Development of an observation method for assessing pain behaviors in children with juvenile rheumatoid arthritis

Jaworski, Theresa M.; Bradley, Laurence A.; Heck, Louis W.; A, Roca; Alarcón, Graciela S.

doi:10.1002/art.1780380818

Cited by 28 publications

(11 citation statements)

References 28 publications

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“…All patients were evaluated using an objective observation method to record motor pain behaviors. We recently validated this observation method in adult patients with fibromyalgia (38), and others have documented the reliability and validity of this method in children and adolescents with juvenile rheumatoid arthritis (39). The observation protocol consisted of a 10-minute videotaped session in which the patient engaged in a standard, timed set of activities: sitting, walking, standing, and reclining.…”

Section: Measures Coping Strategies Questionnaire Formentioning

confidence: 99%

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress

Schanberg

Kredich

Keefe

et al. 1996

Arthritis Care & Research

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Objectives. The purpose of this study was twofold: (1) to describe the coping strategies used by children with juvenile primary fibromyalgia syndrome (JPFS), and (2) to examine how pain coping relates to measures of pain, disability/function, psychological distress, and pain behavior. Methods. Sixteen children with JPFS completed the Child Version of the Coping Strategies Questionnaire (CSQ‐C), the visual analog scale for pain, the McGill Pain Questionnaire, the Fibromyalgia Impact Questionnaire modified for children, the Arthritis Impact Measurement Scales 2, and the Symptom Checklist‐90‐Revised. Subjects also underwent pain behavior observation. Pearson's product moment correlations were conducted to examine the relationship of coping to measures of pain and disability. Results. The Pain Control and Rational Thinking composite factor score on the CSQ‐C correlated with measures of pain severity, functional disability, and psychological distress. Results supported the internal reliability of the CSQ‐C in assessing pain coping. Conclusions. These results suggest that the CSQ‐C may provide a reliable measure for assessing variations in pain coping in JPFS patients. Behavioral interventions aimed at increasing the perception of pain control may be beneficial in treating JPFS.

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Section: Measures Coping Strategies Questionnaire Formentioning

confidence: 99%

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress

Schanberg

Kredich

Keefe

et al. 1996

Arthritis Care & Research

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“…The difference is due to the fact that children older than 2 years have good neurological motor maturity and that, in our context, children had no limitation of mobility, except pain. Hence, more explicit qualitative behavioural changes can be observed in these children, such as guarded movement (Jaworski et al, 1991) and abnormal patterns of movement, as observed by Truckenbrodt (1993) in children with juvenile rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 72%

The development of the DEGR^R: A scale to assess pain in young children with cancer

Gauvain-Piquard

Rodary

Rezvani

et al. 1999

European Journal of Pain

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The Gustave Roussy Child Pain Scale (Douleur Enfant Gustave Roussy, DEGR(R)Scale) is a scale for grading prolonged pain in children aged 2-6 years with cancer. The scale comprised six behaviours specific to pain items, five psychomotor inertia items, and four anxiety items, with a total score ranging from 0 to 60. This work was designed to confirm the scale structure and to study its construct validity and convergent validity.Our work was composed of two parts. In the first part of the study, 152 children with progressive cancer were scored by two nurses using the DEGR(R)scale, in a cross-sectional design. And in the second part, 53 of these 152 children were video-recorded. The tapes were assessed both by a panel of four pain specialists using a 0 to 7 Likert scale and by a nurse using DEGR(R)scale.As for the 152 children, the mean of the total scores derived from the DEGR(R)is 20.2 (SD = 6.2). Both the degree of agreement between the nurses (the weighted kappa coefficient) and the internal consistency of the scale (Cronbach alpha coefficient = 0.90) were high, providing evidence of good reliability. Multivariate factor analyses showed a first factor of intensity of pain (51% of the total variance) and a second factor (14% of the total variance) which distinguishes the psychomotor inertia items from the items concerning voluntary expression of pain. Also, the results showed that psychomotor inertia items contribute to both factors and that it is an important sign of prolonged pain. Construct validity was strengthened by the absence of correlation between DEGR(R)scores and variables not related to pain, including fever, neutropenia and anaemia (indicative of poor medical condition) and the absence of parents' visits (indicative of psychological distress).Concerning the 53 video-recorded children, the nurses' DEGR(R)ratings were strongly correlated with the specialists panel scores indicating a fairly good case for convergent validity. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

