What really matters in pediatric chronic pain rehabilitation? Results of a multi-stakeholder nominal group technique study

Hurtubise, Karen; Brousselle, Astrid; Noel, Melanie; Camden, Chantal

doi:10.1080/09638288.2018.1532462

Cited by 13 publications

(20 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This reflects a neglect of outcomes identified as relevant by patients, family members, and treating health care providers, such as self-efficacy, participation in meaningful activities, social roles and relationships, vocational planning, concentration, acceptance, and resilience. 7 , 88 Although almost half of reviews addressed emotional functioning, many excluded children with co-occurring primary mental health disorders. Thus, these reviews effectively omitted a large proportion of children with chronic pain with mental health concerns 89 and decreased the relevance of available evidence to the identified patient-oriented priority about how co-occurring chronic pain and mental health can be effectively addressed.…”

Section: Discussionmentioning

confidence: 99%

Mapping the evidence and gaps of interventions for pediatric chronic pain to inform policy, research, and practice: A systematic review and quality assessment of systematic reviews

Birnie

Ouellette

Amaral

et al. 2020

Canadian Journal of Pain

View full text Add to dashboard Cite

Background: Reviews in pediatric chronic pain often focus on only one intervention or population, making it difficult for policymakers and decision makers to quickly synthesize knowledge to inform larger-scale policy and funding priorities. Aims: The aims of this study were to (1) create an evidence and gap map of interventions for pediatric chronic pain and (2) identify gaps between existing evidence and recently identified patient-oriented research priorities. Methods: We performed a systematic review of English-language peer-reviewed systematic reviews or clinical practice guidelines of pediatric chronic pain intervention published in the past 20 years. Database searches of Medline, Embase, PsycINFO, Web of Science, CINAHL, and SCOPUS were conducted inclusive to June 3, 2019. Review quality was assessed using the AMSTAR-2. Results: Of 4168 unique abstracts, 50 systematic reviews (including 2 clinical practice guidelines) crossing diverse pediatric chronic pain populations and intervention settings were included. One third were rated high quality, with half rated low to critically low quality. The largest proportion of reviews addressed psychological and pharmacological interventions, followed by interdisciplinary, other (e.g., dietary), and physical interventions. Most common outcomes included pain, physical, emotional, and role functioning and quality of life. Treatment satisfaction and adverse events were less common, with minimal report of sleep or economic factors. Most patient-oriented research priorities had not been investigated. Conclusions: Sufficient quality evidence is available to guide evidence-informed policies in pediatric chronic pain, most notably regarding psychological and pharmacological interventions. Numerous evidence gaps in patient-oriented research priorities and treatment outcomes should guide prioritization of research funds, as well as study aims and design. RÉSUMÉ Contexte: Les études sur la douleur chronique chez les enfants se concentrent souvent sur une seule intervention ou sur une seule population, de sorte qu'il est difficile pour les responsables politiques et les décideurs de synthétiser rapidement les connaissances afin d'éclairer les priorités de financement et les politiques à plus grande échelle. Objectifs: Les objectifs de cette étude étaient (1) de créer une carte présentant les lacunes dans les données probantes en ce qui concerne les interventions pour la douleur chronique chez les enfants et (2) de répertorier les lacunes dans les données probantes existantes par rapport aux priorités de recherche axées sur le patient récemment déterminées. Méthodes: Nous avons effectué une revue systématique des revues systématiques évaluées par des pairs ou des guides de pratique clinique portant sur les interventions en matière de douleur chronique pédiatrique publiés en langue anglaise au cours des 20 dernières années. Des recherches ont été menées dans les bases de données Medline, Embase, PsycINFO, Web of Science, CINAHL et SCOPUS jusqu'au 3 juin 2019 inclusivement. La qualit...

show abstract

Section: Discussionmentioning

confidence: 99%

Mapping the evidence and gaps of interventions for pediatric chronic pain to inform policy, research, and practice: A systematic review and quality assessment of systematic reviews

Birnie

Ouellette

Amaral

et al. 2020

Canadian Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Or in the area “pain management” some pediatric specific goals were considered very important, e.g., improvement of functioning: return to school, relationship to family and peers, etc. These are all recommended contents in pediatric pain rehabilitation [ 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

