedural pain, are at elevated risk for such adverse outcomes as subsequent medical traumatic stress, more intense response to subsequent pain, and development of chronic pain.As with adults, a child's self-report of pain is considered the most accurate and reliable measure of pain. But the assessment of pain in children is challenging, because presentation is influenced by developmental factors, and children's responses to certain features of pain assessment tools are unlike those commonly observed in adults.The authors describe the three types of assessment used to measure pain intensity in children and the tools developed to address the unique needs of children that employ each. Such tools take into account the child's age as well as special circumstances or conditions, such as ventilation requirements, cognitive impairment, and developmental delay. The authors also discuss the importance of proxy pain reporting by the parent or caregiver and how nurses can improve communication between the child, caregiver, and health care providers, thereby promoting favorable patient outcomes.
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8
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Ye DL, Plante I, Roy M, Ouellet JA, Ferland CE. The Tampa Scale of Kinesiophobia: Structural Validation among Adolescents with Idiopathic Scoliosis Undergoing Spinal Fusion Surgery. Phys Occup Ther Pediatr 2020; 40:546-556. [PMID: 32028813 DOI: 10.1080/01942638.2020.1720054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS Spinal fusion surgery is one of the most invasive orthopedic surgeries. Pain while moving or a fear of experiencing pain after surgery may delay return to function and cause prolonged disability. The purpose of the study was to examine the psychometric properties of the Tampa Scale of Kinesiophobia (TSK) in pediatric patients undergoing scoliosis surgery. METHODS Fifty-five adolescents (10-18 years old) scheduled for spinal fusion surgery were enrolled. Participants completed the TSK questionnaire before surgery and six weeks after surgery. Reliability, exploratory and confirmatory factor analyses were performed on the two-factors TSK including activity avoidance (TSK-AA) and somatic focus (TSK-SF). RESULTS Before and after surgery, all TSK-AA items conformed into the same factor component and revealed good internal reliability with Cronbach's alpha of .76 and .70 respectively. TSK-SF items were separated into different factor components and revealed poor reliability (.11 and .56). The TSK-AA also produced an adequate fit to the data, as reflected with several fit indices at both timepoints, respectively: χ2/df = 1.19 and 1.22; CFI=.96 and .94; and RMSEA=.06 and .06. CONCLUSIONS The TSK-AA demonstrated good psychometric properties in patients undergoing scoliosis surgery, which provides empirical evidence for pediatrics. Its validation in distinct populations and settings is recommended prior to its use.
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Affiliation(s)
- Diana-Luk Ye
- Shriners Hospitals for Children-Canada, Montreal, Canada.,Department of Surgery, McGill University, Montreal, Canada.,McGill Scoliosis & Spine Research Group, Montreal, Canada
| | - Isabelle Plante
- Département d'éducation et formation spécialisées, Université du Québec à Montréal, Montreal, Canada
| | - Mathieu Roy
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada.,Department of Psychology, McGill University, Montreal, Canada
| | - Jean A Ouellet
- Shriners Hospitals for Children-Canada, Montreal, Canada.,Department of Surgery, McGill University, Montreal, Canada.,McGill Scoliosis & Spine Research Group, Montreal, Canada.,Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Catherine E Ferland
- Shriners Hospitals for Children-Canada, Montreal, Canada.,McGill Scoliosis & Spine Research Group, Montreal, Canada.,Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada.,Department of Anesthesia, McGill University, Montreal, Canada
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9
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Hedén L, von Essen L, Ljungman G. Children's self-reports of fear and pain levels during needle procedures. Nurs Open 2020; 7:376-382. [PMID: 31871722 PMCID: PMC6917931 DOI: 10.1002/nop2.399] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 09/02/2019] [Accepted: 09/23/2019] [Indexed: 11/23/2022] Open
Abstract
Aim The objective was to determine the levels of and potential relationships between, procedure-related fear and pain in children. Design Clinical based cross-sectional. Methods Ninety children aged between 7-18 years were included consecutively and self-reported levels of pain and fear on a 0-100 mm visual analogue scales (VAS) when undergoing routine needle insertion into a subcutaneously implanted intravenous port following topical anaesthesia. Results The needle-related fear level was reported to be as high as the needle-related pain level (mean VAS: 14 mm and 12 mm, respectively, N = 90). With fear as the dependent variable, age and pain were significantly associated and explained 16% of the variance. With pain as the dependent variable, fear was significantly associated and explained 11% of the variance. A post hoc analysis indicated that younger children reported their fear levels to be higher than their pain levels.
