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Thorsell Cederberg J, Bartels SL, Thulin M, Beeckman M, Wicksell RK, Goubert L. Child and Parent Risk and Resilience Factors as Predictors of Long-term Recovery in Youth Undergoing Spinal Fusion Surgery. Clin J Pain 2024; 40:278-287. [PMID: 38287774 PMCID: PMC11005675 DOI: 10.1097/ajp.0000000000001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES Undertreated pediatric postsurgical pain negatively affects health-related quality of life (HRQOL) and functioning and may lead to chronic postsurgical pain (CPSP). Predictors of recovery have been identified but more research is needed, particularly regarding resilience, social factors, and long-term effects. The aim of the present study was to investigate child and parent risk and resilience factors as predictors of long-term postsurgical recovery for adolescents. METHODS Participants were patients with Adolescent Idiopathic Scoliosis (AIS), 12 to 18 years old, undergoing spinal fusion, and their parents. Recruitment occurred at the orthopedic units at 4 hospitals in Belgium. Data were collected before surgery (T0), at 3 (T1) and 6 weeks (T2), 6 months (T3), and 1 year (T4) post surgery. Multiple regression models were used to evaluate the predictive effect of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance on long-term functioning, HRQOL, and pain. RESULTS The sample comprised 100 adolescents and 61 parents. Pain at T0, T1, and T3 and adolescent pain catastrophizing (T0) predicted health-related quality of life, functioning, and pain at T4 (while pain at T2 predicted HRQOL and pain). Parent pain catastrophizing predicted pain at T4. Adolescent and parental psychological flexibility predicted HRQOL, and parent psychological flexibility also predicted pain at T4. Adolescent acceptance at T1 predicted pain, and acceptance at T2 predicted HRQOL, at T4. DISCUSSION The study identified pain and adolescent pain catastrophizing as risk factors, and adolescent and parental psychological flexibility and adolescent pain acceptance as resilience factors, for long-term recovery in youths undergoing spinal fusion. Postsurgical pain management targeting these factors may therefore promote recovery for these adolescents.
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Affiliation(s)
| | | | - Måns Thulin
- Mathematics, Uppsala University, Uppsala, Sweden
| | | | | | - Liesbet Goubert
- Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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De Bruyne E, Eloot S, Willem L, Van Hoeck K, Walle JV, Raes A, Van Biesen W, Goubert L, Van Hoecke E, Snauwaert E. Mental health and professional outcomes in parents of children with chronic kidney disease. Pediatr Nephrol 2024:10.1007/s00467-024-06372-y. [PMID: 38653885 DOI: 10.1007/s00467-024-06372-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/08/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND This study evaluated parenting stress, anxiety, and depression symptoms and their associated factors in parents of children with chronic kidney disease (CKD). METHODS This cross-sectional study compared parents of patients with CKD (0-18 years) with a matched control group of parents of healthy children. Both groups completed the Parenting Stress Index - Short Form, the Hospital Anxiety and Depression Scale, and a sociodemographic questionnaire. RESULTS The study group consisted of 45 parents (median age 39; 32 mothers) of CKD patients (median age 8; 36% female). Nearly 75% of children had CKD stages 2, 3, or 4, and 44.5% had congenital anomaly of the kidney and urinary tract. Five children (11%) were on dialysis, and 4 (9%) had a functioning kidney graft. Compared with parents of healthy children, more stress and anxiety symptoms were reported. Since the CKD diagnosis, 47% of parents perceived a deterioration of their own health, and 40% reduced work on a structural basis. Higher levels of stress, anxiety, and depression symptoms were associated with a more negative perception of own health, and more child medical comorbidities and school absence. CONCLUSIONS This study showed higher levels of parenting stress and anxiety symptoms in parents of children with CKD compared with parents of healthy children. This was associated with a less positive perception of their own health, especially if the child had more medical comorbidities or more absence from school. Psychosocial interventions to reduce the parental burden should be integrated in the standard care of pediatric nephrology departments.
