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Schwerdt H, Christe G, Pate JW, Blake C, Smart KM. The prevalence of chronic pain in adolescents in Central Switzerland: A cross- sectional school-based study protocol. PLoS One 2024; 19:e0297088. [PMID: 38330041 PMCID: PMC10852288 DOI: 10.1371/journal.pone.0297088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/23/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Chronic pain is associated with substantial personal suffering and societal costs and is a growing healthcare concern worldwide. While chronic pain has been extensively studied in adults, limited data exists on its prevalence and impact in adolescents. Understanding the prevalence and impact of chronic pain and pain beliefs in adolescents is crucial for developing effective prevention and treatment strategies. This study aims to estimate the prevalence, characteristics, and impact of chronic pain, and explore adolescents' knowledge and beliefs about pain. METHODS This is an observational cohort study of school-going adolescents aged 11 to 17 years in Central Switzerland. The study will estimate the point prevalence, characteristics (location, intensity, frequency, duration) and impact (PROMIS Pediatric Short Form v2.0 -Pain Interference Scale, PPIS) of chronic pain in school-going adolescents. We will also measure and investigate pupils' beliefs about pain (Concept of Pain Inventory (COPI)). Data will be collected through manual and digital self-report questionnaires and from participants in primary, secondary, and high schools between September 2023 and January 2024. ANALYSES The primary analyses will utilise descriptive statistics to estimate the point prevalence, characteristics, and impact of chronic pain. Secondary analyses will analyse associations and correlations between chronic pain, impact of pain and beliefs about pain. OUTCOMES This study will provide an estimate of the prevalence, characteristics and impact of chronic pain in adolescents in Central Switzerland and a measure of adolescents' understanding and beliefs about pain. In doing so, this study will provide insights into the scale of chronic pain as a public health concern. By understanding adolescents' pain beliefs and their influence on pain experience, this study can contribute to the development of educational approaches to enhance adolescents' knowledge and understanding of pain in order to optimise the prevention and treatment of chronic pain in adolescents. The findings may be useful to healthcare professionals and funders, policymakers, and researchers involved in the prevention, assessment, and treatment of pain in adolescents.
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Affiliation(s)
- Helen Schwerdt
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Guillaume Christe
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Joshua W. Pate
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Catherine Blake
- UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Physiotherapy Department, St. Vincent’s University Hospital, Dublin, Ireland
- UCD Centre for Translational Pain Research, University College Dublin, Dublin, Ireland
| | - Keith M. Smart
- UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Physiotherapy Department, St. Vincent’s University Hospital, Dublin, Ireland
- UCD Centre for Translational Pain Research, University College Dublin, Dublin, Ireland
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Deng S, Lau J, Wang Z, Wargocki P. Associations between illness-related absences and ventilation and indoor PM 2.5 in elementary schools of the Midwestern United States. ENVIRONMENT INTERNATIONAL 2023; 176:107944. [PMID: 37216835 DOI: 10.1016/j.envint.2023.107944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/24/2023]
Abstract
This study monitored indoor environmental data in 144 classrooms in 31 schools in the Midwestern United States for two consecutive days every fall, winter, and spring during a two-year period; 3,105 pupils attended classrooms where the measurements were conducted. All classrooms were ventilated with mechanical systems that had recirculation; there were no operable exterior windows or doors. The daily absence rate at the student level and demographic data at the classroom level were collected. The overall mean ventilation rate, using outdoor air, was 5.5 L/s per person (the corresponding mean carbon dioxide concentrations were < 2,000 ppm), and the mean indoor PM2.5 was 3.6 μg/m3. The annual illness-related absence rate at the classroom level was extracted from the student-level absence data and regressed on measured indoor environmental parameters. Significant associations were found. Every 1 L/s per person increase in ventilation rate was associated with a 5.59 decrease in days with absences per year. This corresponds to a 0.15% increase in the annual daily attendance rate. Every additional 1 μg/m3 of indoor PM2.5 was associated with a 7.37 increase in days with absences per year. This corresponds to a 0.19% decrease in the annual daily attendance rate. No other relationships were significant. Present results agree with the previously demonstrated benefits of reduced absence rates when classroom ventilation is improved and provide additional evidence on the potential benefits of reducing indoor inhalable particles. Overall, reduced absence rates are expected to provide socioeconomic benefits and benefits for academic achievements, while higher ventilation rates and reduced particle levels will also contribute to reduced health risks, including those related to airborne respiratory pathogens.
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Affiliation(s)
- Shihan Deng
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, 727 South Jingming Road, Chenggong District, Kunming, Yunnan, 650500, China; Durham School of Architectural Engineering and Construction, University of Nebraska - Lincoln, 1110 S. 67th Street, Omaha, NE, 68182-0816, United States
| | - Josephine Lau
- Durham School of Architectural Engineering and Construction, University of Nebraska - Lincoln, 1110 S. 67th Street, Omaha, NE, 68182-0816, United States.