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Affiliation(s)
- Lena Hedén
- Faculty of Caring Sciences, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Louise von Essen
- Department of Women's and Children's HealthClinical Psychology in HealthcareUppsala UniversityUppsalaSweden
| | - Gustaf Ljungman
- Department of Women's and Children's HealthPediatric OncologyUppsala UniversityUppsalaSweden
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10
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Efficacy of adding interoceptive exposure to intensive interdisciplinary treatment for adolescents with chronic pain: a randomized controlled trial. Pain 2019; 159:2223-2233. [PMID: 29939961 DOI: 10.1097/j.pain.0000000000001321] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Fear of pain plays an important role in the maintenance of chronic pain. It may be reduced through exposure therapy. This 2-arm parallel samples randomized controlled trial aimed to investigate whether interoceptive exposure (IE) therapy enhances reductions in fear of pain (primary outcome), pain (pain intensity, pain-related disability, and school absence), and emotional characteristics (anxiety and catastrophizing) when implemented as an adjunctive treatment in the context of intensive interdisciplinary pain treatment for pediatric chronic pain patients. N = 126 adolescents, aged 11 to 17 years, who were receiving standard intensive interdisciplinary pain treatment were randomly assigned to either receive additional IE (n = 64) or additional relaxation therapy (RT) (n = 62). All patients were assessed at admission, discharge, and 3 months after discharge. The data of N = 104 patients were analyzed. Significant large reductions were found in the total score and subscale scores of the Fear of Pain Questionnaire for Children in both study groups (eg, total score [range 0-60; IE/RT]: admission M = 23.5/24.9; discharge M = 16.0/19.7; P < 0.001, (Equation is included in full-text article.)= 0.27) and mainly large reductions in pain characteristics. There were no greater decreases in the IE group (P > 0.1). The exploratory analyses revealed that the patients with high fear of pain before treatment (P < 0.05, (Equation is included in full-text article.)> 0.03) and the patients with abdominal pain (P < 0.04, (Equation is included in full-text article.)> 0.25) showed greater decreases in their fear of pain (total and subscale score) in the IE group than in the RT group. In conclusion, the results suggest that IE is not particularly effective for all the pediatric chronic pain patients, but the patients with high fear of pain before treatment and with abdominal pain strongly benefit from this intervention.
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Fisher E, Heathcote LC, Eccleston C, Simons LE, Palermo TM. Assessment of Pain Anxiety, Pain Catastrophizing, and Fear of Pain in Children and Adolescents With Chronic Pain: A Systematic Review and Meta-Analysis. J Pediatr Psychol 2018; 43:314-325. [PMID: 29049813 PMCID: PMC6927870 DOI: 10.1093/jpepsy/jsx103] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/29/2017] [Accepted: 07/05/2017] [Indexed: 12/11/2022] Open
Abstract
Objective To conduct a systematic review of pain anxiety, pain catastrophizing, and fear of pain measures psychometrically established in youth with chronic pain. The review addresses three specific aims: (1) to identify measures used in youth with chronic pain, summarizing their content, psychometric properties, and use; (2) to use evidence-based assessment criteria to rate each measure according to the Society of Pediatric Psychology (SPP) guidelines; (3) to pool data across studies for meta-analysis of shared variance in psychometric performance in relation to the primary outcomes of pain intensity, disability, generalized anxiety, and depression. Methods We searched Medline, Embase, PsycINFO, and relevant literature for possible studies to include. We identified measures studied in youth with chronic pain that assessed pain anxiety, pain catastrophizing, or fear of pain and extracted the item-level content. Study and participant characteristics, and correlation data were extracted for summary and meta-analysis, and measures were rated using the SPP evidence-based assessment criteria. Results Fifty-four studies (84 papers) met the inclusion criteria, including seven relevant measures: one assessed pain anxiety, three pain catastrophizing, and three fear of pain. Overall, five measures were rated as "well established." We conducted meta-analyses on four measures with available data. We found significant positive correlations with the variables pain intensity, disability, generalized anxiety, and depression. Conclusion Seven measures are available to assess pain anxiety, pain catastrophizing, and fear of pain in young people with chronic pain, and most are well established. We present implications for practice and directions for future research.
