title: Changes in willingness to self-manage pain among children and adolescents and their parents enrolled in an intensive interdisciplinary pediatric pain treatment program.
abstract: The importance of willingness to adopt a self-management approach to chronic pain has been demonstrated in the context of cognitive-behaviorally oriented interdisciplinary pain treatment programs for adults, both as a treatment outcome and as a process that facilitates functional improvements. Willingness to self-manage pain has not been studied in pediatric interdisciplinary pain treatment settings. Study aims were (1) to investigate willingness to self-manage pain among children and parents undergoing intensive interdisciplinary pain treatment and (2) to determine whether increased willingness to self-manage pain influenced functional treatment outcomes. A total of 157 children ages 10 to 18 and their parents enrolled in a pediatric pain rehabilitation program completed the Pain Stages of Change Questionnaire (PSOCQ youth and parent versions) at pretreatment, posttreatment, and short-term follow-up. They also reported on pain, functional disability, depressive symptoms, fear of pain, and use of passive and accommodative coping strategies. Results show that willingness to self-manage pain increased during treatment among both children and parents, with gains maintained at follow-up. Increases in children's readiness to self-manage pain from pretreatment to posttreatment were associated with decreases in functional disability, depressive symptoms, fear of pain, and use of adaptive coping strategies. Increases in parents' readiness to adopt a pain self-management approach were associated with changes in parent-reported fear of pain but not with other child outcomes. Few associations emerged between pretreatment willingness to self-manage pain and posttreatment outcomes. Findings suggest that interdisciplinary pediatric pain rehabilitation may facilitate increased willingness to self-manage pain, which is associated with improvements in function and psychological well-being.
authors: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
authors: Deirdre E
authors: DE
authors: Logan
authors: Caitlin
authors: C
authors: Conroy
authors: Christine B
authors: CB
authors: Sieberg
authors: Laura E
authors: LE
authors: Simons
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001290:Attitude; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015331:Cohort Studies; D003631:Day Care, Medical / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D009788:Occupational Therapy / Q000379:methods; D010146:Pain / Q000523:psychology*; D059408:Pain Management / Q000379:methods / Q000523:psychology*; D010147:Pain Measurement; D010290:Parents / Q000523:psychology*; D026741:Physical Therapy Modalities; D012648:Self Care / Q000523:psychology*