scholarly journals Patient Versus Parental Perceptions about Pain and Disability in Children and Adolescents with a Variety of Chronic Pain Conditions

2014 ◽  
Vol 19 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Thomas R Vetter ◽  
Cynthia L Bridgewater ◽  
Lee I Ascherman ◽  
Avi Madan-Swain ◽  
Gerald L McGwin
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Correlation Coefficient ◽  
Functional Disability ◽  
Pediatric Pain ◽  
Proxy Reports ◽  
Pediatric Chronic Pain ◽  
Self Reports ◽  
The Difference ◽  
Parent Proxy

BACKGROUND: Cross-informant variance is often observed in patient self-reports versus parent proxy reports of pediatric chronic pain and disability.OBJECTIVE: To assess the relationship and merit of the child versus parent perspective.METHODS: A total of 99 patients (eight to 17 years of age [mean 13.2 years]; 71% female, 81% Caucasian) and parents completed the Pediatric Pain Questionnaire and Functional Disability Inventory at their initial clinic visit. Patients’ and parents’ pain intensity and disability scores were analyzed using an intraclass correlation coefficient (ICC), Wilcoxon signed-rank test, Bland-Altman plot and Spearman’s correlation coefficient. The association between clinical/demographic variables and differences in patient/parent pain intensity and disability scores was assessed using multivariable regression.RESULTS: There was significant agreement between patients’ self-reports and parents’ proxy reports of their child’s pain intensity (ICC=0.52; P<0.001) and disability (ICC=0.57; P=0.004) at the individual level. There were no significant group differences in patient versus parent-proxy pain intensity scores (P=0.40) and disability scores (P=0.54). The difference between patient and parent-proxy pain intensity was associated with patients’ self-reported pain intensity (P<0.001). The difference between patient and parent-proxy disability was associated with patient’s self-reported pain disability (P<0.001). Bland-Altman plots revealed major inter-rater variation in the Pediatric Pain Questionnaire and Functional Disability Inventory across their score ranges. A significant relationship (r=0.38; P<0.001) was observed between patients’ self-reported pain intensity and disability.CONCLUSIONS: While equal merit should ideally be given to pediatric chronic pain patients’ self-reports and their parents’ proxy reports of pain intensity and disability, it would appear that, as needed, pediatric patients or parents can offer a clinically valid, single clinical perspective.

scholarly journals Biomarkers of Allostatic Load as Correlates of Impairment in Youth with Chronic Pain: An Initial Investigation

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 709
Author(s):  
Sarah Nelson ◽  
Samantha Bento ◽  
Michelle Bosquet Enlow
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Allostatic Load ◽  
Functional Disability ◽  
Pain Treatment ◽  
Pediatric Pain ◽  
Childhood Experiences ◽  
High Exposure ◽  
Pediatric Chronic Pain ◽  
Study Results

Pediatric chronic pain is common and responsible for significant healthcare burden. However, the mechanisms underlying the development and/or maintenance of pediatric chronic pain remain poorly understood. Allostatic load (AL), or wear and tear on the nervous system following significant or prolonged stress, has been proposed to play a role in the maintenance of chronic pain, but minimal research has examined this possibility. This gap in research is particularly notable given the high exposure to adverse childhood experiences (ACEs; abuse/neglect, etc.) and psychological stress in this population. Accordingly, the current study aimed to preliminarily examine the measurement of AL in a treatment-seeking pediatric pain population. Biomarkers were collected during an already scheduled new patient pain evaluation and included salivary cortisol, dehydroepiandrosterone (DHEA), and C-reactive protein, in addition to waist–hip ratio, body-mass index, and blood pressure. A total of 61 children and adolescents with chronic pain (Mage = 14.47 years; 88.5% female and white/Caucasian) completed study procedures and were included in analyses. Preliminary results indicated that a multifactorial AL composite is feasible to assess for in a tertiary pain treatment setting and that over 50% of youth with chronic pain were classified as high risk for AL (two or more risk factors). Further, it was found that individual AL risk factors were significantly associated with functional disability and that AL may moderate the association between psychosocial and functional outcomes. Given the pilot nature of this study, results should be used to inform future investigations with larger and more diverse pediatric pain samples.

scholarly journals Caregiver–Child Discrepancies in Reports of Child Emotional Symptoms in Pediatric Chronic Pain