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Affiliation(s)
- Emma Fisher
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute
| | - Lauren C Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine
| | - Christopher Eccleston
- Centre for Pain Research, University of Bath
- Department of Clinical and Health Psychology, Ghent University
| | - Laura E Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine
| | - Tonya M Palermo
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute
- Departments of Anesthesiology and Pain Medicine, Psychiatry, and Pediatrics, University of Washington
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12
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Stoltz P, Manworren RCB. Comparison of Children's Venipuncture Fear and Pain: Randomized Controlled Trial of EMLA® and J-Tip Needleless Injection System®. J Pediatr Nurs 2017; 37:91-96. [PMID: 28823623 DOI: 10.1016/j.pedn.2017.08.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 07/27/2017] [Accepted: 08/11/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Needle procedures, like venipuncture and intravenous (IV) catheter insertion, are recognized as a common cause of pain and fear for children in hospitals and emergency departments. The purpose of this study was to compare children's self-reported pain and fear related to IV insertion with administration of either the topical local anesthetic EMLA® or 1% buffered lidocaine delivered with the J-Tip Needleless Injection System® (J-Tip®). DESIGN AND METHODS In this prospective, randomized trial, 150 consecutive pediatric patients 8 to 18years of age undergoing IV insertion were randomly assigned 1:1 to treatment group. Participants self-reported procedural pain using a Visual Analog Scale, and procedural fear using the Children's Fear Scale. RESULTS Procedural pain scores were significantly lower in the EMLA® group (mean score 1.63+1.659) vs. the J-Tip® group (2.99±2.586; p<0.001). Post-procedure fear scores were significantly lower than pre-procedure fear scores in both treatment groups (p<0.002), but there was no difference in fear scores between the two treatment groups (p=0.314). CONCLUSION EMLA® provided superior pain relief for IV insertion compared to J-Tip®. PRACTICE IMPLICATIONS Although EMLA® use resulted in lower self-reported pain scores compared to J-Tip®, pain scores for both treatments were low and fear scores did not differ. When IV insertion can be delayed for 60-90min, EMLA® should be used. When a delay is contraindicated, J-Tip® may be a reasonable alternative to minimize procedural pain of IV insertion.
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Affiliation(s)
- Petronella Stoltz
- Division of Pediatric Critical Care, Connecticut Children's Medical Center, Hartford, CT, United States; Division of Pediatric Neurosurgery, Connecticut Children's Medical Center, Hartford, CT, United States.
| | - Renee C B Manworren
- Nursing Research & Professional Practice, Posey and Fred Love Chair in Nursing Research, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; (d)Northwestern University Feinberg School of Medicine, United States.
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13
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Flack F, Gerlach A, Simons L, Zernikow B, Hechler T. Validation of the German fear of pain questionnaire in a sample of children with mixed chronic pain conditions. Eur J Pain 2017; 21:1224-1233. [DOI: 10.1002/ejp.1022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 12/18/2022]
Affiliation(s)
- F. Flack
- German Paediatric Pain Centre; Children's and Adolescent's Hospital; Datteln Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care; Faculty of Health - School of Medicine; Witten/Herdecke University; Germany
| | - A.L. Gerlach
- Department of Psychology; Institute of Clinical Psychology and Psychotherapy; University of Cologne; Germany
| | - L.E. Simons
- Department of Anaesthesiology, Perioperative and Pain Medicine; Stanford University School of Medicine; USA
| | - B. Zernikow
- German Paediatric Pain Centre; Children's and Adolescent's Hospital; Datteln Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care; Faculty of Health - School of Medicine; Witten/Herdecke University; Germany
| | - T. Hechler
- Department of Clinical Child and Adolescent Psychology and Psychotherapy; University of Trier; Germany
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Dekker C, Bastiaenen CHG, de Vries JE, Simons LE, Goossens MEJB, Verbunt JAMCF. Dutch version of the Fear of Pain Questionnaire for adolescents with chronic pain. Disabil Rehabil 2017. [PMID: 28637153 DOI: 10.1080/09638288.2017.1289255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Fear of pain is important in the development and maintenance of chronic pain. The Fear of Pain Questionnaire-Child version has been developed to assess pain related fear in children and adolescents. OBJECTIVE Translating the original questionnaire into Dutch, and investigating internal consistency and construct validity to enable use in the Dutch pain rehabilitation setting for treatment and research. METHODS Cross-sectional validation study: After forward and back translation of the FOPQ-C, adolescents (11-22 years old) with chronic musculoskeletal pain completed an assessment containing the Dutch Fear of Pain Questionnaire, and questionnaires about demographics, pain catastrophizing, functional disability, and pain intensity. Internal consistency and construct validity were evaluated through exploratory factor analysis (principal axis factoring with oblique rotation) and hypotheses testing using pain catastrophizing, functional disability, and pain intensity as comparative constructs. RESULTS Eighty-six adolescents completed the assessment. Exploratory factor analysis resulted in a two-factor structure, explaining 43% of the variance. Internal consistency was strong (Cronbach's α = 0.92 total scale, α = 0.88 factor 1, and α = .86 factor 2). Five out of 6 hypotheses were confirmed. CONCLUSIONS The Dutch version demonstrated good internal consistency and good construct validity in a population of adolescents with chronic musculoskeletal pain. Implications for rehabilitation The Fear of Pain Questionnaire-Child version was developed to measure fear of pain and avoidance in children and adolescents with chronic pain. Identification of fear of pain and activities that are being avoided are important during screening and assessment of the adolescent for chronic pain rehabilitation treatment. The presence of fear of pain and/or avoidance behavior is important information to shape and target multidisciplinary rehabilitation treatment.