| | - Zhihao Wang
- Faculty of Civil Engineering and Mechanics, Kunming University of Science and Technology, 727 South Jingming Road, Chenggong District, Kunming, Yunnan, 650500, China
| | - Pawel Wargocki
- Department of Environmental and Resource Engineering (DTU Sustain), Technical University of Denmark, Koppels Allé, 402, 2800 Kgs. Lyngby, Denmark
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Owiredua C, Flink I, Boersma K. Prevalence and risk factors for pain-specific school absenteeism in adolescents with recurrent pain: A prospective population-based design. Eur J Pain 2023; 27:390-400. [PMID: 36478020 DOI: 10.1002/ejp.2065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/16/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adolescents with recurrent pain miss out from school more often than pain-free peers. Research has so far used cross-sectional designs, focusing on non-specific absenteeism in clinical samples. Hence, it is unknown whether estimates of absenteeism are specifically linked to the pain itself or reflects the characteristics of clinical samples. OBJECTIVES This study aimed to prospectively explore pain-related school absenteeism in a non-clinical sample, its variance and potential risk factors. METHODS This prospective study followed a cohort of 1300 Sweden-based adolescents (mean age = 16.9; 17.2% immigrants; 62.7% girls) with recurrent pain (headache, abdominal and/or musculoskeletal pain) through self-reports at two assessment points 12 months apart. RESULTS Overall, 64.2% reported any absenteeism at follow-up and about half of these (26.2%) reported frequent absenteeism. Adolescents who indicated missing school were more often girls, slightly older and had a higher overall pain burden and stressor levels. Yet, after adjusting for previous absenteeism, independent predictors were age, pain intensity, medication use and stress associated with school attendance. Further to this, immigrant status predicted frequent absenteeism. CONCLUSIONS Many adolescents with pain frequently miss out from school due to pain. Identified risk factors points at pain characteristics and coping, stressors associated with participation and advancing age. Taken together, the burden of pain and its correlates emerge earlier and escalate with increasing age hence, early interventions targeting broader domains are needed. SIGNIFICANCE This study adds substantially to the field by estimating the prevalence of pain-specific school absenteeism in a large sample of adolescents with recurrent pain in the general population using a prospective design. Furthermore, it identifies risk factors of pain-specific absenteeism from a broader context of the adolescent's life with independent predictors being the previous history of absenteeism, age, immigrant status, pain intensity, medication use and stress related to school attendance.
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Affiliation(s)
- Christiana Owiredua
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Ida Flink
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Katja Boersma
- Subject of Psychology, Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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Salvo T, Davison-Jenkins A, Hitchcock M, Daniilidi X, Lambert D. The journey of 'Living with Pain': A feasibility study of the development and running of a collective narrative group. Clin Child Psychol Psychiatry 2023; 28:35-55. [PMID: 35790724 DOI: 10.1177/13591045221112719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Chronic Pain is increasingly affecting young people, their quality of life and wellbeing including education, social life and mental health. Current Western approaches to psychological support for Chronic Pain often focus on 'pain management' and learning skills and strategies from professionals, making use of Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and psychoeducation approaches in individual and group interventions. As a Paediatric Psychology service, we have trialled groups running over multiple weeks informed by these approaches and experienced low attendance rates. METHOD This paper describes a feasibility study of an alternative group intervention; the 'Living with Pain group', which combines the 'Journey of Life' (Denborough, 2014) with collective narrative and liberation psychology approaches. RESULTS Thirty three young people and eight parents / carers attended the intervention. Attendance rates, quantitative and qualitative feedback from one face-to-face group for young people and parents and two online groups for young people showed increased access and acceptability of the group. CONCLUSION The findings from this study have shown that a 1-day collective narrative group intervention is feasible, suitable and acceptable and has increased access to our group intervention. Future directions include co-creation with young people and families, community engagement to increase accessibility of our groups and developing partnerships to respond to young people's hopes to raise awareness.
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Affiliation(s)
- Tania Salvo
- 8964University College London Hospitals NHS Foundation Trust, UK
| | | | - Megan Hitchcock
- 8964University College London Hospitals NHS Foundation Trust, UK
| | - Xeni Daniilidi
- 8964University College London Hospitals NHS Foundation Trust, UK
| | - Danielle Lambert
- 8964University College London Hospitals NHS Foundation Trust, UK
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Maunder L, Pavlova M, Beveridge JK, Katz J, Salomons TV, Noel M. Sensitivity to Pain Traumatization and Its Relationship to the Anxiety-Pain Connection in Youth with Chronic Pain: Implications for Treatment. CHILDREN (BASEL, SWITZERLAND) 2022; 9:529. [PMID: 35455573 PMCID: PMC9032504 DOI: 10.3390/children9040529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
The bidirectional relationship between anxiety and chronic pain in youth is well-known, but how anxiety contributes to the maintenance of pediatric chronic pain needs to be elucidated. Sensitivity to pain traumatization (SPT), an individual's propensity to develop responses to pain that resemble a traumatic stress response, may contribute to the mutual maintenance of anxiety and pediatric chronic pain. A clinical sample of youth (aged 10-18 years) with chronic pain completed a measure of SPT at baseline and rated their anxiety and pain characteristics for seven consecutive days at baseline and at three-month follow-up. Multiple linear regression analyses were conducted to model whether SPT moderated the relationship between baseline anxiety and pain intensity, unpleasantness, and interference three months later. SPT significantly moderated the relationship between anxiety and pain intensity. High anxiety youth with high SPT reported increased pain intensity three months later, while high anxiety youth with low SPT did not. High anxiety youth who experience pain as potentially traumatizing are more likely to report higher pain intensity three months later than high-anxiety youth who do not. Future research should examine whether children's propensity to become traumatized by their pain predicts the development of chronic pain and response to intervention.
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Affiliation(s)
- Larah Maunder
- Department of Psychology, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Maria Pavlova
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (J.K.B.); (M.N.)
| | - Jaimie K. Beveridge
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (J.K.B.); (M.N.)
| | - Joel Katz
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada;
| | - Tim V. Salomons
- Department of Psychology, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.P.); (J.K.B.); (M.N.)