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Affiliation(s)
- Elke De Bruyne
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium.
| | - Sunny Eloot
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Lore Willem
- Department of Child Nephrology and Organ Transplantation, Leuven University Hospital, Louvain, Belgium
| | - Koen Van Hoeck
- Department of Pediatric Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology & Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Ann Raes
- Department of Pediatric Nephrology & Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Wim Van Biesen
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Eline Van Hoecke
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
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Van Alboom M, Baert F, Bernardes SF, Verhofstadt L, Bracke P, Jia M, Musial K, Gabrys B, Goubert L. Examining the Role of Structural and Functional Social Network Characteristics in the Context of Chronic Pain: An Ego-centered Network Design. J Pain 2024:104525. [PMID: 38609026 DOI: 10.1016/j.jpain.2024.104525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024]
Abstract
The well-being and functioning of individuals with chronic pain (CP) vary significantly. Social factors, such as social integration, may help explain this differential impact. Specifically, structural (network size, density) as well as functional (perceived social support, conflict) social network characteristics may play a role. However, it is not yet clear whether and how these variables are associated with each other. Objectives were to examine 1) both social network characteristics in individuals with primary and secondary CP, 2) the association between structural network characteristics and mental distress and functioning/participation in daily life, and 3) whether the network's functionality mediated the association between structural network characteristics and mental distress, respectively, functioning/participation in daily life. Using an online ego-centered social network tool, cross-sectional data were collected from 303 individuals with CP (81.85% women). No significant differences between individuals with fibromyalgia versus secondary CP were found regarding network size and density. In contrast, ANCOVA models showed lower levels of perceived social support and higher levels of conflict in primary (vs secondary) CP. Structural equation models showed that 1) larger network size indirectly predicted lower mental distress via lower levels of conflict; 2) higher network density increased mental distress via the increase of conflict levels. Network size or density did not (in)directly predict functioning/participation in daily life. The findings highlight that the role of conflict, in addition to support, should not be underestimated as a mediator for mental well-being. Research on explanatory mechanisms for associations between the network's structure, functionality, and well-being is warranted. PERSPECTIVE: This paper presents results on associations between structural (network size, density) and functional (social support, conflict) social network characteristics and well-being in the context of CP by making use of an ego-centered network design. Results suggest an indirect association between structural network characteristics and individuals with CP their mental well-being.
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Affiliation(s)
- Maité Van Alboom
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Fleur Baert
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sónia F Bernardes
- Department of Social and Organizational Psychology, School of Social Sciences and Humanities, ISCTE - University Institute of Lisbon, Lisboa, Portugal
| | - Lesley Verhofstadt
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Piet Bracke
- Faculty of Political and Social Sciences, Department of Sociology, Ghent University, Ghent, Belgium
| | - Mingshan Jia
- Faculty of Engineering, University of Technology Sydney, Sydney, Australia
| | - Katarzyna Musial
- Faculty of Engineering, University of Technology Sydney, Sydney, Australia
| | - Bogdan Gabrys
- Faculty of Engineering, University of Technology Sydney, Sydney, Australia
| | - Liesbet Goubert
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Parsons RD, McParland JL, Halligan SL, Goubert L, Noel M, Jordan A. Looking on the bright side: The relationships between flourishing and pain-related outcomes among adolescents living with chronic pain. J Health Psychol 2023:13591053231214099. [PMID: 38102737 DOI: 10.1177/13591053231214099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
A deficits-based approach to adolescent chronic pain currently dominates the literature, to the exclusion of positive approaches, such as flourishing. Addressing this knowledge gap, this study examined the relationships between flourishing and pain-related outcomes in adolescent chronic pain. Seventy-nine adolescents aged 11-24 years were asked to complete self-report measures of three domains of flourishing and four pain-related outcomes. Correlation coefficients and four hierarchical linear regression analyses were conducted, controlling for age and gender. Flourishing mental health was associated with, and significantly contributed to explaining, anxiety and depressive symptoms, and social and family functioning impairment. Benefit finding and posttraumatic growth were each associated with social and family functioning impairment, while posttraumatic growth was also associated with anxiety and depressive symptoms. Additionally, benefit finding significantly contributed to explaining pain intensity. Study findings underscore the importance of assessing the relationships between flourishing and pain-related outcomes in adolescents with chronic pain.