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Affiliation(s)
- Carolien Dekker
- a Department of Rehabilitation Medicine, CAPHRI, Functioning and Rehabilitation , Maastricht University , Maastricht , The Netherlands
| | - Caroline H G Bastiaenen
- b Department of Epidemiology, CAPHRI, Functioning and Rehabilitation , Maastricht University , Maastricht , The Netherlands.,c Department of Health, School of Health Professions , Zurich University of Applied Sciences (ZUAS) , Winterthur , Switzerland
| | - Janneke E de Vries
- d Faculty of Health, European school of Physiotherapy , Amsterdam University of Applied Sciences , Amsterdam , The Netherlands.,e Department of Rehabilitation , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.,f ACHIEVE - Center of Applied Research, Faculty of Health , Amsterdam University of Applied Sciences , Amsterdam , The Netherlands
| | - Laura E Simons
- g Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine , Boston Children's Hospital , Boston , MA , USA.,h Department of Psychiatry , Harvard Medical School , Boston , MA , USA
| | - Mariëlle E J B Goossens
- a Department of Rehabilitation Medicine, CAPHRI, Functioning and Rehabilitation , Maastricht University , Maastricht , The Netherlands.,i Department of Clinical Psychological Sciences, Experimental Psychopathology , Maastricht University , Maastricht , The Netherlands
| | - Jeanine A M C F Verbunt
- a Department of Rehabilitation Medicine, CAPHRI, Functioning and Rehabilitation , Maastricht University , Maastricht , The Netherlands.,j Adelante Zorggroep , Hoensbroek , The Netherlands
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Fear of pain in children and adolescents with neuropathic pain and complex regional pain syndrome. Pain 2016; 157 Suppl 1:S90-S97. [PMID: 26785161 DOI: 10.1097/j.pain.0000000000000377] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A significant proportion of children and adolescents with chronic pain endorse elevated pain-related fear. Pain-related fear is associated with high levels of disability, depressive symptoms, and school impairment. Because of faulty nerve signaling, individuals with neuropathic pain and complex regional pain syndrome may be more prone to develop pain-related fear as they avoid use of and neglect the affected body area(s), resulting in exacerbated symptoms, muscle atrophy, maintenance of pain signaling, and ongoing pain-related disability. Not surprisingly, effective treatments for elevated pain-related fears involve exposure to previously avoided activities to downregulate incorrect pain signaling. In the context of intensive interdisciplinary pain treatment of youth with neuropathic pain, decreasing pain-related fear is associated with improved physical and psychological functioning, whereas high initial pain-related fear is a risk factor for less treatment responsiveness. An innovative approach to targeting pain-related fear and evidence of a neural response to treatment involving decoupling of the amygdala with key fear circuits in youth with complex regional pain syndrome suggest breakthroughs in our ability to ameliorate these issues.