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB T2N 4Z6, Canada
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Supporting Primary School Children with Juvenile Idiopathic Arthritis: A Qualitative Investigation of Teaching Staff Experiences. CHILDREN-BASEL 2021; 8:children8070555. [PMID: 34203152 PMCID: PMC8306313 DOI: 10.3390/children8070555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022]
Abstract
Background: Juvenile idiopathic arthritis (JIA) has a deleterious impact on numerous areas of children’s lives, including school functioning. This study moves beyond eliciting child reports of school functioning to examine teaching staff’s experiences of supporting a child with JIA in school. Methods: A total of 51 UK-based teaching staff members with experience of supporting a child aged 7–11 years with JIA in school were recruited. Participants completed an online qualitative survey regarding their perceptions and experiences of supporting a child with JIA in school, with a subsample of 9 participants completing a subsequent telephone interview to explore responses in greater detail. Survey and interview data were analyzed using the conventional approach to qualitative content analysis. Results: Analyses generated 4 themes: (1) communicating, (2) flexing and adapting, (3) including, and (4) learning and knowing. Findings highlighted the importance of clear communication between teaching staff and parents in addition to the need for teaching staff to provide individualized support for children with JIA which maximized their inclusion within the class. Conclusions: This paper provides new knowledge regarding how teaching staff adopt proactive and creative strategies to support children with JIA, often in the absence of appropriate training, identifying support needs and resources for teaching staff.
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Ives LT, Stein K, Rivera-Cancel AM, Nicholas JK, Caldwell K, Datta N, Mauro C, Egger H, Puffer E, Zucker NL. Children's Beliefs about Pain: An Exploratory Analysis. CHILDREN (BASEL, SWITZERLAND) 2021; 8:452. [PMID: 34071866 PMCID: PMC8228747 DOI: 10.3390/children8060452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022]
Abstract
Functional abdominal pain (FAP) is one of the most common childhood medical complaints, associated with significant distress and impairment. Little is known about how children understand their pain. Do they attribute it to personal weakness? Do they perceive pain as having global impact, affecting a variety of activities? How do they cope with pain? We explored the pain beliefs of 5- to 9-year-old children with FAP using a novel Teddy Bear Interview task in which children answered questions about a Teddy bear's pain. Responses were analyzed quantitatively and qualitatively. Results indicate that the majority of young children with FAP are optimistic about pain outcomes. Children generated many types of coping strategies for Teddy's pain and adjusted their calibration of Teddy's pain tolerance dependent on the activity being performed. Early warning signs also emerged: a subset of children were pessimistic about Teddy's pain, and several children identified coping strategies that, while developmentally appropriate, could lead to excessive help seeking if not intervened upon (e.g., physician consultation and shot). The Teddy Bear Interview allows children to externalize their pain, making it a useful tool to access cognitive pain constructs in younger children. Thus, these findings highlight the importance of early intervention for childhood FAP.
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Affiliation(s)
- Lindsay T. Ives
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA; (L.T.I.); (E.P.)
| | - Kate Stein
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK;
| | - Alannah M. Rivera-Cancel
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; (A.M.R.-C.); (J.K.N.); (K.C.); (C.M.)
| | - Julia K. Nicholas
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; (A.M.R.-C.); (J.K.N.); (K.C.); (C.M.)
| | - Kristen Caldwell
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; (A.M.R.-C.); (J.K.N.); (K.C.); (C.M.)
| | - Nandini Datta
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Christian Mauro
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; (A.M.R.-C.); (J.K.N.); (K.C.); (C.M.)
| | - Helen Egger
- Department of Child and Adolescent Psychiatry, NYU Langone Health, New York, NY 10016, USA;
| | - Eve Puffer
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA; (L.T.I.); (E.P.)
| | - Nancy L. Zucker
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA; (L.T.I.); (E.P.)
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; (A.M.R.-C.); (J.K.N.); (K.C.); (C.M.)
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The Relationship between Stressors and Pain-Related Clinical Outcomes in Pediatric Chronic Pain Patients. CHILDREN-BASEL 2021; 8:children8010021. [PMID: 33406657 PMCID: PMC7824521 DOI: 10.3390/children8010021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/03/2020] [Accepted: 12/21/2020] [Indexed: 11/17/2022]
Abstract
Youth with chronic pain and youth who have experienced stressors are at risk for poor outcomes; however, little is known about the intersection of pain and stressors. This study aims to understand the prevalence of stressors among youth with chronic pain and the relationship between stressors and pain-related outcomes. Seven hundred and seventy youth with chronic pain aged 8–18 (Mage = 14.15 years, 70% female) reported pain characteristics, stressors, anxiety, disability, and quality of life. Most participants (82%) endorsed at least one stressor. A greater number of stressors was significantly related to greater anxiety and disability, and lower levels of quality of life. School stressors were significantly associated with functional disability; family, school, and peer stressors were significantly associated with anxiety and quality of life. Stressors are common in youth with chronic pain, and the presence of stressors is related to greater functional impairment. The results of this preliminary study using semi-structured clinical interviews suggest the importance of developing a validated measure that encompasses a wide variety of stressors for youth with pain. Future research on patient-reported stressors, relative intensity, and impact are needed.