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Van Alboom M, Baert F, Bernardes SF, Bracke P, Goubert L. Public Chronic Pain Stigma and the Role of Pain Type and Patient Gender: An Experimental Vignette Study. J Pain 2023; 24:1798-1812. [PMID: 37196927 DOI: 10.1016/j.jpain.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/06/2023] [Accepted: 05/07/2023] [Indexed: 05/19/2023]
Abstract
Research exploring the specific manifestations of chronic pain (CP) public stigma is scarce. One potential factor influencing public stigma manifestations may be the CP type, that is, the presence (secondary CP) or absence (primary CP) of a clearly identifiable pathophysiology. Furthermore, patient gender may play a key role, whereby pain-related gender stereotypes may evoke distinct gender role expectations towards men and women experiencing CP. The aim of the research was 2-fold. First, by means of an experimental vignette design, the general population's cognitive, affective, and behavioral responses were investigated, both towards primary versus secondary CP and towards men versus women. Second, a potential interaction was examined between CP type and patient gender. The research is divided into 2 separate samples: individuals with CP (N = 729) and individuals without CP (N = 283). Factorial ANOVA models were estimated with CP type, patient gender, and participant gender included as factors, age as control variable. The findings support, partly, the general hypothesis of higher (perceived) public stigma towards individuals with primary (vs secondary) CP. No main effects of patient gender were observed. Gender bias in stigmatizing manifestations only emerged in certain contextual circumstances (ie, pain type and participant gender). Different interaction effects (with a combination of gender, patient gender, or CP type) were significant for the distinctive outcome variables. Interestingly, throughout the findings, different patterns of results are found in both samples. The study contributes to the literature on CP stigma, as well as the psychometric examination of items assessing stigmatizing manifestations. PERSPECTIVE: This study examined the role of contextual factors chronic pain type and patient gender into cognitive, affective, and behavioral stigmatizing manifestations coming from the general population towards individuals with chronic pain through an experimental vignette study. The study contributes to the chronic pain stigma literature, as well as the psychometric examination of items assessing stigmatizing manifestations.
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Affiliation(s)
- Maité Van Alboom
- Ghent University, Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent, Belgium.
| | - Fleur Baert
- Ghent University, Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent, Belgium
| | - Sónia F Bernardes
- ISCTE, University Institute of Lisbon, School of Social Sciences, Department of Social and Organizational Psychology, Lisboa, Portugal
| | - Piet Bracke
- Ghent University, Faculty of Political and Social Sciences, Department of Sociology, Ghent, Belgium
| | - Liesbet Goubert
- Ghent University, Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent, Belgium
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Ackermans T, Schelfaut S, Beeckman M, Michielsen J, Moens P, Goubert L, Plasschaert F. Monitoring the initial recovery after fusion surgery using activity trackers in adolescent idiopathic scoliosis: going in the lumbar spine decreases the daily step count. Spine Deform 2023; 11:927-932. [PMID: 37000346 DOI: 10.1007/s43390-023-00677-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/04/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE Although the functional outcome (e.g. the return to daily activities) plays an important role in the evaluation of treatment success for the paediatric patient, clinicians currently cannot make accurate and objective predictions regarding the very early (≤ 6 weeks) functional outcome and its recovery over time. The purpose of the present study is to objectively measure initial postoperative physical activity levels and examine the relationship with patient characteristics, fusion levels and pain. METHODS Step count (SC) was obtained pre- (Pre-Op) and postoperatively (Post-3W: 3 weeks after surgery; Post-6W: 6 weeks after surgery) using an accelerometer. Patients were grouped based on LIV (thoracic (T-group) and lumbar (L-group)) and fusion length (FL ≤ 10 levels = SF-group and FL ≥ 11 levels = LF-group). Differences in the daily SC between groups (LIV and FL) and the three timepoints was investigated using a two-way ANOVA. RESULTS The SC was significantly lower at both Post-3W (p < 0.001) and Post-6W (p < 0.001) compared to the preoperative SC, and significantly (p < 0.001) increased from Post-3W to Post-6W (Pre-Op = 13,049 ± 3214 steps/day; Post-3W = 6486 ± 2925 steps/day; Post-6W = 8723 ± 3020 steps/day). At both post-op timepoints the T-group had a higher SC compared to the L-group. CONCLUSION A fusion surgery with the LIV at L2 or below has a negative impact on the very early postoperative activity levels. The initial functional outcome level of AIS patients was not related to the presently collected patient characteristics. This suggests that objective activity trackers provide novel information and could have an added value in very early rehabilitation programs.