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Systematic review with meta-analysis of childhood and adolescent risk and prognostic factors for musculoskeletal pain. Pain 2016; 157:2640-2656. [DOI: 10.1097/j.pain.0000000000000685] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
PURPOSE OF REVIEW This article provides a summary of recommendations for the multimodal and multidisciplinary approach to acute pediatric pain management and highlights recent research on this topic. RECENT FINDINGS Recent literature has focused on updating recommendations for the use of various analgesics in the pediatric population. While codeine is no longer recommended due to increasing evidence of adverse effects, the more liberal use of intranasal fentanyl is now encouraged because of the ease of administration and rapid delivery. The evidence base for the use of ultrasound-guided regional nerve blocks by qualified providers in the acute pediatric pain setting continues to grow. SUMMARY The pediatric emergency medicine provider should be able to assess pain and develop individualized pain plans by utilizing a range of nonpharmacologic and pharmacologic strategies. Knowledge of the most recent literature and changes in recommendations for various pain medications is essential.
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Aziato L, Dedey F, Marfo K, Asamani JA, Clegg-Lamptey JNA. Validation of three pain scales among adult postoperative patients in Ghana. BMC Nurs 2015; 14:42. [PMID: 26265901 PMCID: PMC4531519 DOI: 10.1186/s12912-015-0094-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 07/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pain assessment is an important component of pain management and health professionals require valid tools to assess pain to guide their pain management decisions. The study sought to select, develop, and validate context-appropriate unidimensional pain scales for pain assessment among adult post-operative patients. METHODS A mixed methods design was adopted. The study was conducted at two hospitals in Accra, Ghana. The qualitative phase involved 17 patients and 25 nurses, and the quantitative phase involved 150 post-operative patients. Qualitative data was collected iteratively through individual interviews and focus groups. RESULTS Two existing pain scales (0-10 Numeric Rating Scale [NRS] and Wong-Baker FACES [FPS] scales) and one new pain scale (Colour-Circle Pain Scale-[CCPS]) were validated. The psychometric properties of the three scales were assessed when patients had fully recovered from anesthesia. The CCPS had higher scale preference than NRS and FPS. Convergent validity was very good and significant (0.70-0.75). Inter-rater reliability was high (0.923-0.928) and all the scales were sensitive to change in the intensity or level of pain experienced before and after analgesia such as paracetamol and diclofenac suppositories, injectable pethidine, and oral tramadol had been administered. CONCLUSION Using a valid tool for pain assessment gives the clinician an objective criterion for pain management. Due to the subjective nature of pain, consideration of socio-cultural factors for the particular context ensures that the appropriate tool is used.
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Affiliation(s)
- Lydia Aziato
- />Department of Adult Health, School of Nursing, University of Ghana, Legon, Accra, Ghana
- />School of Nursing, College of Health Sciences, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana
| | - Florence Dedey
- />Department of Surgery, University of Ghana Medical School, Accra, Ghana
| | - Kissinger Marfo
- />Public Health Unit (Biostatistics), Korle-Bu Teaching Hospital, Accra, Ghana
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Verbunt JA, Nijhuis A, Vikström M, Stevens A, Haga N, de Jong J, Goossens M. The psychometric characteristics of an assessment instrument for perceived harmfulness in adolescents with musculoskeletal pain (PHODA-youth). Eur J Pain 2014; 19:695-705. [PMID: 25243825 DOI: 10.1002/ejp.592] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cognitive-behavioural models of chronic pain predict that dysfunctional assumptions about harmfulness of activities may maintain pain-related fear and disability. To assess perceived harmfulness in adolescents, the Photograph Series of Daily Activities for youth (PHODA-youth) was developed. Information concerning its methodological quality is currently lacking. OBJECTIVE To investigate psychometric characteristics (factor structure, test-retest reliability, construct validity) and feasibility of the PHODA-youth in adolescents with chronic musculoskeletal pain. STUDY DESIGN Test-retest design. STUDY POPULATION Adolescents aged 13-21 years with chronic nonspecific musculoskeletal pain. METHODS Participants filled in an electronic version of the PHODA-youth including 89 items twice with a 4-week interval. The instrument's factor structure was determined by a factor analysis. Construct validity was studied with criterion variables: catastrophizing (Pain Catastrophizing Scale for Children), pain intensity (visual analogue scale), depression (Children's Depression Inventory) and pain-related disability (Functional Disability Inventory) using regression analysis. Test-retest reliability was evaluated based on the Pearson correlation coefficient. Feasibility was studied with self-constructed questions. RESULTS Seventy-one adolescents participated. Results show a three-factor structure for the PHODA-youth including 51 items with subscales labelled as: 'activities of daily life', 'intensive physical activities' and 'social activities'. Total and subscale scores showed a high internal consistency. Its test-retest reliability was good (r = 0.94) and its construct validity is supported by the finding that both catastrophizing (β = 0.25; p = 0.02) and disability (β = 0.71; p < 0.001) were uniquely related to the PHODA-youth. In addition, feasibility appeared adequate. CONCLUSION The findings support the PHODA-youth as a valid and reliable measure of the perceived harmfulness of activities in adolescents with musculoskeletal pain.