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Könning A, Rosenthal N, Friese M, Hirschfeld G, Brown D, Wager J. Factors associated with physician consultation and medication use in children and adolescents with chronic pain: A scoping review and original data. Eur J Pain 2020; 25:88-106. [DOI: 10.1002/ejp.1661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Anna Könning
- German Paediatric Pain CentreChildren’s and Adolescents’ Hospital Datteln Germany
- Department of Children’s Pain Therapy and Paediatric Palliative Care Faculty of Health School of Medicine Witten/Herdecke University Witten Germany
| | - Nicola Rosenthal
- German Paediatric Pain CentreChildren’s and Adolescents’ Hospital Datteln Germany
- Department of Children’s Pain Therapy and Paediatric Palliative Care Faculty of Health School of Medicine Witten/Herdecke University Witten Germany
| | - Michelle Friese
- German Paediatric Pain CentreChildren’s and Adolescents’ Hospital Datteln Germany
- Department of Children’s Pain Therapy and Paediatric Palliative Care Faculty of Health School of Medicine Witten/Herdecke University Witten Germany
| | - Gerrit Hirschfeld
- Department for Business and Health University of Applied Sciences Bielefeld Bielefeld Germany
| | - Donnamay Brown
- German Paediatric Pain CentreChildren’s and Adolescents’ Hospital Datteln Germany
| | - Julia Wager
- German Paediatric Pain CentreChildren’s and Adolescents’ Hospital Datteln Germany
- Department of Children’s Pain Therapy and Paediatric Palliative Care Faculty of Health School of Medicine Witten/Herdecke University Witten Germany
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Abstract
OBJECTIVE The objective of this study was to estimate the national burden of school absenteeism associated with pain among 6 to 17-year-old children in the United States. METHODS Data were analyzed from a large, nationally representative sample from the 2012 National Health Interview Survey. Associations between pain and school absence were analyzed using multivariate negative binomial models controlling for sociodemographic and clinical characteristics. RESULTS The sample contained 8641 participants, of whom 30.3% reported pain over the preceding 12 months. Mean number of parent-reported school days missed across the entire sample was 3 per child; however pain was associated with an additional 1.5 reported missed school days per child. Furthermore, pain was associated with higher rates of chronic absenteeism (missing >15 d of school): 6.1% of children with pain was chronically absent as compared with 1.3% of children without pain. Extrapolated to the nation, childhood pain in the United States was associated with 22.2 million additional days of missed school, whereas childhood asthma, in comparison, was associated with 8 million additional days of school missed. DISCUSSION Associations between pain and school absenteeism highlight the need for interventions aimed at improving school attendance among children with pain.
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Alsaggaf F, Coyne I. A systematic review of the impact of chronic pain on adolescents' school functioning and school personnel responses to managing pain in the schools. J Adv Nurs 2020. [DOI: 10.1111/jan.14404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/01/2020] [Accepted: 04/09/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Fatimah Alsaggaf
- School of Nursing and Midwifery Trinity College Dublin Dublin Ireland
- Nursing College King Abdulaziz University Jeddah Saudi Arabia
| | - Imelda Coyne
- School of Nursing and Midwifery Trinity College Dublin Dublin Ireland
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Parent cognitive, behavioural, and affective factors and their relation to child pain and functioning in pediatric chronic pain: a systematic review and meta-analysis. Pain 2020; 161:1401-1419. [DOI: 10.1097/j.pain.0000000000001833] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Nilsson S, Wallbing U, Alfvén G, Dalenius K, Fors A, Golsäter M, Rosvall PÅ, Wigert H, Lundberg M. Development of the Help Overcoming Pain Early (HOPE) Programme Built on a Person-Centred Approach to Support School Nurses in the Care of Adolescents with Chronic Pain-A Feasibility Study. CHILDREN-BASEL 2019; 6:children6090095. [PMID: 31450645 PMCID: PMC6770885 DOI: 10.3390/children6090095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 11/23/2022]
Abstract
Chronic pain and its consequences are major global health challenges, and the prevalence is increasing worldwide among adolescents. Adolescents spend most of their waking hours in school; however, there is limited research available on how school nurses can address chronic pain among adolescents in the Swedish school context. Therefore, we designed a person-centred intervention, known as Help Overcoming Pain Early (HOPE), to enable school nurses to offer adolescents strategies to manage their stress and pain. We used the Medical Research Council (MRC) framework for developing and designing this new complex intervention. For this study, we describe two of the four phases: (a) development and (b) feasibility and piloting. The final version of the HOPE programme consists of (i) an educational package for school nurses in the areas person-centred care, stress and pain education/management and gender perspective; and (ii) an intervention package for adolescents with chronic pain. The programme consists of four sessions during which adolescents with chronic pain have person-centred dialogues with a school nurse. The HOPE programme is based on the existing evidence of managing chronic pain and on the assumption that school nurses can support adolescents with chronic pain by using person-centred care.
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Affiliation(s)
- Stefan Nilsson
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
| | - Ulrika Wallbing
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Department of Neurobiology, Care and Sciences and Society, Division of Physiotherapy, Karolinska Institute, 141 52 Huddinge, Sweden
| | - Gösta Alfvén
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Clintec, Karolinska Institute, 141 52 Huddinge, Sweden
| | | | - Andreas Fors
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Närhälsan Research and Development Primary Health Care, Region Västra Götaland, SE 411 18 Gothenburg, Sweden
| | - Marie Golsäter
- Child Health Care and Futurum, Region Jönköping County, Barnhälsovården, Regionens hus, 551 85 Jönköping, Sweden
- CHILD Research Group, School of Health and Welfare, Jönköping University, 551 11 Jönköping, Sweden
| | - Per-Åke Rosvall
- Department of Applied Educational Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Helena Wigert
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Mari Lundberg
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
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14
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Characterizing Social and Academic Aspects of School Anxiety in Pediatric Chronic Pain. Clin J Pain 2019; 35:625-632. [DOI: 10.1097/ajp.0000000000000720] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The Paediatric electronic Persistent Pain Outcomes Collaboration (PaedePPOC): establishment of a binational system for benchmarking children's persistent pain services. Pain 2019; 160:1572-1585. [DOI: 10.1097/j.pain.0000000000001548] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Topical Review: Basic Psychological Needs in Adolescents with Chronic Pain-A Self-Determination Perspective. Pain Res Manag 2019; 2019:8629581. [PMID: 30723533 PMCID: PMC6339741 DOI: 10.1155/2019/8629581] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/10/2018] [Indexed: 12/16/2022]
Abstract
This topical review outlines the resilience pathway to adaptive functioning in pediatric pain within a developmental perspective. Self-Determination Theory proposes that the satisfaction of one's basic psychological needs (for autonomy, relatedness, and competence) is crucial for understanding human flourishing and healthy development. However, the role of the basic psychological needs received little attention in a pediatric-pain population. Yet, we propose that need satisfaction may be a resilience factor and need frustration a risk factor, for living with chronic pain. In this topical review, we first discuss two major models that have been developed to understand pain-related disability: the fear-avoidance model of pain and the ecological resilience-risk model in pediatric chronic pain. Both models have been used with children and adolescents but do not include a developmental perspective. Therefore, we introduce Self-Determination Theory and highlight the potentially moderating and mediating role of the basic needs on pain-related disability in children and adolescents. Taken together, we believe that Self-Determination Theory is compatible with the fear-avoidance model of pain and the ecological resilience-risk model in pediatric chronic pain and may deepen our understanding of why some adolescents are able to live adaptively in spite of chronic pain.
