Assessing pain catastrophizing and functional disability in pediatric epidermolysis bullosa patients

Abstract

Background/Objectives The primary objective was to assess pain catastrophizing and functional disability in pediatric patients with epidermolysis bullosa (EB) and their parents/guardians. Secondary objectives included examining relationships between pain catastrophizing, functional disability, and correlations with other factors (e.g., age, disease severity, and percent of body surface area (BSA) involved). Methods Patients with EB ages 8–16 and their parents/guardians who were English or Spanish speaking completed a one‐time online survey. Parent measures included: demographics questionnaire, Pain Catastrophizing Scale‐Parent (PCS), and Parent Functional Disability Inventory (FDI). Child measures included: PCS child and child FDI. Higher scores on both scales indicate higher levels of catastrophizing and functional disability. Results Of 31 children, the mean age was 11.47 years and the majority (70.97%) had dystrophic EB. Mean scores were: 35.84 = PCS parent; 34.58 = PCS child; 30.87 = parent FDI; 29.77 = child FDI. Total scores for PCS parent, parent FDI, and child FDI increased significantly with disease severity and percentage of involved BSA (p < .01 for all). Total scores for PCS child increased significantly with percent of EB skin involvement (p = .04) but not disease severity. Older children reported more functional disability than their parents and younger children (p = .02). Conclusions Our results demonstrate significant positive correlations between negative thoughts related to pain and the experience of functional difficulties in patients with EB and their caregivers. Psychological, psychiatric, and/or behavioral interventions to help managing chronic pain may be effective for patients with EB.

To prevent pain and anxiety, culture samples may be obtained from wound dressings

“…1 Furthermore, EB patients have high levels of anticipatory anxiety and pain catastrophizing, heightening their concern about potentially painful procedures. 2 It is vital to obtain wound cultures prior to starting antimicrobial treatment to identify causative organisms as well as to ascertain antibiotic sensitivities. 3 We have thus adopted a method of obtaining wound cultures in which wound exudate on dressings is swabbed rather than directly swabbing the wound itself in situ.…”