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Affiliation(s)
- Thijs Ackermans
- Department of Development and Regeneration, Institute for Orthopaedic Research and Training (IORT), KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Sebastiaan Schelfaut
- Division of Orthopaedics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Melanie Beeckman
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Jozef Michielsen
- Department of Orthopedics, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
| | - Pierre Moens
- Division of Orthopaedics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Frank Plasschaert
- Department of Orthopedics and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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Mikkonen J, Luomajoki H, Airaksinen O, Goubert L, Leinonen V. Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic non-specific low back pain: randomized feasibility trial with two-month follow-up. BMC Musculoskelet Disord 2023; 24:354. [PMID: 37147638 PMCID: PMC10161472 DOI: 10.1186/s12891-023-06434-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/15/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is a leading cause of disability globally. Exercise therapies are one of the commonly prescribed treatment options for CLBP. The specific exercise therapies for CLBP most commonly target movement dysfunction, but seldom brain-based pain modulation. Exercise therapies with specific breathing techniques (SBTs) have been shown to influence and enhance brain-based structural and functional pain modulation. AIMS AND OBJECTIVES To assess the feasibility of the SBTs protocol, eligibility criteria, randomization, and dropout rates. To quantify the changes in patient outcome measures and choose the most relevant measure for larger-scale study. To quantify self-adherence levels to home exercise and monitor and record possible pain medication and other treatment modality usage, and adverse events during exercise. DESIGN A parallel randomised analyst-blinded feasibility trial with two-month follow-up. OUTCOME MEASURES Feasibility related to aims and objectives. Multiple pain- and health-related patient-reported outcome measures of pain intensity, disability, central sensitization, anxiety, kinesiophobia, catastrophising, self-efficacy, sleep quality, quality of life, and health and well-being status. Exercise adherence, pain medication and other treatment modality usage, and possible adverse events related to exercises will be monitored and recorded. METHODS Thirty participants will be randomized to movement control exercise with SBTs (15 subjects in experimental group) or movement control exercise without SBTs (15 subjects in control group) in private chiropractic practice setting with two-month follow-up. Trial registration number; NCT05268822. DISCUSSION The clinical difference in effectiveness between practically identical exercise programs in uniform study settings with or without SBTs has not been studied before. This study aims to inform feasibility and help determine whether progression to a full-scale trial is worthwhile.
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Affiliation(s)
- Jani Mikkonen
- Private Practice, Mikonkatu 11, 00100, Helsinki, Finland.
- Department of Surgery (Incl. Physiatry), Institute of Clinical Medicine, University of Eastern Finland, 70211, Kuopio, Finland.
| | - Hannu Luomajoki
- ZHAW School of Health Professions, Zurich University of Applied Sciences, CH-8401, Winterthur, Switzerland
| | - Olavi Airaksinen
- Department of Surgery (Incl. Physiatry), Institute of Clinical Medicine, University of Eastern Finland, 70211, Kuopio, Finland
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000, Ghent, Belgium
| | - Ville Leinonen
- Department of Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, 70211, Kuopio, Finland
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Parsons RD, McParland JL, Halligan SL, Goubert L, Jordan A. Glass half full: A diary and interview qualitative investigation of flourishing among adolescents living with chronic pain. Eur J Pain 2023. [PMID: 37128852 DOI: 10.1002/ejp.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/17/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Counter to paediatric pain literature that typically highlights the deleterious impacts associated with adolescent chronic pain, evidence suggests that some adolescents flourish in their experience of pain. This study sought to explore how adolescents experience, understand and perceive flourishing while living with chronic pain. METHODS Twenty-four adolescents aged 11-24 years were recruited via clinical and online settings. All adolescents were asked to complete daily diary entries, with a subset of 10 participants asked to complete follow-up interviews. RESULTS Inductive reflexive thematic analysis generated two themes: 'Appreciating the moment' and 'Becoming a better version of myself'. Themes addressed how self and other comparisons facilitated a renewed appreciation for achievements and pleasures in life due to living with chronic pain. Adolescents further demonstrated a perception of continued personal and social growth in their experience of chronic pain, including increased emotional maturity, resilience, positivity, kindness and improved communication skills. CONCLUSIONS We conclude that adolescents can experience positive changes in functioning and flourish in some domains of life despite, or resulting from, chronic pain. Further research with an exclusive focus on flourishing is needed to build on this work and address this important gap in knowledge. SIGNIFICANCE We present evidence that adolescents can flourish when living with chronic pain. Such knowledge may inform the development of positive psychological treatment strategies that are focused on reinforcing adolescents' existing strengths, to expand on current treatment options for adolescents living with chronic pain.