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“…Jaworski et al [21] proposed that children who experience pain secondary to JRA also would demonstrate specific, identifiable, and quantifiable pain behaviors, similar to those that have been observed in adults with RA. Their study investigated the usefulness of a behavioral observation method, similar to that developed for adult RA patients by McDaniel et al [ZO], for assessing pain behaviors in pediatric patients with chronic JRA.…”

Section: Behavioral Observations Of Pain Behaviorsmentioning

confidence: 95%

Juvenile rheumatoid arthritis: pain‐related and psychosocial aspects and their relevance for assessment and treatment

Jaworsk

1993

Arthritis & Rheumatism

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Objective. To review literature in the area of juvenile rheumatoid arthritis that has focused on pain experience, functional losses, and psychosocial functioning.Methods. This article provides a critical review of research addressing these three primary issues.Results. Subjective and behavioral measures have been developed to assess pain in juvenile rheumatoid arthritis patients, but further work is needed to determine the validity and reliability of these instruments. Tools to assess functional losses in juvenile rheumatoid arthritis patients also appear promising in preliminary studies. Patients can be at risk for difficulties in psychosocial functioning, although research suggests that there are a variety of family, parental, and child variables that influence child and sibling adaptation. Methodologic shortcomings prevent definitive conclusions in this area.Conclusions. A1 t hough met hodologic limitations have plagued this research in the past, new advances are facilitating improved understanding of children and adolescents with juvenile rheumatoid arthritis. Implications for future study with this challenging population are offered. Theresa M. Jaworski. PhD, is at the Mayo Clinic Foundation, Rochester, Minnesota.Address correspondence to Theresa M. Jaworski, PhD, Section of Psychology, Mayo Clinic Foundation, 200 First Street, SW, Rochester, MN 55905.Submitted for publication February 3,1993; accepted July 15,1993. 0 11193 by the Arthritis Foundation.Key Words: Juvenile rheumatoid arthritis; Psychosocial aspects; Pain; Assessment.It has been estimated that 60,000 to 250,000 children in the United States are affected with juvenile rheumatoid arthritis (JRA); thus, JRA is one of the most common chronic diseases in children [1,2]. Juvenile rheumatoid arthritis is an inclusive term for children with joint involvement occurring before or at age 16 years. Three distinct forms are recognized at diseaseonset: (1) the systemic form, characterized mainly by fever, rash, and modest arthritis; (2) the pauciarticular form, characterized by involvement of four joints or fewer; and (3) the polyarticular form, which involves more than four joints. The pauci-and polyarticular forms are further subdivided into two types each. Pauciarticular type I occurs mainly in young girls who may also have eye involvement, whereas type I1 is more frequent in older boys and primarily involves the lower extremities and the axial skeleton. The polyarticular form also has two types, seropositive and seronegative (for immunoglobulin M-rheumatoid faotor). (Children with systemic-onset JRA that evolves into polyarthritis and those with seropositive polyarthritis tend to have persistent joint inflammation and joint cdestruction and must cope with chronic pain and experience greater functional losses [3-51. Psychologically-related research has been conducted to better understand three aspects of JRA: (1) the experience of pain in children and adolescents with JRA; ( 2 ) how functional activity levels might be compromised by the disease and t...

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Development of an observation method for assessing pain behaviors in children with juvenile rheumatoid arthritis

Cited by 28 publications

References 28 publications

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress

The development of the DEGR^R: A scale to assess pain in young children with cancer

Juvenile rheumatoid arthritis: pain‐related and psychosocial aspects and their relevance for assessment and treatment

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Development of an observation method for assessing pain behaviors in children with juvenile rheumatoid arthritis

Cited by 28 publications

References 28 publications

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress

The development of the DEGRR: A scale to assess pain in young children with cancer

Juvenile rheumatoid arthritis: pain‐related and psychosocial aspects and their relevance for assessment and treatment

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The development of the DEGR^R: A scale to assess pain in young children with cancer