Parent Responses to Child Pain During Intensive Interdisciplinary Pain Treatment and 1-Year Follow-Up

Pielech, Melissa; Wallace, Dustin P.; Fitzgerald, Megan; Hoffart, C.

doi:10.1016/j.jpain.2018.05.002

Cited by 16 publications

(35 citation statements)

References 42 publications

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“…As a result, it can be challenging to identify parents’ role in treatment while balancing functional independence and accountability. Two recent studies have demonstrated that parent behavior changes positively relates to children’s pain and function outcomes when parents are included in children’s interdisciplinary inpatient pain treatment [77,78]. In this section, we describe the creation of a parent education program delivered in the context of an inpatient pain rehabilitation program, the Functional Independence Restoration (FIRST) program, and examine parents’ responses to the implementation.…”

Section: Methods Measures and Resultsmentioning

confidence: 99%

“…There is growing evidence that parents of children with chronic pain play a significant role in their children’s pain experience and as such, it is critical that parents play as active a role in their child’s treatment [77]. It can be challenging to fully appreciate a parent’s role in their child’s treatment in both outpatient and inpatient contexts.…”

Section: Discussionmentioning

confidence: 99%

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Parenting in the Context of Children’s Chronic Pain: Balancing Care and Burden

et al. 2018

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Parents of youth with chronic health conditions encounter numerous challenges in supporting their children across pediatric treatment contexts. Structural barriers to care, such as access issues and coordinating care across school, health, and family settings, can exacerbate challenges to daily functioning. Parents are often concomitantly managing their child’s chronic condition, their own health care needs, work and family demands. For these parents, accomplishing a manageable “work-life balance” feels elusive, if not impossible, when a chronic health condition is part of family life. Based on a recent symposium presentation, combined perspectives from the disciplines of pediatric psychology, parenting, and human development and family studies consider key challenges and opportunities to assist parent coping with stress associated with caregiving amidst pervasive changes in healthcare service delivery. Two innovative interventions to support parents in both an outpatient (“Parents as Coping Coaches”) and an inpatient (“Putting Parents FIRST”) context are described, with commonalities and unique aspects highlighted for each. These programs are considered in reference to a rapidly changing healthcare landscape, growing focus on the family as a core context for care, and importance of parent/caregiver self-care and crucial role in supporting children’s long-term health and resiliency.

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Section: Methods Measures and Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Parenting in the Context of Children’s Chronic Pain: Balancing Care and Burden

et al. 2018

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“…Based on this approach, specific interventions in ACT aim to undermine problematic functions of cognitions and language, for example, by means of acceptance (i.e., noting experiences of, e.g., pain/distress, without attempting to change them) and perspective-taking exercises (i.e., placing yourself as an active observer of such thoughts/experiences), and to facilitate adaptive and flexible behavioral repertoires in line with motivating verbal antecedents (i.e., personal values) [30,31]. Following ACT for pediatric chronic pain including parental support, results show improvements in parental depressive symptoms and psychological flexibility [24,26,32], and sustained improvements in parent responses to child pain have been reported after ACT-based parent support [33]. To date, only a few studies have sought to explore factors in treatment that are related to changes in outcomes after ACT for pediatric chronic pain.…”

Section: Introductionmentioning

confidence: 99%

Adolescent and Parent Experiences of Acceptance and Commitment Therapy for Pediatric Chronic Pain: An Interpretative Phenomenological Analysis

2019

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Pediatric chronic pain is common and can be related to reduced functioning in many domains for the young person and their parents. Existing psychological treatments such as Acceptance and Commitment Therapy (ACT) have shown to be effective, but improvements are needed. Qualitative approaches can help improve our understanding of treatment processes and outcomes. The aim of the present qualitative interview study was to explore the lived experiences of young people and parents who had participated in ACT for pediatric chronic pain. Four young persons and four parents were interviewed, and data was analyzed using Interpretative Phenomenological Analysis (IPA). Three themes were generated, each comprising two subthemes: (1) ‘Warning system’, which included experiences from being offered this psychological intervention, and the alternative explanations provided for pain; (2) ‘Change and challenges’, which suggested the importance of the values-based work, and of individual adaptation; and (3) ’A common language’ in which the interaction with others and new ways to communicate around the pain experience were described. Findings highlight the importance of pain education, formulating and acting in line with personal values, and communication around the pain experience, as well as the need for developmental and individual adaptations of interventions.