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Affiliation(s)
- Ryan D Parsons
- Department of Psychology, University of Bath, Bath, UK
- Centre for Pain Research, University of Bath, Bath, UK
| | | | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Abbie Jordan
- Department of Psychology, University of Bath, Bath, UK
- Centre for Pain Research, University of Bath, Bath, UK
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Parsons RD, McParland JL, Halligan SL, Goubert L, Jordan A. Flourishing among adolescents living with chronic pain and their parents: A scoping review. Paediatr Neonatal Pain 2022; 4:158-168. [PMID: 36618512 PMCID: PMC9798043 DOI: 10.1002/pne2.12088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/30/2022] [Accepted: 09/22/2022] [Indexed: 12/31/2022]
Abstract
Evidence exists regarding the impact of flourishing in individuals living with chronic pain, but there are currently no reviews which collate the literature on flourishing in adolescents living with chronic pain and their parents. Therefore, the aim of this scoping review was to map and review the current literature, to document how flourishing is defined and understood in the literature, and to identify gaps in the field. Six databases were searched (Web of Science, Medline, Embase, APA PsycNet and the Cochrane Central Register of Controlled Trials). In addition, a limited gray literature search was conducted. The resulting data were collated and reported in relation to the review questions, by examining the included papers to search for the presence of flourishing. Database searches resulted in 7326 papers after duplicate removal, with eight remaining papers being assessed for full-text eligibility. Following full-text screening, a final four papers were included in the review. Within the papers, flourishing was defined in relation to commonalities of benefit finding, enhanced maturity and growth, and social support. Gaps in the literature and directions for future research are considered. This review suggests that there is a dearth of knowledge and research regarding flourishing among adolescents living with chronic pain and their parents, despite aspects of flourishing identified in limited literature. This warrants further investigation.
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Affiliation(s)
- Ryan D. Parsons
- Department of PsychologyUniversity of BathBathUK,Centre for Pain ResearchUniversity of BathBathUK
| | | | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUK,Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Liesbet Goubert
- Department of Experimental‐Clinical and Health PsychologyGhent UniversityGhentBelgium
| | - Abbie Jordan
- Department of PsychologyUniversity of BathBathUK,Centre for Pain ResearchUniversity of BathBathUK
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Jia M, Van Alboom M, Goubert L, Bracke P, Gabrys B, Musial K. Encoding edge type information in graphlets. PLoS One 2022; 17:e0273609. [PMID: 36026434 PMCID: PMC9416998 DOI: 10.1371/journal.pone.0273609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
Graph embedding approaches have been attracting increasing attention in recent years mainly due to their universal applicability. They convert network data into a vector space in which the graph structural information and properties are maximumly preserved. Most existing approaches, however, ignore the rich information about interactions between nodes, i.e., edge attribute or edge type. Moreover, the learned embeddings suffer from a lack of explainability, and cannot be used to study the effects of typed structures in edge-attributed networks. In this paper, we introduce a framework to embed edge type information in graphlets and generate a Typed-Edge Graphlets Degree Vector (TyE-GDV). Additionally, we extend two combinatorial approaches, i.e., the colored graphlets and heterogeneous graphlets approaches to edge-attributed networks. Through applying the proposed method to a case study of chronic pain patients, we find that not only the network structure of a patient could indicate his/her perceived pain grade, but also certain social ties, such as those with friends, colleagues, and healthcare professionals, are more crucial in understanding the impact of chronic pain. Further, we demonstrate that in a node classification task, the edge-type encoded graphlets approaches outperform the traditional graphlet degree vector approach by a significant margin, and that TyE-GDV could achieve a competitive performance of the combinatorial approaches while being far more efficient in space requirements.
