Effects of a person‐centred approach in a school setting for adolescents with chronic pain—The HOPE randomized controlled trial

Abstract

BackgroundChronic pain among adolescents is common but effective interventions applicable in a school setting are rare. Person‐centred care (PCC) is a key factor in improving health by engaging persons as partners in their own care.MethodsIn this randomized controlled trial, a total of 98 adolescents in secondary school or upper secondary school (aged 14 − 21 years) with chronic pain were randomly assigned to a PCC intervention or standard school healthcare. In the intervention group a pain management programme, based on a PCC approach, comprising four face‐to‐face sessions with a school nurse over a period of 5 weeks was added to standard school healthcare. The main outcome measure was self‐efficacy in daily activities (SEDA scale) and rating scales for pain intensity and pain impact were used as secondary outcome measures.ResultsAt the follow‐up, no significant differences were found between the groups in the SEDA scale (p = .608) or in the rating scales for pain intensity (p = .261) and pain impact (p = .836). In the sub‐group analysis, a significant improvement in the SEDA scale was detected at the secondary school in favour of the PCC intervention group (p = .021).ConclusionIn this pain management programme based on a PCC approach, we found no effect in the total sample, but the programme showed promising results to improve self‐efficacy in daily activities among adolescents at secondary school.SignificanceThis study evaluates the effects of a pain management programme based on a PCC approach in a school setting addressing adolescents at upper secondary and secondary schools with chronic pain. No overall effects were shown, but results illustrate that the intervention improved self‐efficacy in adolescents at secondary school. Implementation of a PCC approach in a school setting may have the potential to improve self‐efficacy in daily activities for adolescents with chronic pain at secondary school.

Animation Narrative on Stress Relief and Psychological Cognitive Development in Adolescents

“…They are mostly used to relax and soothe people, to give constant comfort, to soothe hurts and to give people positive strength [ 6 ]. The reasons why the “healing boom” is in full swing in China are similar to the context in which it arose in Japan [ 7 ].…”

Being heard – Supporting person‐centred communication in paediatric care using augmentative and alternative communication as universal design: A position paper

“…Principle 3 furthermore stipulates that design should provide effective prompting and feedback during and after task completion (Table 1). This aligns to ‘the story’ and ‘the documentation’, which are key concepts of person‐centred care for children (Britten et al, 2017; Ekman et al, 2011; Fors et al, 2020). The interviews clearly showed that this was the case, and that healthcare practitioners, parents and children experienced that the children's participation increased – both before, during and after the hospital visit.…”

“…The practitioners at the child psychiatry clinic also believed that the provision of communication material with pictures, which could be taken home and used there, could make parents more active and children more involved, even after the visit to the clinic. It is important for everyone to talk and discuss the visit, as this constitutes a basic element in person‐centred care processes, namely creating one's personal story (Britten et al, 2020; Fors et al, 2020). Person‐centred paediatric care invites the child into the process of decision‐making and negotiating of care, and researchers argue that universal access to pictorial support and possibly other supportive tools may be necessary to involve children in person‐centred care (Carter & Ford, 2013; Nilsson et al, 2020).…”

“…For example, some children said that they used the pictorial support to tell their family what would happen at the hospital. Meeting the patient's preferences and abilities is also at the core of person‐centred care (Fors et al, 2020). It is interesting to note that in order to realise this, the first step actually implies a preparedness to meet a broad range of preferences and abilities with regard to communication.…”

“…This understanding of person‐centred paediatric care is based on three key elements: generating a co‐created partnership; eliciting the child's story; and safeguarding the partnership through documenting the child's story, preferences and care plan (Britten et al, ,2017, 2020; Ekman et al, 2011; Fors et al, 2020). The research‐based evidence for a person‐centred paediatric approach is sparse, and proxy reports by parents (Almasri et al, 2018; Hill et al, 2018) seem to be more common than reports from children themselves.…”