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Jones K, Nordstokke D, Wilcox G, Schroeder M, Noel M. The ‘work of childhood’: understanding school functioning in youth with chronic pain. Pain Manag 2018; 8:139-153. [DOI: 10.2217/pmt-2017-0048] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
School is often cited as the ‘work of childhood’ and serves as an important site for child and adolescent development. Frequent school absences in children and adolescents with chronic pain are well documented; however, variables that may explain school impairment are not understood. The potential consequences of school impairment are extensive, as these children and adolescents are at great risk for achieving poor grades and sometimes require full-time homebound instruction. This, in turn, can have adverse effects on occupational and social functioning well into adulthood. The present review provides a summary of selected studies that have investigated why children and adolescents with chronic pain may experience disruptions in school functioning. A conceptual model of school functioning is presented to summarize factors accumulated to date and to guide future investigations.
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Affiliation(s)
- Kailyn Jones
- Werklund School of Education, Educational Psychology, University of Calgary, Canada, T2N 1N4
| | - David Nordstokke
- Werklund School of Education, Educational Psychology, University of Calgary, Canada, T2N 1N4
| | - Gabrielle Wilcox
- Werklund School of Education, Educational Psychology, University of Calgary, Canada, T2N 1N4
- Hotchkiss Brain Institute, Full Member, University of Calgary, Canada, T2N 1N4
| | - Meadow Schroeder
- Werklund School of Education, Educational Psychology, University of Calgary, Canada, T2N 1N4
| | - Melanie Noel
- Department of Psychology, University of Calgary, Canada, T2N 1N4
- Alberta Children's Hospital Research Institute, Full Member, Alberta Children’s Hospital, Canada, T2N 1N4
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Whale K, Cramer H, Joinson C. Left behind and left out: The impact of the school environment on young people with continence problems. Br J Health Psychol 2017; 23:253-277. [PMID: 29228510 PMCID: PMC5900927 DOI: 10.1111/bjhp.12284] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 10/27/2017] [Indexed: 11/30/2022]
Abstract
Objectives To explore the impact of the secondary school environment on young people with continence problems. Design In‐depth qualitative semi‐structured interviews. Methods We interviewed 20 young people aged 11–19 years (11 female and nine male) with continence problems (daytime wetting, bedwetting, and/or soiling). Interviews were conducted by Skype (n = 11) and telephone (n = 9). Transcripts were analysed using inductive thematic analysis. Results We generated five main themes: (1) Boundaries of disclosure: friends and teachers; (2) Social consequences of avoidance and deceit; (3) Strict and oblivious gatekeepers; (4) Intimate actions in public spaces; and (5) Interrupted learning. Conclusion Disclosure of continence problems at school to both friends and teachers was rare, due to the perceived stigma and fears of bullying and social isolation. The lack of disclosure to teachers and other school staff, such as pastoral care staff, creates challenges in how best to support these young people. Young people with continence problems require unrestricted access to private and adequate toilet facilities during the school day. There is a need for inclusive toilet access policies and improved toilet standards in schools. Addressing the challenges faced by young people with continence problems at school could help to remove the barriers to successful self‐management of their symptoms. It is particularly concerning that young people with continence problems are at higher risk of academic underachievement. Increased support at school is needed to enable young people with continence problems to achieve their academic potential. Statement of Contribution What is already known on this subject? Continence problems are among the most common paediatric health problems Self‐management of continence problems requires a structured schedule of fluid intake and bladder emptying Inadequate toilet facilities and restricted access make it difficult for young people to manage their incontinence
What does this study add? Improvement is needed in teacher understanding of the needs of young people with continence problems Young people are reluctant to disclose continence problems due to perceived stigma and fear of social isolation Young people with continence problems may be at increased risk of academic underachievement
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Affiliation(s)
- Katie Whale
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
| | - Helen Cramer
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, UK
| | - Carol Joinson
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
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School Anxiety in Children and Adolescents with Chronic Pain. Pain Res Manag 2017; 2017:8328174. [PMID: 29081682 PMCID: PMC5634599 DOI: 10.1155/2017/8328174] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/14/2017] [Indexed: 11/23/2022]
Abstract
Anxiety is highly prevalent in pediatric chronic pain. This comorbidity has been explained by the presence of shared mechanisms underlying the development and maintenance of chronic pain and anxiety. Accumulating evidence demonstrates that school is a significant source of anxiety among youth with chronic pain and that anxiety contributes to school-related functional impairment in this population. This article reviews the cooccurrence of pediatric chronic pain and anxiety, identifies unique sources of heightened school anxiety among youth with chronic pain, and describes current approaches for assessing anxiety in pediatric pain settings. Highlighted by this review is the absence of a comprehensive evidence-based approach for assessing school anxiety in pediatric chronic pain. Given the psychometric limitations inherent to gathering data from a single source, recommendations for advancing measurement methods are provided. Novel approaches may be needed to shed more light on the way in which school anxiety is experienced in pediatric chronic pain.