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Affiliation(s)
- Mingshan Jia
- Complex Adaptive Systems Lab, School of Computer Science, University of Technology Sydney, Sydney, NSW, Australia
- * E-mail:
| | | | | | - Piet Bracke
- Health Psychology Lab, Ghent University, Ghent, Belgium
| | - Bogdan Gabrys
- Complex Adaptive Systems Lab, School of Computer Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Katarzyna Musial
- Complex Adaptive Systems Lab, School of Computer Science, University of Technology Sydney, Sydney, NSW, Australia
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Koechlin H, Beeckman M, Meier AH, Locher C, Goubert L, Kossowsky J, Simons LE. Association of parental and adolescent emotion-related factors with adolescent chronic pain behaviors. Pain 2022; 163:e888-e898. [PMID: 35050962 PMCID: PMC9199105 DOI: 10.1097/j.pain.0000000000002508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
ABSTRACT Chronic pain is a prevalent condition in youth, and the pain experience is strongly influenced by emotional processes. Studying emotion variability and regulation (ER) may help better understand pain behavior. As the development of emotion-related abilities predominantly takes place in the family context, examining ER within parent-adolescent dyads is important. We set out to test the association of parent and adolescent ER and adolescent emotional variability with adolescent pain behavior (ie, pain interference, activity avoidance, and activity engagement). A sample of 56 adolescents (Mage = 14.5, 85.7% women) with chronic pain and one of their parents (92.9% mothers) participated in this study. Adolescents completed baseline measures of average pain intensity, ER, and mean positive and negative affect. Furthermore, adolescents completed an electronic diary for 14 consecutive days, reporting on emotional state, activity avoidance, activity engagement, and pain interference. Parents completed measures of ER and their own history of pain. We performed a variable selection procedure, the least absolute shrinkage and selection operator method, to determine important predictors of adolescent pain behavior. Adolescent high positive affect was associated with more activity engagement, less pain interference, and less activity avoidance, indicating that positive affect might enhance the willingness to engage in activities in the presence of pain. Adolescent ER strategy emotional reappraisal and parents' own history of pain were predictors of less activity engagement. Parent ER was not related to adolescent ER. In conclusion, our results highlight the potential of enhancing positive affect as an intervention target for chronic pain.
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Affiliation(s)
- Helen Koechlin
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Melanie Beeckman
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Andrea H. Meier
- Division of Clinical Psychology and Epidemiology, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Cosima Locher
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology, Ghent University, Ghent, Belgium
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Laura E. Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
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12
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Schroeter AC, MacDonald DA, Scholten-Peeters GGM, Goubert L, Kendall E, Coppieters MW. Preferred self-administered questionnaires to assess resilience, optimism, pain acceptance and social support in people with pain. A modified Delphi study. Pain Medicine 2022; 23:1891-1901. [DOI: 10.1093/pm/pnac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
The plethora of self-administered questionnaires to assess positive psychosocial factors complicates questionnaire selection. This study aimed to identify and reach consensus on the most suitable self-administered questionnaires to assess resilience, optimism, pain acceptance and social support in people with pain.
Design
A three-round modified Delphi study.
Participants
Forty international experts.
Methods
In Round 1, the experts suggested questionnaires deemed appropriate to assess resilience, optimism, pain acceptance and/or social support. In Round 2, experts indicated whether they considered the suggested questionnaires to be suitable (Yes/No/Don’t know) to assess these psychosocial factors, taking into consideration content, feasibility, personal experience and the measurement properties which we provided for each questionnaire. Questionnaires that were considered suitable by the majority of experts (≥60%) were retained for Round 3. In Round 3, the suitability of each questionnaire was rated on a 0–10 Likert scale. Consensus was reached if ≥ 75% of experts rated the questionnaire ≥7.
Results
From the 67 questionnaires suggested in Round 1, one questionnaire could be recommended per domain. For resilience: Pain Resilience Scale; for optimism: Revised Version of the Life Orientation Test; for pain acceptance: 8-item and Revised Versions of the Chronic Pain Acceptance Questionnaire; for social support: Emotional Support Item Bank of the PROMIS tool. Consensus for these questionnaires was also reached in a sensitivity analysis which excluded the ratings of experts involved in the development, translation and/or validation of relevant questionnaires.
Conclusion
We advocate the use of these recommended questionnaires so data can be compared and pooled more easily.