2019 ◽  
Vol 45 (4) ◽  
pp. 359-369
Author(s):  
Sarah R Martin ◽  
Lonnie K Zeltzer ◽  
Laura C Seidman ◽  
Katherine E Allyn ◽  
Laura A Payne
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Functional Impairment ◽  
Internalizing Symptoms ◽  
Functional Disability ◽  
Child Anxiety ◽  
Depression Scale ◽  
Proxy Report ◽  
Proxy Reports ◽  
Pediatric Chronic Pain

Abstract Objective Pediatric chronic pain evaluation includes self-reports and/or caregiver proxy-reports across biopsychosocial domains. Limited data exist on the effects of caregiver–child discrepancies in pediatric pain assessment. In children with chronic pain, we examined associations among discrepancies in caregiver–child reports of child anxiety and depressive symptoms and child functional impairment. Methods Participants were 202 children (Mage=14.49 ± 2.38 years; 68.8% female) with chronic pain and their caregivers (95.5% female). Children and caregivers completed the Revised Child Anxiety and Depression Scale (RCADS) and RCADS-Parent, respectively. Children also completed the Functional Disability Inventory. Mean difference tests examined caregiver–child discrepancies. Moderation analyses examined whether associations between child self-reported anxiety and depressive symptoms and functional impairment varied as a function of caregiver proxy-report. Results Children reported more anxiety and depressive symptoms compared with their caregivers’ proxy-reports (Z = −4.83, p &lt; .001). Both informants’ reports of child anxiety and depressive symptoms were associated with child functional impairment (rs = .44, rs = .30, p &lt; .001). Caregiver proxy-report moderated associations between child-reported anxiety and depressive symptoms and functional impairment (B = −0.007, p = .003). When caregiver proxy-report was low, child self-reported anxiety and depressive symptoms were positively related to functional impairment (B = 0.28, SE = 0.07, 95% CI [0.15, 0.41], p &lt; .001). Conclusions Discrepant caregiver–child perceptions of child anxiety and depressive symptoms may be associated with functioning in children with chronic pain, especially when caregivers report less child internalizing symptoms. These findings highlight the need for further examination of the effects of caregiver–child discrepancies on pediatric chronic pain outcomes and may indicate targets for intervention.

scholarly journals Validation and Clinical Application of a Biopsychosocial Model of Pain Intensity and Functional Disability in Patients with a Pediatric Chronic Pain Condition Referred to a Subspecialty Clinic

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Thomas R. Vetter ◽  
Gerald McGwin ◽  
Cynthia L. Bridgewater ◽  
Avi Madan-Swain ◽  
Lee I. Ascherman
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Clinical Application ◽  
Functional Disability ◽  
Published Data ◽  
Pain Coping ◽  
Patient Anxiety ◽  
Pediatric Chronic Pain ◽  
Patient Pain ◽  
Anxiety Patient

Background. Pediatric chronic pain is considered to be a multidimensional construct that includes biological, psychological, and social components. Methods. The 99 enrolled study patients (mean age 13.2 years, 71% female, 81% Caucasian) and an accompanying parent completed a series of health-related questionnaires at the time of their initial appointment in a pediatric chronic pain medicine clinic. Results. Significant correlations (, ) were observed between pediatric chronic pain intensity and patient anxiety, patient depression, patient pain coping, parent chronic pain intensity, and parent functional disability. Pediatric chronic pain intensity was significantly associated with patient anxiety (). Significant correlations (, ) were observed between pediatric functional disability and patient chronic pain intensity, patient anxiety, patient depression, patient pain coping, parent chronic pain intensity, parent functional disability, parent anxiety, parent depression, and parent stress. Pediatric functional disability was significantly associated with patient chronic pain intensity (), patient anxiety (), patient pain coping (), and parent functional disability (). Conclusions. These findings provide empirical support of a multidimensional Biobehavioral Model of Pediatric Pain. However, the practical clinical application of the present findings and much of the similar previously published data may be tenuous.

scholarly journals Children self-reports and Parent proxy reports of physical activity and sedentary behaviour

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Sumonja ◽  
M Jevtic
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Local Community ◽  
Physical Activities ◽  
After School ◽  
Tv Viewing ◽  
Proxy Reports ◽  
Self Reports ◽  
Parent Proxy ◽  
Level Of Agreement

