Recommendations for a Pediatric Pain Education Curriculum for Physical and Occupational Therapists: Scoping Review and Survey

Laekeman, Marjan; Schäfer, Axel; Moog, Martina Egan; Kuss, Katrin

doi:10.3390/children8050390

Cited by 4 publications

(3 citation statements)

References 52 publications

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“…Whilst these messages appear simple, they are not well understood by the public (Turner et al, 2017); there is value in this knowledge—adults with chronic pain who shift their understanding of pain towards these types of messages have better outcomes than those who do not (Lee et al, 2016). However, research on paediatric populations is needed (Laekeman et al, 2021; Robins et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Communicating with children about ‘everyday’ pain and injury: A Delphi study

Wallwork

Noel

Moseley

2022

European Journal of Pain

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Background ‘Everyday’ pain experiences are potentially critical in shaping our beliefs and behaviours around injury and pain. Influenced by social, cultural and environmental contexts, they form the foundation of one's understanding of pain and injury that is taken into adulthood. How to best communicate to young children about their everyday pain experiences, in order to foster adaptive beliefs and behaviours, is unknown. Methods In this Delphi survey, we sought expert opinion on the key messages and strategies that parents/caregivers can consider when communicating with young children (aged 2–7 years) about ‘everyday’ pain that is most likely to promote recovery, resilience and adaptive pain behaviours. Eighteen experts participated including specialists in paediatric pain, trauma, child development and psychology; educators and parents. The survey included three rounds. Results Response rate was over 88%. Two hundred fifty‐three items were raised; 187 reached ‘consensus’ (≥80% agreement amongst experts). Key messages that the experts agreed to be ‘very important’ were aligned with current evidence‐based understandings of pain and injury. Strategies to communicate messages included parent/caregiver role modelling, responses to child pain and discussion during and/or after a painful experience. Other key themes included promoting emotional development, empowering children to use active coping strategies and resilience building. Conclusions This diverse set of childhood, pain and parenting experts reached consensus on 187 items, yielding 12 key themes to consider when using everyday pain experiences to promote adaptive pain beliefs and behaviours in young children. Significance Parents and caregivers likely play a critical role in the development of children's fundamental beliefs and behaviours surrounding pain and injury that are carried into adulthood. Everyday pain experiences provide key opportunities to promote positive pain‐related beliefs and behaviours. This Delphi survey identified key messages and strategies that caregivers can consider to optimize learning, encourage the development of adaptive pain behaviours and build resilience for future pain experiences.

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Section: Discussionmentioning

confidence: 99%

Communicating with children about ‘everyday’ pain and injury: A Delphi study

Wallwork

Noel

Moseley

2022

European Journal of Pain

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“…If multidisciplinary care is not feasible, it may be necessary to design and implement interventions for adolescents with persistent back pain in which physiotherapists, occupational therapists or chiropractors assess and target factors in all three biopsychosocial domains. However, additional training and education are likely necessary (Laekeman et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Describing the nonsurgical, nonpharmacological interventions offered to adolescents with persistent back pain in randomized trials: A scoping review

Hauber

Robinson

Kirby

et al. 2023

European Journal of Pain

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Background and Objectives: Persistent nonspecific back pain is now established as a biopsychosocial phenomenon that can be meaningfully affected by individuals' cognitions, emotions, lifestyle factors and family and social relationships. Recent guidelines for the treatment of adolescents with persistent nonspecific back pain, as well as those for youth with mixed chronic pain, strongly recommend interdisciplinary care in which adolescents receive treatment for both mind and body. The objective of this scoping review was to examine the interventions evaluated in randomized trials for adolescents with persistent back pain to determine whether they correspond to these guidelines and to reveal future research priorities. Databases and data treatment:The review protocol was registered in March 2022. We followed the PRISMA guidelines for scoping reviews. Twelve electronic databases were searched for relevant study reports. Data were charted on study characteristics, participant characteristics and intervention details using the Template for Intervention Description and Replication (TIDieR) checklist. Results: The search yielded 1952 records, of which eight reports representing seven randomized trials were eligible. The most common interventions were exercise therapy (n = 6) and back education (n = 4). Five studies employed multiple intervention components, but none was multidisciplinary. Studies primarily targeted posture or biomechanical factors. One study included an intervention addressing participants' fears and beliefs about pain. Conclusions: Randomized trials for adolescents with persistent back pain have primarily relied upon an outdated, biomechanical explanation of persisting pain. Future randomized trials should align with current treatment recommendations and measure outcomes across multiple biopsychosocial domains. Significance: This scoping review describes in detail the interventions included in randomized trials for adolescents with persistent, nonspecific back pain. The review is important because it reveals discrepancies between those interventions and the interventions recommended for this population.

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“…11 In a study it is mentioned that evaluation should be an ongoing and continuous process to improve and manage treatment plans while also recognizing and treating patients' problems. 12,13 . A neurological evaluation focuses on the nervous system to detect and identify any anomalies that may be interfering with the function and everyday activities.…”

Section: Introductionmentioning

confidence: 99%

Pain Assessment and Management of Neurologic Impairments by Pediatric Physical Therapists; A Cross-Sectional Survey

Kashif

Tariq²

2022

THJ

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Background: Physical therapists indicated the use of standardized pain assessment instruments like subjective measures, self-reported scales, behavioral and physiological measures to assess pain in children with neurological impairments. Indicators such as diminished attention, retreat, and changes in sleeping and feeding patterns were also reported along with facial expression, sobbing, and vocalizations. Therapists' perspectives on behavioral pain expressions may be significantly different from the perspectives of the children's parents or caregivers. Objective: To determine the methods of pain assessment and management for children with neurologic impairments used by pediatric physical therapists. Methods: A cross-sectional survey in which the data was collected from different public hospitals in Faisalabad, Pakistan. Convenient sampling was applied to recruit physiotherapists for this study and data was gathered through a structured questionnaire after taking their written informed consent. Results: Frequently used behaviors included facial expression, vocalizations, and irritability. Cues that were rarely used included changes in sleeping, withdrawal, eating behaviors, and decreased attention. Physiotherapists prefer to use pain interventions that were supported by research like praise and distraction as well as distress-producing potentially harmful measures such as reassurance and procedural talk. About 84% percent of the respondents used subjective measures to assess pain, 60% used self-report scales, and 32% used behavioral and physiological measures. The results regarding procedural explanation showed that 41.1% of physiotherapists had very often done procedural explanation and 58.9% had often done it. Conclusion: A well-structured practice pattern of pain assessment and treatment of neurologic deficits was observed among pediatric physical therapists. Praise, distraction, and procedural explanation were often used to ease discomfort and pain while doing physiotherapy treatment sessions. Overt signs such as vocalizations, weeping and facial expressions were used to measure pain more often than subtle markers such as lower attention, disengagement, and disturbed sleep and feeding habits.

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Recommendations for a Pediatric Pain Education Curriculum for Physical and Occupational Therapists: Scoping Review and Survey

Cited by 4 publications

References 52 publications

Communicating with children about ‘everyday’ pain and injury: A Delphi study

Communicating with children about ‘everyday’ pain and injury: A Delphi study

Describing the nonsurgical, nonpharmacological interventions offered to adolescents with persistent back pain in randomized trials: A scoping review

Pain Assessment and Management of Neurologic Impairments by Pediatric Physical Therapists; A Cross-Sectional Survey

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