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Affiliation(s)
- Andrea C Schroeter
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | - David A MacDonald
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | | | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Elizabeth Kendall
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
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13
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De Bruyne E, Eloot S, Vande Walle J, Raes A, Van Biesen W, Goubert L, Vervoort T, Snauwaert E, Van Hoecke E. Validity and reliability of the Dutch version of the PedsQL™ 3.0 End Stage Renal Disease Module in children with chronic kidney disease in Belgium. Pediatr Nephrol 2022; 37:1087-1096. [PMID: 34599378 DOI: 10.1007/s00467-021-05224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/10/2021] [Accepted: 06/29/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children with chronic kidney disease (CKD) have a low quality of life (QoL). The PedsQL™ 4.0 Generic Core Scales are widely used to assess general QoL in children. The aim of this cross-sectional study was to translate the original version of the CKD-specific PedsQL™ 3.0 End Stage Renal Disease Module into a Dutch version and to evaluate its validity and reliability. METHODS The forward-backward translation method based on the guidelines from the original developer was used to produce the Dutch version of the PedsQL™ 3.0 ESRD Module. Fifty-eight CKD patients (aged 8-18 years) and their parents (n = 31) filled in both generic and disease-specific modules. The non-clinical control group consisted of the same number of healthy children (matched for gender and age) and their parents. RESULTS Cronbach's alpha coefficients (α's) for the PedsQL™ 3.0 ESRD Module demonstrated excellent reliability for the Total Scale scores. For all 7 subscales, α's were greater than 0.60, except for Perceived Physical Appearance. Overall, intercorrelations with the PedsQL™ 4.0 Generic Core Scales were in the medium to large range, supporting construct validity. Parent proxy reports showed lower generic QoL for all domains in CKD patients compared to healthy children. Child self-reports only demonstrated lower QoL on the domain School Functioning in children with CKD compared to healthy children. CONCLUSIONS This study shows good validity and reliability for the Dutch version of the PedsQL™ 3.0 ESRD Module. However, testing with a larger study group is recommended in order to make final conclusions about the psychometric qualities of this measure. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Elke De Bruyne
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium.
| | - Sunny Eloot
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology & Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Ann Raes
- Department of Pediatric Nephrology & Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Wim Van Biesen
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tine Vervoort
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | | - Eline Van Hoecke
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
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14
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Bernardes SF, Tomé-Pires C, Brandão T, Campos L, Teixeira F, Goubert L. Classism in pain assessment and management: the mediating role of female patient dehumanization and perceived life hardship. Pain 2021; 162:2854-2864. [PMID: 33769369 DOI: 10.1097/j.pain.0000000000002278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/09/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Compared with racism and sexism, classism in pain assessment and management practices (PAMPs) has been less investigated, and its mediating mechanisms are still unknown. Drawing on a social psychological model of dehumanization, this research aimed to test (1) the effect of patient socioeconomic status (SES; a proxy of social class) on PAMPs and (2) whether patient dehumanization and perceived life hardship mediated these effects. Two online experimental studies were conducted, in which patient SES was manipulated (low vs high) within-subjects. One-hundred sixty-two female medical students (study 1) and 105 female nurses (study 2) were presented with vignettes/images depicting 2 cases of women with chronic low-back pain, followed by videos of them performing a pain-inducing movement. Participants reported on patient dehumanization, perceived life hardship, and PAMPs. The low SES patient was perceived as less pain sensitive (medical students alone) but more disabled, credible, and her pain more attributed to psychological causes (by nurses alone). Medical students recommended less nonpharmacological treatments but prescribed slightly stronger medication. Medical students were less willing to provide individualized care to the low SES patient, whereas nurses showed the opposite pattern. Patient mechanistic dehumanization mediated SES effects on pain disability (medical students alone). Perceived life hardship mediated SES effects on pain disability, credibility (nurses alone), and intentions of providing individualized care (nurses alone). These finding bear novel contributions to the fields of pain, health service research, and social psychology and have important implications to the development of more effective future interventions to reduce classism in PAMPs.