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Affiliation(s)
- J A Verbunt
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, The Netherlands; Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
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Factorial Validity of the English-Language Version of the Pain Catastrophizing Scale–Child Version. THE JOURNAL OF PAIN 2013; 14:1383-9. [DOI: 10.1016/j.jpain.2013.06.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 05/29/2013] [Accepted: 06/11/2013] [Indexed: 11/23/2022]
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Pediatric fear-avoidance model of chronic pain: foundation, application and future directions. Pain Res Manag 2013; 17:397-405. [PMID: 23248813 DOI: 10.1155/2012/908061] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The fear-avoidance model of chronic musculoskeletal pain has become an increasingly popular conceptualization of the processes and mechanisms through which acute pain can become chronic. Despite rapidly growing interest and research regarding the influence of fear-avoidance constructs on pain-related disability in children and adolescents, there have been no amendments to the model to account for unique aspects of pediatric chronic pain. A comprehensive understanding of the role of fear-avoidance in pediatric chronic pain necessitates understanding of both child⁄adolescent and parent factors implicated in its development and maintenance. The primary purpose of the present article is to propose an empirically-based pediatric fear-avoidance model of chronic pain that accounts for both child⁄adolescent and parent factors as well as their potential interactive effects. To accomplish this goal, the present article will define important fear-avoidance constructs, provide a summary of the general fear-avoidance model and review the growing empirical literature regarding the role of fear-avoidance constructs in pediatric chronic pain. Assessment and treatment options for children with chronic pain will also be described in the context of the proposed pediatric fear-avoidance model of chronic pain. Finally, avenues for future investigation will be proposed.
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Bird L, McMurtry CM. Fear in pediatric acute pain: role and measurement. Pain Manag 2012; 2:527-9. [DOI: 10.2217/pmt.12.56] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Leanne Bird
- Department of Psychology, University of Guelph, 87 Trent Lane, Guelph, ON, N1G 2W1, Canada
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, 87 Trent Lane, Guelph, ON, N1G 2W1, Canada
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Noel M, Chambers CT, Petter M, McGrath PJ, Klein RM, Stewart SH. Pain is not over when the needle ends: a review and preliminary model of acute pain memory development in childhood. Pain Manag 2012; 2:487-97. [DOI: 10.2217/pmt.12.41] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
SUMMARY Over the past several decades, the field of pediatric pain has made impressive advances in our understanding of the pain experience of the developing child, as well as the devastating impact of inadequately managed pain early in life. It is now well recognized that, from infancy, children are capable of developing implicit memories of pain that can influence their subsequent reactions to pain. The present review provides a synthesis of selected studies that made a significant impact on this field of inquiry, with particular emphasis on recent clinical and laboratory-based experimental research examining children’s explicit autobiographical memories for acute pain. Research has begun to move towards improving the precision with which children at risk for developing negatively estimated pain memories can be identified, given the adverse influence these memories can have on subsequent pain experiences. As such, several fear- and anxiety-related child and parent variables implicated in this process are discussed, and avenues for future research and clinical intervention are identified throughout. Finally, a preliminary empirically and theoretically derived model of acute pain memory development in childhood is presented to parsimoniously summarize the evidence accumulated to date and guide future investigation in this area.