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Logan DE, Gray LS, Iversen CN, Kim S. School Self-Concept in Adolescents With Chronic Pain. J Pediatr Psychol 2017; 42:892-901. [DOI: 10.1093/jpepsy/jsx063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/17/2017] [Indexed: 11/13/2022] Open
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Pain in School: Patterns of Pain-Related School Impairment among Adolescents with Primary Pain Conditions, Juvenile Idiopathic Arthritis Pain, and Pain-Free Peers. CHILDREN-BASEL 2016; 3:children3040039. [PMID: 27916882 PMCID: PMC5184814 DOI: 10.3390/children3040039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/19/2016] [Accepted: 11/21/2016] [Indexed: 11/16/2022]
Abstract
Children with chronic pain frequently experience impairment in the school setting, but we do not yet understand how unique these struggles are to children with primary pain conditions compared to peers with disease-related pain or those without chronic pain symptoms. The objective of this study is to examine school functioning, defined as school attendance rates, overall quality of life in the school setting, and school nurse visits among adolescents with primary pain conditions, those with juvenile idiopathic arthritis (JIA)-related pain, and healthy peers. Two hundred and sixty adolescents participated in the study, including 129 with primary pain conditions, 61 with JIA, and 70 healthy comparison adolescents. They completed self- and parent-reported measures of school function. Findings show that as a group, youth with primary pain conditions reported more school absences, lower quality of life in the school setting, and more frequent school nurse visits compared to both adolescents with JIA-related pain and healthy peers. We conclude that compared to those who experience pain specific to a disease process, adolescents with primary pain conditions may face unique challenges in the school setting and may require more support to help them succeed in school in spite of pain.
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Predicting Multiple Facets of School Functioning in Pediatric Chronic Pain: Examining the Direct Impact of Anxiety. Clin J Pain 2016; 31:867-75. [PMID: 25411857 DOI: 10.1097/ajp.0000000000000181] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The relationships among chronic pain, anxiety, and school functioning are complex, and school functioning is often negatively impacted in youth with chronic pain. The objective of this study was to empirically test a model of associations between constructs predicting school functioning in youth with chronic pain to examine the direct effect of anxiety on school attendance and other indicators of school-related disability. MATERIALS AND METHODS Participants included 349 youth and their parents (311 mothers and 162 fathers) who attended a multidisciplinary pain clinic. Youth, mothers, fathers, and clinicians completed assessments of clinical outcomes important to family and clinician perceptions of school functioning; youth, mothers, and fathers completed an assessment of youth anxiety. Structural equation modeling was used to examine interrelations among predictors. RESULTS Measurement and structural models for predicting youth school functioning provided a very good fit of the data to the conceptual model. Anxiety was directly related to problems with school attendance and avoidance, concentration, and keeping up with schoolwork. DISCUSSION Anxiety was a robust predictor of school functioning across a range of domains. Evaluating anxiety symptoms in pediatric chronic pain will likely facilitate case conceptualization and treatment planning. This study supports a shift in focus from pain to anxiety as the driving force of school impairment in youth with chronic pain.
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Hansen AR, Pritchard T, Melnic I, Zhang J. Physical activity, screen time, and school absenteeism: self-reports from NHANES 2005-2008. Curr Med Res Opin 2016; 32:651-9. [PMID: 26700770 DOI: 10.1185/03007995.2015.1135112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to examine how lifestyle behaviors in the context of physical activity levels and screen time are associated with school absenteeism. METHODS We analyzed 2005-2008 NHANES data of proxy interviews for 1048 children aged 6-11 years and in-person self-reports of 1117 adolescents aged 12-18 years. Missing 10% of school days during the past school year was defined as severe school absenteeism (SSA). RESULTS Watching TV ≥2 hours a day was significantly associated with SSA among both children (OR = 3.51 [1.03-12.0]) and adolescents (OR = 3.96 [1.84-8.52]) compared with their peers watching <2 hours a day. A U-shaped association was identified between the level of physical activity and SSA among children. Both inactive children (OR = 12.4 [1.43-108]) and highly active children (14.8 [2.82-77.7]) had higher odds of SSA compared with children with medium levels of physical activity. No associations were observed for either children 0.57 ([0.16-1.99]) or adolescents (0.94 [0.44-2.03]) using a computer ≥3 hours a day. LIMITATIONS Cross-sectional study involving self-reports. Transportation to and from school not included in physical activity assessment. Absenteeism was not validated with report cards. Unable to account for the absence type or frequency of illness or injury. No psychometric properties provided for subjective measures regarding participants' attitudes and characteristic traits towards physical activity, TV viewing, and school attendance. CONCLUSIONS Excessive TV watching among children and adolescents, and inactivity and high activity levels (≥7 times per week) among children are independently associated with severe school absenteeism.
