Early signaling, referral, and treatment of adolescent chronic pain: a study protocol.
BACKGROUND
Chronic pain is prevalent among young people and negatively influences their quality of life. Furthermore, chronic pain in adolescence may persist into adulthood. Therefore, it is important early on to promote the self-management skills of adolescents with chronic pain by improving signaling, referral, and treatment of these youngsters. In this study protocol we describe the designs of two complementary studies: a signaling study and an intervention study.


METHODS
The signaling study evaluates the Pain Barometer, a self-assessed signaling instrument for chronic pain in adolescents. To evaluate the feasibility of the Pain Barometer, the experiences of youth-health care nurses will be evaluated in semi-structured interviews. Also, we will explore the frequencies of referral per health-care provider. The intervention study evaluates Move It Now, a guided self-help intervention via the Internet for teenagers with chronic pain. This intervention uses cognitive behavioural techniques, including relaxation exercises and positive thinking. The objective of the intervention is to improve the ability of adolescents to cope with pain. The efficacy of Move It Now will be examined in a randomized controlled trial, in which 60 adolescents will be randomly assigned to an experimental condition or a waiting list control condition.


CONCLUSIONS
If the Pain Barometer is proven to be feasible and Move It Now appears to be efficacious, a health care pathway can be created to provide the best tailored treatment promptly to adolescents with chronic pain. Move It Now can be easily implemented throughout the Netherlands, as the intervention is Internet based.


BACKGROUND
Dutch Trial Register NTR1926.
Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Hospital, PO Box 2040, Rotterdam, CA 3000, the Netherlands. j.s.voerman@erasmusmc.nl
Jessica S
JS
Voerman
Sylvia
S
Remerie
L Esther
LE
de Graaf
Petra
P
van de Looij-Jansen
Tessa
T
Westendorp
Ina
I
van Elderen
Frouwkje
F
de Waart
Jan
J
Passchier
Anke Dommisse
AD
van Berkel
Cora
C
de Klerk
D000293:Adolescent; D002648:Child; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy; D005240:Feasibility Studies; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D009426:Netherlands; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D012017:Referral and Consultation; D012064:Relaxation Therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome