title: Treatment expectations among adolescents with chronic musculoskeletal pain and their parents before an initial pain clinic evaluation.
abstract: OBJECTIVE
  To understand expectations regarding treatment recommendations among treatment-seeking adolescents with chronic musculoskeletal pain and their parents.
  
  
  METHODS
  A total of 102 adolescent-parent dyads were recruited at the time of initial contact with a multidisciplinary pain management clinic. Each participant completed reports of adolescent pain intensity and disability, biopsychosocial perspective of pain, and treatment expectations related to recommendations and feedback for a vignette description of an adolescent presenting at an initial multidisciplinary pain clinic evaluation.
  
  
  RESULTS
  Descriptive findings for individual treatment expectations and adolescent-parent dyad agreement statistics were examined. Slight to fair levels of agreement occurred for 50% of the expectations assessed. The strongest shared expectations were for recommendations to return to school, pursue psychological counseling, and pursue PT/OT treatment. Stronger agreement occurred for items reflecting alternative, emotional, behavioral, and activity recommendations with weaker agreement for medical interventions (eg, medication and surgery). Correlations emerged between individual expectations and adolescent pain intensity, disability, with the greatest number of significant relationships found for adolescent and parent expectations and biopsychosocial perspectives of pain.
  
  
  CONCLUSIONS
  Our results document that adolescents and parents show modest levels of agreement on expectations for treatment at the time of an initial pain clinic evaluation. This may relate to expectations being internal perspectives not clearly expressed within families; thus, the initial treatment consultation may provide an important opportunity to create and align appropriate expectations. Implications of our findings are considered with respect to education, treatment, and future research to understand factors that contribute to treatment adherence and outcomes.
authors: Departments of *Anesthesiology and Critical Care Medicine §Pediatrics, Division of Rheumatology, The Children's Hospital of Philadelphia Departments of ∥Biostatistics and Epidemiology ‡Biotechnology, School of Engineering and Applied Science †Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA.
authors: Jessica W
authors: JW
authors: Guite
authors: Sohee
authors: S
authors: Kim
authors: Chia-Pei
authors: CP
authors: Chen
authors: Jennifer L
authors: JL
authors: Sherker
authors: David D
authors: DD
authors: Sherry
authors: John B
authors: JB
authors: Rose
authors: Wei-Ting
authors: WT
authors: Hwang
mesh_terms: D000293:Adolescent; D059031:Anticipation, Psychological; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000523:psychology* / Q000628:therapy*; D018710:Pain Clinics / Q000706:statistics & numerical data*; D059408:Pain Management / Q000523:psychology* / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology* / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015143:Philadelphia / Q000453:epidemiology