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

Laekeman

Schäfer²,

Moog³

et al. 2021

Children

View full text Add to dashboard Cite

Specialization training for physiotherapists, occupational therapists, and sports therapists involved in pediatric pain is scarce and curricula are rarely published. The objectives of this study are twofold: firstly, to perform a scoping review to derive important contents for a pediatric pain education curriculum for specialized pain therapists. Secondly, to conduct a survey on specific contents in curricula currently used by pain experts and to obtain their evaluation regarding the importance of such contents for a specialized curriculum. The review substantiated the importance of a specific curriculum in pediatric pain education, but provided little information on adequate contents. In the survey, 45 experts in pediatric pain education confirmed that specific curricula and specialized contents for pediatric pain education are missing. Their answers give a well-defined picture of the specifics needed in the interaction with a pediatric population. The most important items they classified were e.g., the biopsychosocial framework and the impact of pediatric pain on daily life. Those expert ratings were in line with the recommendations of pediatric pain management guidelines. Further curriculum work in an interdisciplinary, international network is highly recommended.

show abstract

“…As part of these decisions, the advisory committee completed a consensus-building exercise where six outcome domains were prioritized for measurement in the effect analysis. 18 These outcome domains included participation in meaningful activities, activities of daily living, mood and affect, roles and relationships, school engagement, and self-efficacy.…”

Section: Methodsmentioning

confidence: 99%

“…To ensure appropriate interpretation of participants’ timelines, individual semistructured interviews were conducted with each participant by one coauthor (KH), who is experienced in qualitative interviewing in this setting. 18 , 52 Parents and youth were informed that KH was not involved in the delivery of services with either program and that this work was associated with a doctoral dissertation. Using the timeline as a memory aid to facilitate the recollection, sequencing, and reflection of personal events, participants led the interview process, with KH simply identifying events on the graph by asking, “What happened here?” or “Tell me more about this.” 48 Specific inquiries about school, family, peer relationships, and other meaningful activities (e.g., sports, recreation, work) were used occasionally (as per the interview schedule subprompts listed in Table 2 ).…”

Section: Methodsmentioning

confidence: 99%

“… 13 Recently, the relevance of some of these outcome domains (e.g., pain intensity) has been called into question by stakeholders, and the lack of appropriate tools to measure some of these domains has been underscored. 18 Despite promising results demonstrated by these quantitative studies, many questions remain unanswered. For example, little is known about why some youth beneﬁt more than others, why adherence to therapeutic recommendations can be problematic, and what aspects of treatment promote long-term benefits.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Youth and parent perceptions on participating in specialized multidisciplinary pain rehabilitation options: A qualitative timeline effect analysis

Hurtubise

Brousselle

Noel

et al. 2021

Canadian Journal of Pain

Self Cite

View full text Add to dashboard Cite

Background : Little is known about how the specialized treatment journey is perceived by youth with pain-related disability and their parents. Aims : Describe and compare the treatment effects and outcomes as perceived by youth and their parents enrolled in intensive interdisciplinary pain treatment (IIPT) or multimodal treatment (MMT). Methods : Eleven IIPT youth and five parents and three MMT youth and five parents were recruited. All were asked to complete a treatment journey timeline, followed by separately conducted semistructured interviews. Transcribed interviews were analyzed using reflective thematic analysis. Results : The main themes spanned the treatment trajectory. All participants described similar initial struggles (Theme 1). Positive and negative treatment effects associated with acquisitions and disruptions (Theme 2), and outcomes post-discharge related to supports and realities (Theme 3) emerged. Knowledge, skills, and support acquisition during treatment and feeling empowered and confident to self-manage postdischarge were identified as IIPT benefits. However, the change effort and life disruptions required and the difficulty transitioning to real life postprogram were acknowledged as detrimental IIPT impacts. Continuing with life as usual and maintaining supports in daily contexts (e.g., school personnel, friends) were reported MMT benefits. However, the challenges of managing pain, treatment adherence within the competing demands of daily realities, and the lack of support to integrate strategies were emphasized as detrimental MMT impacts. Conclusions : Detailed impacts of two specialized multidisciplinary pain rehabilitation interventions on the lives of youth with pain-related disability and their parents are described. The treatments benefits and previously unexplored detrimental effects are unveiled.

show abstract

What really matters in pediatric chronic pain rehabilitation? Results of a multi-stakeholder nominal group technique study

Abstract: What really matters in pediatric chronic pain rehabilitation?Results of a multi-stakeholder nominal group technique study.

Cited by 13 publications

References 55 publications

Mapping the evidence and gaps of interventions for pediatric chronic pain to inform policy, research, and practice: A systematic review and quality assessment of systematic reviews

Mapping the evidence and gaps of interventions for pediatric chronic pain to inform policy, research, and practice: A systematic review and quality assessment of systematic reviews

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

Youth and parent perceptions on participating in specialized multidisciplinary pain rehabilitation options: A qualitative timeline effect analysis

Contact Info

Product

Resources

About