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Affiliation(s)
- Andrew R Hansen
- a Department of Community Health Behavior and Education , Jiann-Ping Hsu College of Public Health, Georgia Southern University , Statesboro , GA , USA
| | - Tony Pritchard
- b School of Health and Kinesiology, Georgia Southern University , Statesboro , GA , USA
| | - Irina Melnic
- c Immigrant Health and Cancer Disparities Services, Memorial Sloan Kettering Cancer Center , New York , NY , USA
| | - Jian Zhang
- d Department of Epidemiology , Jiann-Ping Hsu College of Public Health, Georgia Southern University , Statesboro , GA , USA
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Al-Saqladi AW. The impact of sickle cell disease severity on school performance in affected Yemeni children. JOURNAL OF APPLIED HEMATOLOGY 2016. [DOI: 10.4103/1658-5127.198506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gren-Landell M, Ekerfelt Allvin C, Bradley M, Andersson M, Andersson G. Teachers’ views on risk factors for problematic school absenteeism in Swedish primary school students. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2015. [DOI: 10.1080/02667363.2015.1086726] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rohde G, Westergren T, Haraldstad K, Johannessen B, Høie M, Helseth S, Fegran L, Slettebø Å. Teachers' experiences of adolescents' pain in everyday life: a qualitative study. BMJ Open 2015; 5:e007989. [PMID: 26338838 PMCID: PMC4563248 DOI: 10.1136/bmjopen-2015-007989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES More adolescents report pain now than previously. In Norway, episodic pain problems have been reported by 60% of children and adolescents aged 8-18 years, with 21% reporting duration of pain of more than 3 months. Since adolescents spend much time at school, the attitude and behaviour of teachers play important roles regarding the experience of pain felt by adolescents in everyday life. Yet research on how teachers perceive the pain experienced by adolescents in a school setting is limited. We therefore seek to gain insight to teachers' classroom experiences with (1) adolescent's self-reported pain symptoms; (2) adolescents management of their pain and (3) how to help adolescents manage their pain. SETTING Teachers in 5 junior high schools in Norway representing municipalities in 3 rural areas and 2 cities. RESEARCH DESIGN A qualitative study with an explorative design comprising 5 focus group interviews. Each group consisted of 3-8 junior high school teachers. A semistructured interview guide was used to cover the issues. The transcribed text was analysed with qualitative content analysis. PARTICIPANTS 22 teachers participated (5 men, 17 women; age range 29-62 years) with teaching experience ranging from 3 to nearly 40 years. RESULTS The main theme describing the experience of teachers with adolescents' pain in everyday life is that pain and management of pain is a social, physical and psychological interwoven phenomenon. Through empirical analyses, 3 subcategories emerged: (1) everyday pain--expressing strenuous life; (2) managing pain--escaping struggle and (3) strategies of teachers--support and normalisation. CONCLUSIONS Teachers have a biopsychosocial understanding and approach to pain experienced by adolescents. This understanding influences the role of teachers as significant others in the lives of adolescents with regard to pain and management of their pain in a school setting.
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Affiliation(s)
- Gudrun Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Berit Johannessen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Magnhild Høie
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Sølvi Helseth
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Oslo, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Åshild Slettebø
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Filce HG, LaVergne L. Absenteeism, educational plans, and anxiety among children with incontinence and their parents. THE JOURNAL OF SCHOOL HEALTH 2015; 85:241-250. [PMID: 25731198 DOI: 10.1111/josh.12245] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 07/31/2014] [Accepted: 10/22/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Children with incontinence have more absenteeism, poorer academic performance, and potential social difficulties during the school years. These children and their parents are at risk for illness-related anxiety. Whereas educational plans are designed to remediate educational, medical, and social-emotional barriers at school, little research has explored the relationship among absenteeism, educational plans, and anxiety for this population. METHODS Eighty-three families provided demographic information and completed either the Revised Children's Manifest Anxiety Scale Second Edition (RCMAS-2) or the Adult Manifest Anxiety Scale (AMAS-A). A multiple regression analysis was conducted to determine the relationships among these variables. RESULTS Children with chronic illness resulting in incontinence had greater than expected rates of absenteeism. A high level of absenteeism was a significant predictor of parental anxiety, but not child anxiety. Over one third reported having no plan in place to support the child's needs at school. However, when a plan was present, it had no impact on child or parental anxiety. CONCLUSIONS Absenteeism contributes to familial anxiety and educational difficulties. Despite the potential for educational plans to support these children at school, these plans are underutilized for children with incontinence. This population requires more attention to their academic and social-emotional well-being at school.
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Affiliation(s)
- Hollie G Filce
- Curriculum, Instruction and Special Education, University of Southern Mississippi, 118 College Drive, No. 5057, Hattiesburg, MS 39406-0001.
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Wager J, Zernikow B, Darlington A, Vocks S, Hechler T. Identifying subgroups of paediatric chronic pain patients: A cluster-analytic approach. Eur J Pain 2014; 18:1352-62. [DOI: 10.1002/j.1532-2149.2014.497.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2014] [Indexed: 01/24/2023]
Affiliation(s)
- J. Wager
- German Paediatric Pain Centre; Children's and Adolescents' Hospital; Datteln Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine; Witten/Herdecke University; Germany
| | - B. Zernikow
- German Paediatric Pain Centre; Children's and Adolescents' Hospital; Datteln Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine; Witten/Herdecke University; Germany
| | - A. Darlington
- Faculty of Health Sciences; University of Southampton; UK
| | - S. Vocks
- Department of Psychology; Clinical Psychology and Psychotherapy; Osnabrück University; Germany
| | - T. Hechler
- German Paediatric Pain Centre; Children's and Adolescents' Hospital; Datteln Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine; Witten/Herdecke University; Germany
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Kaczynski KJ, Claar RL, Lebel AA. Relations between pain characteristics, child and parent variables, and school functioning in adolescents with chronic headache: a comparison of tension-type headache and migraine. J Pediatr Psychol 2012; 38:351-64. [PMID: 23248346 DOI: 10.1093/jpepsy/jss120] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess for differences in headache characteristics and psychosocial factors based on headache diagnosis, and to evaluate whether headache diagnosis moderates relations between psychosocial factors and school difficulties. METHODS Retrospective chart review was conducted with 262 adolescents with chronic tension-type headache (TTH; N = 153) and migraine evaluated at a pediatric headache clinic. Adolescents completed measures of anxiety, depression, and pain coping. Parents completed a measure of parental protective behavior and school functioning. RESULTS Adolescents with TTH reported greater depression symptoms, and their parents endorsed greater school difficulties, whereas parents of adolescents with migraine reported more protective parenting. Protective parenting was positively associated with school difficulties in both groups, but the relation was significantly stronger in adolescents with TTH. Headache duration and depression symptoms were significant predictors of school functioning in both groups. CONCLUSIONS Headache duration and depression may impact school functioning independent of headache diagnosis. Protective parenting, in particular, seems to be linked to school-related disability in adolescents with TTH, and this link may be important to consider in assessment and treatment.
