The burden and impact of recurrent abdominal pain – exploring the understanding and perception of children and their parents

Children's and Their Parents' Experiences With Home-Based Guided Hypnotherapy: Qualitative Study

Background

Management of children with functional abdominal pain (FAP) or irritable bowel syndrome (IBS) is difficult in primary care. When education and reassurance do not alleviate symptoms, primary care physicians lack treatment options for children with FAP or IBS. Home-based guided hypnotherapy is a promising treatment because of its accessibility. To address feasibility, it is of utmost importance to take experiences from children and their parents into account.

Objective

We aimed to explore children's and their parents' experiences with home-based guided hypnotherapy for children with FAP or IBS.

Methods

This qualitative study used open-ended questions from a questionnaire and in-depth semistructured interviews with children and their parents who had a hypnotherapy intervention prescribed. The interviews were audio-recorded and transcribed verbatim. Data were collected and analyzed iteratively using thematic content analysis.

Results

A total of 76 children were eligible, and we collected questionnaire data from 56 children. A total of 23 interviews were conducted with 10 children and 15 parents. Six themes emerged from questionnaire data and interviews: impression of the exercises, not for everyone, influence of perceived effect, integrating exercises in daily life, content and practicalities of the website, and customization to personal preferences. Children with FAP or IBS experienced home-based guided hypnotherapy and the exercises differently, ranging from boring to fun. From interviews with the parents, it emerged that hypnotherapy is not suitable for everyone; for example, when children are very young or have a low developmental level, cannot sit still, cannot surrender to the exercises, or are too energetic or stressed, it might be difficult to comply. Experiences were shaped by the influence of a perceived effect and to which extent children were able to integrate exercises in daily life. The content and practicalities of the website also influenced experiences, and hypnotherapy that is adaptable to personal preferences, including by appearance and content, would be highly appreciated.

Conclusions

The children and parents experienced home-based guided hypnotherapy differently, ranging from boring to fun. Hypnotherapy might be difficult or boring for some children. The children enjoyed hypnotherapy when they liked the topic or story, felt positive effects, could easily integrate exercises in daily life, or enjoyed the website in general. The children's experiences and adherence can be further improved by adding short exercises and customizing hypnotherapy to their personal preferences on the website's appearance and content. This could increase effectiveness but must be studied further.

How children and adolescents with chronic pain describe their pain experiences: A qualitative systematic review

PURPOSE

To explore how children and adolescents with chronic pain describe their pain experiences.

METHOD

A systematic search of OVID Medline, CINAHL Complete, OVID Embase and APA PsycINFO (database inception to 19th August 2024) was conducted for qualitative or mixed-method studies investigating children's chronic pain experiences. Studies were excluded if focused on post-surgical or acute pain. Two independent reviewers screened studies, and disagreements resolved by a third reviewer. Methodological quality was assessed with the CASP checklist. Data from included studies were extracted and analysed using qualitative analysis.

RESULTS

Forty studies were included, and 4 main themes were identified: 1. 'I'm missing out because of my pain'; in which children described frustration and isolation due to missing activities. 2. 'Things that help me to get by with my pain'; described a variety of children's coping mechanisms. 3. 'It hurts and no one else understands my pain'; where children felt frequently disbelieved about their pain severity, and 4. 'I keep trying to make sense of my pain'; in which children identified ways they seek to understand the cause and possible outcomes of their pain, including accessing health care services.

CONCLUSIONS

This review highlights how children describe their pain challenges in managing their day to day while emphasising the necessity of understanding and incorporating children's perspectives into research and practice.

PRACTICE IMPLICATIONS

This review found that children were primarily concerned by how their pain affects their day-to-day activities and highlights the need to equip children with multiple strategies and promote autonomy in managing their pain. Additionally, further research is warranted into the ways that children understand their pain experience and seek information about their pain.

Recurrent abdominal pain in children in Wuhu, China was not associated with Helicobacter pylori infection, but associated with <1 h/day physical activity and academic stress

Background

Recurrent abdominal pain (RAP) is one of the most common gastrointestinal disorders in children. The aim of this study was to investigate the relationship between RAP and Helicobacter pylori infection in children in Wuhu, China as well as the risk factors for Helicobacter pylori infection in this region.

Materials and methods

In this cross-sectional survey, we randomly selected children aged 6-17 years who underwent health examinations at three public hospital examination centers in Wuhu city, Anhui Province, China. Helicobacter pylori infection was assessed by a 13C-urea breath test (UBT) kit. Questionnaires were custom designed to obtain data on behavioral, sociodemographic, and environmental characteristics, and to investigate the relationship between RAP and Helicobacter pylori infection in children.

Results

A total of 1,187 children aged 6-17 years were enrolled, among these children, 182 were diagnosed with RAP, with an incidence rate of 15.3%. A total of 266 children were infected with Helicobacter pylori, with an infection rate of 22.4%. Multivariate regression analysis revealed that physical activity for <1 h/day and academic stress are associated with RAP in children, whereas Helicobacter pylori infection, age, sex, body mass index (BMI), and fast-food consumption are not associated with RAP in children. Our research also found that the risk of Helicobacter pylori infection increases with age in children. Risk factors for Helicobacter pylori infection in children include left-behind children, poor hygiene habits, family history of Helicobacter pylori infection, and mother with low cultural levels.

Conclusions

Recurrent abdominal pain in children in Wuhu, China was not associated with Helicobacter pylori infection, but strongly associated with <1 h/day physical activity and academic stress.

Parent-perceived recurrent pain in children: associations with maternal pain, depressiveness, socioeconomic status, and children's behavioural difficulties

Objectives

The current study aimed to examine the potential transgenerational associations between maternal pain and depressiveness and childhood pain, and to explore the associations between the children's difficulties and recurrent pain (defined as pain occurring at least once a month in the previous 6 month) in healthy children aged 3-13 years.

Methods

We collected Data between 2015 and 2019 as part of the LIFE Child study in Germany and investigated associations of maternal pain and depressiveness, child age, sex, pubertal stage, emotional difficulties, conduct difficulties, hyperactivity/inattention, peer group difficulties, and prosocial skills, and family socioeconomic status with the frequency of parent-perceived headache, backache, and stomachache in a sample of 1,850 children (4,819 documented visits) using logistic and ordinal regression analyses.

Results

Overall, 10.4%, 24.4%, and 45.2% of parents reported their children had recurrent backache, headache, and stomachache, respectively, with 5.5% of children were reported to experience all three types of pain simultaneously. Higher age, female sex, puberty, emotional difficulties, low family socioeconomic status, as well as higher maternal impairment due to pain and maternal depressiveness were significantly associated with more frequent pain.

Conclusions

Our study suggests that maternal pain, maternal depressiveness, and lower family socioeconomic status as well as child's emotional difficulties are significantly associated with a higher frequency of recurrent pain in children perceived by their parents.