Abstract Background Aim of this study was to determine agreement between parent proxy reports and children self-reports of physical activities and sedentary behaviour. Methods The sample included 7-10 year-old children and their parents (n = 188) in a local community in Northern Serbia. Data were collected by questionnaires designed to assess context-specific measures of children’s physical activity (outside play, organized sports) and sedentary behavior (TV viewing, using computer, playing electronic games). Children and their parents completed questionnaires separately. Agreement between children’s and parent`s responses was calculated with Cohen’s kappa. Differences in parent`s and children`s responses in relation to gender, grade and BMI were analyzed using χ2 test. Values p &lt; 0.05 were considered statistically significant. Results Level of agreement between parents’ and children’s reports ranged from poor for variable TV viewing before going to school (κ = 0.21; p = 0.04) to substantial for variable physical activity before going to school (κ = 0.74; p = 0.00). Girls were more likely than boys to agree with parents about time spent playing on the computer after school (χ2=11.23;p=0.01). Overweight and obese children tended to report more time in TV viewing than their parents (χ2=26.4;p=0.01). Conclusions There are differences in reports of physical activities and sedentary behaviour between 7 to 10 year-old children and their parents The lowest level of agreement found for variable TV viewing indicates low awareness and control of this screen-based sedentary behaviour. Key messages Differences in parents’ and children’s reports of children’s physical activities and sedentary behaviour are confirmed. It should be taken into consideration in studies which use self-reports or proxy reports for assessing children’s physical activities and sedentary behaviour.

Concordance between paediatric self-reports and parent proxy reports on fatigue: A multicentre prospective longitudinal study

2020 ◽  
Vol 49 ◽  
pp. 101829
Author(s):  
Elena Rostagno ◽  
Anna Marchetti ◽  
Anna Bergadano ◽  
Marta Canesi ◽  
Moreno Crotti Partel ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Prospective Longitudinal Study ◽  
Proxy Reports ◽  
Self Reports ◽  
Prospective Longitudinal ◽  
Parent Proxy

scholarly journals School Anxiety in Children and Adolescents with Chronic Pain

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
K. E. Jastrowski Mano
Keyword(s):  
Chronic Pain ◽  
Functional Impairment ◽  
Measurement Methods ◽  
Evidence Based ◽  
Single Source ◽  
Pediatric Pain ◽  
School Anxiety ◽  
Pediatric Chronic Pain ◽  
Novel Approaches ◽  
Gathering Data

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.

scholarly journals Differential changes in functional disability and pain intensity over the course of psychological treatment for children with chronic pain

Pain ◽  
2014 ◽  
Vol 155 (10) ◽  
pp. 1955-1961 ◽  
Author(s):  
Anne M. Lynch-Jordan ◽  
Soumitri Sil ◽  
James Peugh ◽  
Natoshia Cunningham ◽  
Susmita Kashikar-Zuck ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Functional Disability ◽  
Psychological Treatment

scholarly journals Leveraging VR/AR to combat chronic pain in youth: Position paper from the Interdisciplinary Network on Virtual and Augmented (AR/VR) Technologies for Pain (INOVATE-Pain) Management (Preprint)

2020 ◽  
Author(s):  
Deirdre Elizabeth Logan ◽  
Laura Edith Simons ◽  
Thomas Caruso ◽  
Jeffry I Gold ◽  
Anya Griffin ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Best Practices ◽  
Digital Health ◽  
Clinical Care ◽  
Design Evaluation ◽  
Pediatric Pain ◽  
Research And Practice ◽  
Pediatric Chronic Pain ◽  
Chronic Pain Conditions ◽  
Interdisciplinary Network

UNSTRUCTURED Background: Virtual reality (VR) and augmented reality (AR) interventions are emerging as promising tools in the treatment of pediatric chronic pain conditions, but in this young field there is little consensus to guide the process of engaging in the development and evaluation of targeted VR-based interventions. Methods: The INOVATE-Pain consortium aims to advance the field of VR for pediatric chronic pain rehabilitation by providing guidance for best practices in the design, evaluation, and dissemination of VR-based interventions targeting this population. Results and Conclusions: Reviewing the state of the field, the consortium identified important directions for research-driven innovation in VR/AR clinical care, highlighted key opportunities and challenges facing the field, and established a consensus on best methodological practices to adopt in future efforts to advance the research and practice of VR/AR in pediatric pain. The consortium also identified important next steps to undertake to continue to advance the work in this promising new area of digital health pain interventions.

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