title: Living in fear of your child's pain: the Parent Fear of Pain Questionnaire.
abstract: Fear and avoidance have been consistently associated with poor pain-related outcomes in children. In the context of the pediatric pain experience, parent distress and behaviors can be highly influential. This study validated the Parent Fear of Pain Questionnaire (PFOPQ) to assess a parent's fears and avoidance behaviors associated with their child's pain. Using the PFOPQ in conjunction with measures of parent and child pain-related variables, we tested the interpersonal fear-avoidance model (IFAM). The sample comprised 321 parents and their child with chronic or new-onset pain who presented to a multidisciplinary outpatient pain clinic. An exploratory factor analysis yielded a 4-factor structure for the PFOPQ consisting of Fear of Pain, Fear of Movement, Fear of School, and Avoidance. As hypothesized, Fear of Pain was most closely related to parent pain catastrophizing and child fear of pain, whereas Avoidance was most closely related to parent protective behaviors and child avoidance of activities. In testing the IFAM, parent behavior contributed directly and indirectly to child avoidance, whereas parent fear and catastrophizing contributed indirectly to child avoidance through parent behavior and child fear and catastrophizing, in turn, influencing child functional disability levels. This study provides the first measure of parent pain-related fears and avoidance behaviors and evaluates the theorized IFAM. These results underscore the important influence of parents on child pain-related outcomes and put forth a psychometrically sound measure to assess parent fear and avoidance in the context of their child's pain.
authors: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
authors: Laura E
authors: LE
authors: Simons
authors: Allison
authors: A
authors: Smith
authors: Karen
authors: K
authors: Kaczynski
authors: Molly
authors: M
authors: Basch
mesh_terms: D000293:Adolescent; D058443:Catastrophization; D002648:Child; D019988:Children with Disabilities / Q000523:psychology; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008960:Models, Psychological; D010146:Pain / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement; D010290:Parents / Q000523:psychology*; D015203:Reproducibility of Results; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
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