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Affiliation(s)
- Karen J Kaczynski
- Pain Treatment Service, Children's Hospital Boston, 333 Longwood Avenue, Boston, MA 02115, USA.
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Guite JW, Logan DE, Ely EA, Weisman SJ. The ripple effect: systems-level interventions to ameliorate pediatric pain. Pain Manag 2012; 2:593-601. [PMID: 23544034 PMCID: PMC3609659 DOI: 10.2217/pmt.12.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The focus of this brief review is to highlight to the reader some of the 'ripple effects' of broader systems-level healthcare issues and the implications they may have for effective treatment of pediatric chronic pain. Many healthcare providers focus almost exclusively on the patient, but lack the knowledge of how to intervene effectively at systems levels with families, schools and healthcare institutions surrounding the pediatric patient with pain. We provide a case example and consider this issue across three systems that are particularly relevant to pediatric pain management: the outpatient pain clinic, school and inpatient settings. The information presented will improve the healthcare provider's ability to effectively treat pediatric pain through an enhanced understanding of the multiple systems of care that surround children with pain.
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Affiliation(s)
- Jessica W Guite
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Pain & Palliative Medicine, Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106, USA
| | - Deirdre E Logan
- Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Boston, MA, USA
| | - Elizabeth A Ely
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Steven J Weisman
- Medical College of Wisconsin, Milwaukee, WI, USA
- Children’s Hospital of Wisconsin, Milwaukee, WI, USA
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Jastrowski Mano KE, Evans JR, Tran ST, Anderson Khan K, Weisman SJ, Hainsworth KR. The Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders in Pediatric Chronic Pain. J Pediatr Psychol 2012; 37:999-1011. [DOI: 10.1093/jpepsy/jss069] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Too sick for school? Parent influences on school functioning among children with chronic pain. Pain 2011; 153:437-443. [PMID: 22169177 DOI: 10.1016/j.pain.2011.11.004] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 11/02/2011] [Accepted: 11/03/2011] [Indexed: 11/22/2022]
Abstract
Parental responses to children with chronic pain have been shown to influence the extent of the child's functional disability, but these associations have not been well studied in relation to children's pain-related school functioning. The current study tests the hypothesis that parental pain catastrophizing and parental protective responses to child pain influence the extent of school impairment in children with chronic pain. A mediational model was tested to determine whether parental protective behaviors serve a mediating role between parental pain catastrophizing and child school impairment. Study participants were a clinical sample of 350 children ages 8-17 years with chronic pain and their parents. Measures of pain characteristics, demographic characteristics, child depressive symptoms, school attendance rates, overall school functioning, parental pain catastrophizing, and parental protective responses to pain were collected. Results show that, controlling for the known influences of pain intensity and child depressive symptoms, parental pain catastrophizing and parental protective responses to child pain each independently predict child school attendance rates and reports of overall school impairment. Parental protectiveness was found to mediate the association between parental cognitions (i.e., parent pain catastrophizing) and child school functioning outcomes. These findings underscore the importance of intervening with parents to foster parental responses to child pain that help children engage and succeed in the school environment despite pain.
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Logan DE, Simons LE. Development of a group intervention to improve school functioning in adolescents with chronic pain and depressive symptoms: a study of feasibility and preliminary efficacy. J Pediatr Psychol 2010; 35:823-36. [PMID: 20167628 DOI: 10.1093/jpepsy/jsq008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To establish feasibility and preliminary efficacy of "Coping with Pain in School" (CPS), an intervention to improve school functioning in adolescents with chronic pain and depressive symptoms. METHODS Forty adolescents and parents participated in this uncontrolled trial. Participants completed measures of pain severity, depression, and school attendance at baseline and one month after participating in a manualized group intervention. Several other indicators of school functioning were explored. RESULTS CPS was generally acceptable and satisfying to families and feasible to implement but participation was low. Post-treatment analyses suggest that pain, some dimensions of depression, and school attendance improved after treatment. Conclusions CPS is feasible and holds promise in terms of its effects on pain and school attendance. Addressing enrollment challenges, refining the role of depression and its treatment, and further developing treatments with a school-functioning focus for adolescents with chronic pain are key areas for continued research.
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Affiliation(s)
- Deirdre E Logan
- Pain Treatment Service, Children's Hospital, Boston, MA 02115, USA.
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Sato AF, Clifford LM, Silverman AH, Davies WH. Cognitive-Behavioral Interventions Via Telehealth: Applications to Pediatric Functional Abdominal Pain. CHILDRENS HEALTH CARE 2009. [DOI: 10.1080/02739610802615724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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