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Affiliation(s)
- Melanie Noel
- Department of Psychology, Dalhousie University, Life Sciences Centre, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
| | - Christine T Chambers
- Department of Psychology, Dalhousie University, Life Sciences Centre, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980, University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada
- Department of Pediatrics, Dalhousie University and the IWK Health Centre, 5850 University Avenue, PO Box 9700, B3K 6R8, Canada
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, 8th floor, Abbie J Lane Memorial Building QEII Health Sciences Centre, Halifax, Nova Scotia, B3H 2E2, Canada
| | - Mark Petter
- Department of Psychology, Dalhousie University, Life Sciences Centre, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980, University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada
| | - Patrick J McGrath
- Department of Psychology, Dalhousie University, Life Sciences Centre, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, 5850/5980, University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada
- Department of Pediatrics, Dalhousie University and the IWK Health Centre, 5850 University Avenue, PO Box 9700, B3K 6R8, Canada
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, 8th floor, Abbie J Lane Memorial Building QEII Health Sciences Centre, Halifax, Nova Scotia, B3H 2E2, Canada
- Research, IWK Health Centre, 5850/5980 University Avenue, PO Box 9700, Halifax, NS B3K 6R8, Canada
| | - Raymond M Klein
- Department of Psychology, Dalhousie University, Life Sciences Centre, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
| | - Sherry H Stewart
- Department of Psychology, Dalhousie University, Life Sciences Centre, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, 8th floor, Abbie J Lane Memorial Building QEII Health Sciences Centre, Halifax, Nova Scotia, B3H 2E2, Canada
- Department of Community Health & Epidemiology, Centre for Clinical Research, 5790 University Avenue, Halifax, NS B3H 1V7, Canada
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Eccleston C, Fisher EA, Vervoort T, Crombez G. Worry and catastrophizing about pain in youth: A reappraisal. Pain 2012; 153:1560-1562. [DOI: 10.1016/j.pain.2012.02.039] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 02/24/2012] [Accepted: 02/27/2012] [Indexed: 11/29/2022]
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Abstract
PURPOSE OF REVIEW To review recent research on the management of acute procedural pain in pediatric patients. RECENT FINDINGS Pediatric patients experience pain with the same or greater intensity as their adult counterparts. Recent studies have acknowledged the importance of people's beliefs about pain and of a multidisciplinary approach to the assessment and treatment of acute pain. SUMMARY Pediatric patients experience pain from procedures related to their care. Pediatricians should educate themselves regarding the accurate assessment of pain, and the pharmacologic and nonpharmacologic methods of managing acute pain.
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Current World Literature. Curr Opin Support Palliat Care 2012; 6:289-98. [DOI: 10.1097/spc.0b013e328353e091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bearden DJ, Feinstein A, Cohen LL. The influence of parent preprocedural anxiety on child procedural pain: mediation by child procedural anxiety. J Pediatr Psychol 2012; 37:680-6. [PMID: 22623729 DOI: 10.1093/jpepsy/jss041] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Data suggest parents' preprocedural anxiety is related to children's acute procedural anxiety and pain. This study examined the temporal relations among these constructs to determine whether children's anxiety mediates the relation between parents' anticipatory anxiety and children's procedural pain. METHODS A total of 90 preschoolers receiving immunizations, their parents, and the nurses rated children's procedural anxiety and pain. Parents provided ratings of their own preprocedural anxiety. RESULTS Bootstrapping analyses revealed that children's procedural anxiety mediated the relation between parents' preprocedural anxiety and children's procedural pain according to parents' report and nurses' report but not children's self-report of anxiety and pain. CONCLUSIONS Analyses suggest that children's procedural anxiety mediates the relation between parents' anticipatory anxiety and children's procedural pain. Thus, targeting parents' preprocedural anxiety might be beneficial to the parents as well as the children undergoing a distressing medical procedure.
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Affiliation(s)
- Donald J Bearden
- Department of Psychology, Georgia State University, Atlanta, GA 30302-5010, USA
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Abstract
Headache in children and adolescents represents a number of complex and multifaceted pain syndromes that can benefit from psychological intervention. There is good evidence for the efficacy of cognitive behavioral therapy, relaxation training, and biofeedback. The choice of intervention is influenced by patients' age, sex, family and cultural background, as well as the nature of stressors and comorbid psychiatric symptoms. Management must always be family-centered. Psychological treatments are essential elements of the multidisciplinary, biopsychosocial management of primary headache disorders, particularly for those with frequent or chronic headache, a high level of headache-related disability, medication overuse, or comorbid psychiatric symptoms. Future studies of efficacy and effectiveness of psychological treatment should use the International Headache Society's definition and classification of headache disorders, and stratify results by headache type, associated conditions, and treatment modality.
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Noel M, Chambers CT, McGrath PJ, Klein RM, Stewart SH. The Role of State Anxiety in Children's Memories for Pain. J Pediatr Psychol 2012; 37:567-79. [DOI: 10.1093/jpepsy/jss006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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