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“…Children with AMPS experience significant functional disability with persistent impairment in their ability to participate in age-appropriate daily activities ( Kashikar-Zuck et al., 2001 ; Gmuca & Sherry, 2017 ; Pielech et al., 2018 ; Sherry, 2015 ; Weiss & Stinson, 2018 ). Parental factors play an important role in influencing a child’s experience of pain and treatment outcomes ( Logan et al., 2012 ), with parental pain catastrophizing and engagement in protective behavioral responses linked to increased pain severity ( Birnie et al., 2016 ; Caes et al., 2012 ; Page et al., 2013 ; Palermo et al., 2014 ), and functional disability ( Caes et al., 2012 ; Chow et al., 2016 ; Guite et al., 2011 ; Lynch-Jordan et al., 2018 ; Pielech et al., 2014 ) in children.…”

Section: Discussionmentioning

confidence: 99%

“…Common AMPS subtypes include fibromyalgia and complex regional pain syndrome, and all subtypes share features of an intensified pain signal and increased functional disability, an impairment in the ability to engage in activities of daily living ( Kashikar-Zuck et al., 2001 ; Weiss & Stinson, 2018 ). In children with AMPS, functional disability frequently impacts their engagement in developmentally appropriate activities, such as completing daily hygiene tasks, walking, attending school, and socializing ( Pielech et al., 2018 ; Weiss & Stinson, 2018 ). Evidence-based treatment for AMPS involves a multidisciplinary approach, including individual psychotherapy, intensive physical and/or occupational therapy, and consistent functional activity to reset the nerve pathway and improve engagement in activities of daily living ( Gmuca & Sherry, 2017 ; Sherry, 2015 ; Weiss & Stinson, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

OUP accepted manuscript

Dougherty

Zelikovsky

Miller

et al. 2020

Journal of Pediatric Psychology

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Objective Children with amplified musculoskeletal pain (AMPS) experience significant functional disability, with impairment in their ability to participate in age-appropriate activities of daily living. Parental factors play an important role in a child’s pain symptoms and treatment outcomes, with parental pain catastrophizing and protective behaviors linked to several maladaptive outcomes for children. Aims of the current study were to examine how parental pain catastrophizing, child pain catastrophizing, and parental protective behaviors longitudinally impacted functional disability for children with AMPS. Methods Archival data were examined from parent-child dyads presenting to a tertiary pain clinic for treatment of AMPS. Over 1 year, parents completed measures assessing the level of pain catastrophizing, common behavioral responses to child pain, and child functional disability. Children completed measures of pain catastrophizing and functional disability. Measures were collected at initial evaluation, 6-months, and 12-months. Latent growth models (LGM) were conducted to examine how to study variables longitudinally impacted the rate of change in child functional disability. Results Examining a comprehensive LGM of study variables, parental catastrophizing emerged as the sole contributing factor to slower improvement in functional disability. Conclusions The strong influence of parental pain catastrophizing on functional disability may relate to parents limiting behaviors that promote adaptive coping in children with pain. As such, parents who catastrophize may benefit from specific interventions to increase their use of adaptive behavioral responses, such as redirecting children to complete functional activities and encouraging the use of positive coping skills for pain-related distress.

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Parent Responses to Child Pain During Intensive Interdisciplinary Pain Treatment and 1-Year Follow-Up

Cited by 16 publications

References 42 publications

Parenting in the Context of Children’s Chronic Pain: Balancing Care and Burden

Parenting in the Context of Children’s Chronic Pain: Balancing Care and Burden

Adolescent and Parent Experiences of Acceptance and Commitment Therapy for Pediatric Chronic Pain: An Interpretative Phenomenological Analysis

OUP accepted manuscript

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