Importance of Parental Conceptual Model of Illness in Severe Recurrent Abdominal Pain

Crushell, Ellen; Rowland, Marion; Doherty, Mairin B.; Gormally, Siobhan; Harty, Sinead; Bourke, Billy; Drumm, Brendan

doi:10.1542/peds.112.6.1368

Cited by 100 publications

(94 citation statements)

References 32 publications

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“…For example, it may be that parents are less sure their children can function with pain if they are not going to school (an observed disability); whereas the patients' assessments of self-efficacy may be tied more closely to their (unobservable) feelings, thoughts, symptoms, experiences and/or memories. This is a potentially important distinction since parents can influence the decisions related to functioning, such as school attendance, and family factors have been demonstrated to influence pain perception, functioning and outcomes (Chambers, 2003;Crushell et al, 2003). While parent perception is important to understand, our findings highlight the importance of including child reports for the most relevant assessment of child self-efficacy for functioning normally when in pain.…”

Section: Discussionmentioning

confidence: 76%

Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions)

Bursch

Tsao

Meldrum

et al. 2006

Pain

101

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Despite frequent targeting of health beliefs in pediatric chronic pain treatment interventions, there are currently no reliable and valid self-efficacy measures for children with chronic pain and their parents. The current study examined the psychometric properties of parent and child versions of a self-efficacy measure related to the child functioning normally when in pain. Pediatric pain patients, 9-18 years of age, and a caregiver completed questionnaires before an initial tertiary care clinic appointment. The 67 patients in our sample had an average of 1.7 pain locations, including abdominal pain (43.3%), headaches (50.7%), body pain (25.4%), back pain (23.9%), limb pain (20.9%), and/or chest pain (9.0%). Reliability for the new measures was excellent; the Cronbach's alpha was .89 for the 7 child items and .90 for the 7 parent items. Strong evidence for construct validity was also obtained as 23 of the 27 hypothesized correlations were confirmed. As predicted, parent and child ratings of increased self-efficacy for the child functioning normally when in pain were significantly correlated with each other, and to parent reports of fewer problems functioning due to physical or emotional problems; parent reports of fewer somatic, behavioral or emotional symptoms; parent reports of increased self-esteem, and unrelated to child pain, age and gender. Additionally, child ratings of increased self-efficacy were significantly correlated with child reports of increased selfesteem and fewer somatic symptoms. Replication with a larger sample size, more complex modeling, and prospective studies are indicated.

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Section: Discussionmentioning

confidence: 76%

Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions)

Bursch

Tsao

Meldrum

et al. 2006

Pain

101

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“…Therefore, parents might contribute to a maladaptive role by showing positive consequences to it. Other studies highlight the importance of parental acceptance of a biopsychosocial model for the explanation of the child's symptoms which was associated with long-term symptom recovery [9,37]. A three-session cognitive-behavioral intervention study by Levy and coauthors [35] aimed mainly at modifying the families' response on illness behavior of the child and could demonstrate a long-lasting reduction of parentreported AP in a large sample.…”

Section: Discussionmentioning

confidence: 99%

“…Derived from good evidence in treating adults with long-standing IBS with hypnotherapy (HT) [16,18,58], this might also be a promising approach in handling FAP and IBS in childhood [47][48][49]. The most comprehensive study in HT treatment of FAP and IBS in children and adolescents (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years) by a Dutch workgroup [48,49] could demonstrate that HT was highly superior to standard medical care, even in a longterm follow-up. A study in the United States was able to show that self-administered audio-recorded HT for children and adolescents with FAP (6-15 years) was superior to a waiting list condition [47].…”

Section: Introductionmentioning

confidence: 99%

Brief hypnotherapeutic–behavioral intervention for functional abdominal pain and irritable bowel syndrome in childhood: a randomized controlled trial

et al. 2013

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Functional abdominal pain and irritable bowel syndrome are two prevalent disorders in childhood which are associated with recurrent or chronic abdominal pain, disabilities in daily functioning, and reduced quality of life. This study aimed to evaluate a brief hypnotherapeuticbehavioral intervention program in a prospective randomized controlled design. Thirty-eight children, 6 to 12 years of age, and their parents were randomly assigned to a standardized hypnotherapeutic-behavioral treatment (n=20) or to a waiting list condition (n=18). Both groups were reassessed 3 months after beginning. Primary outcome variables were child-completed pain measures and pain-related disability. Secondary outcome variables were parent-completed measures of their children's pain and pain-related disability. Health-related quality of life from both perspectives also served as a secondary outcome. In the treatment group, 11 of 20 children (55.0 %) showed clinical remission (>80 % improvement), whereas only one child (5.6 %) in the waiting list condition was classified as responder. Children in the treatment group reported a significantly greater reduction of pain scores and pain-related disability than children of the waiting list condition. Parental ratings also showed a greater reduction of children's abdominal pain and pain-related disability. Health-related quality of life did not increase significantly. Conclusions: Hypnotherapeutic and behavioral interventions are effective in treating children with long-standing AP. Treatment success of this brief program should be further evaluated against active interventions with a longer follow-up.

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“…4 Similarly for children with functional pain the critical factor associated with recovery is parental acceptance at the time of diagnosis of a bio-psychosocial model of illness. 8 Regular follow-up visits, if required, can both reassure parents and allow for monitoring for any alarm symptoms. When symptoms persist, referral to child psychology or psychiatry can be helpful especially as cognitive behavioural therapy has been shown to be of benefit in resistant cases.…”

Section: Examinationmentioning

confidence: 99%

An approach to functional abdominal pain in children and adolescents

Brett

Rowland²,

Drumm³

2012

Br J Gen Pract

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Importance of Parental Conceptual Model of Illness in Severe Recurrent Abdominal Pain

Abstract: The acceptance by parents of a biopsychosocial model of illness is important for the resolution of recurrent abdominal pain in children.

Cited by 100 publications

References 32 publications

Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions)

Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions)

Brief hypnotherapeutic–behavioral intervention for functional abdominal pain and irritable bowel syndrome in childhood: a randomized controlled trial

An approach to functional abdominal pain in children and adolescents

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