title: Living Life With My Child's Pain: The Parent Pain Acceptance Questionnaire (PPAQ).
abstract: OBJECTIVE
  Parents' emotional, cognitive, and behavioral responses are highly influential on children's pain and functional outcomes. One important response to pediatric pain is acceptance: the degree to which an individual participates in routine daily activities in the presence of pain and is willing to let pain be a part of their life without efforts to control or avoid it. However, no tool currently exists to assess parents' own acceptance of their child's pain. The aim of this study was to validate the Parent Pain Acceptance Questionnaire (PPAQ).
  
  
  METHODS
  The PPAQ was administered to 310 parents of youth with chronic pain in an outpatient pediatric headache program and a day hospital pain rehabilitation program. An exploratory factor analysis revealed 2 factors for the PPAQ: an 11-item Activity Engagement scale and a 4-item Acceptance of Pain-related Thoughts and Feelings scale.
  
  
  RESULTS
  The PPAQ total score and subscales demonstrated strong internal consistency. Greater parent pain acceptance was positively associated with child pain acceptance, and was negatively correlated with parent protective behaviors, parent minimizing behaviors, parent and child pain catastrophizing, and child fear of pain. Parent protective behaviors and child pain acceptance both served as mediators of the relationship between parent pain acceptance and child functional disability.
  
  
  CONCLUSIONS
  The PPAQ is a valid measure of parent pain acceptance and may provide valuable insights into parent responses to child pain and the ways in which parent acceptance influences child outcomes. Clinical implications and suggestions for future research are discussed.
authors.affiliation: *Pain Treatment Service, Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Boston Children's Hospital †Department of Psychiatry, Harvard Medical School ‡P.A.I.N. (Pain & Analgesia Imaging Neuroscience) Group, Boston Children's Hospital, Center for Pain in the Brain, Harvard Medical School, Boston, MA.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Smith
authors.forename: Christine B
authors.initials: CB
authors.lastname: Sieberg
authors.forename: Shannon
authors.initials: S
authors.lastname: Odell
authors.forename: Edin
authors.initials: E
authors.lastname: Randall
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simons
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D058443:Catastrophization; D002648:Child; D059350:Chronic Pain / Q000523:psychology; D005163:Factor Analysis, Statistical; D005239:Fear; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States