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Affiliation(s)
- Sónia F Bernardes
- Iscte-Instituto Universitário de Lisboa, Centro de Investigação e Intervenção Social, Lisbon, Portugal
| | - Catarina Tomé-Pires
- CIP-Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisbon, Portugal
| | - Tânia Brandão
- CIP-Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisbon, Portugal
| | - Lúcia Campos
- Instituto de Ciências Sociais, Universidade de Lisboa, Lisbon, Portugal
| | - Filipa Teixeira
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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15
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Beeckman M, Hughes S, Van der Kaap-Deeder J, Plasschaert F, Michielsen J, Moens P, Schelfaut S, Goubert L. Risk and Resilience Predictors of Recovery After Spinal Fusion Surgery in Adolescents. Clin J Pain 2021; 37:789-802. [PMID: 34419974 DOI: 10.1097/ajp.0000000000000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This prospective study examined risk and resilience predictors of pain and functional recovery in the first 6 months after spinal fusion surgery in adolescents. METHODS Adolescents with adolescent idiopathic scoliosis undergoing spinal fusion surgery (n=100, aged 12 to 18 y, 77% girls) completed assessments before surgery and at 3 weeks, 6 weeks, and 6 months after surgery. Recovery trajectories in pain, health-related quality of life (HRQOL), and objectively registered physical activity were identified. Presurgical pain catastrophizing and pain intensity (risk), and psychological flexibility, and postsurgical pain acceptance (resilience) were examined as predictors of recovery. RESULTS Latent growth class analyses revealed 4 distinct pain recovery trajectories (ie, Severe-Moderate [11%, n=9], Mild-No [58%, n=49], Moderate-Mild [24%, n=20], and Moderate-Severe [7%, n=6] pain trajectory), 2 HRQOL recovery trajectories; 2 trajectories characterizing recovery in average daily physical activity at moderate-to-vigorous intensity (MVPA); and 3 trajectories characterizing recovery in total physical activity volume characterized by the average daily number of steps. Subsequent multivariate analyses of variance revealed that presurgical pain intensity (partial η2=0.21, P<0.001) and pain catastrophizing (partial η2=0.13, P<0.01) were both predictive of poorer recovery in HRQOL, and pain catastrophizing additionally predicted poorer pain recovery (partial η2=0.15, P<0.05). Psychological flexibility (partial η2=0.25, P<0.001) and postsurgical pain acceptance (partial η2=0.07, P<0.05) were predictive of more favorable recovery trajectories in HRQOL, and psychological flexibility additionally predicted more favorable recovery trajectories in postsurgical pain (partial η2=0.15, P<0.05). Daily MVPA trajectories were not significantly predicted by any of the hypothesized factors, while presurgical pain catastrophizing levels were predictive of a delayed recovery trajectory in the daily amount of steps (partial η2=0.17 P<0.01). CONCLUSIONS Presurgical screening could include assessment of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance to identify adolescents who are at risk for poorer recovery. These are potentially modifiable factors that can be targeted in presurgical interventions to prevent poor and foster adaptive outcomes after major surgery in adolescents.
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Affiliation(s)
| | - Sean Hughes
- Experimental-Clinical and Health Psychology, Ghent University
| | | | - Frank Plasschaert
- Department of Orthopedics and Traumatology, Ghent University Hospital, Ghent
| | | | - Pierre Moens
- Department of Orthopedics, Leuven University Hospital, Leuven, Belgium
| | | | - Liesbet Goubert
- Experimental-Clinical and Health Psychology, Ghent University
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16
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Demoulin C, Gabriel L, Nève de Mévergnies O, Henket L, Roussel N, Goubert L, Vanderthommen M, Pitance L. Several low back pain-related misbeliefs are still around in 2020: A cross-sectional survey in Belgium. Physiother Res Int 2021; 27:e1927. [PMID: 34706135 DOI: 10.1002/pri.1927] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/09/2021] [Accepted: 10/09/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Low back pain (LBP)-related misbeliefs are known to be among risk factors for LBP chronification and for persistence of chronic pain. The main objective of this study was to investigate the current LBP-related beliefs in the general population in Belgium, considering the fact that the last survey in Belgium about the topic was conducted more than 15 years ago. METHODS A cross-sectional study design was used. Belgian adults (>17 years old) were recruited in the three regions of the country by means of non-probabilistic recruitment methods. Participants were invited to fill in a battery of questionnaires including demographic questions as well as questions about their LBP history and the LBP Beliefs Questionnaire (LBPBQ). RESULTS A total of 3724 individuals participated in the study. The LBPBQ scores indicated several LBP-related misbeliefs. About 15%-25% of participants still think that imaging tests can always identify the cause of pain and that bed rest is the mainstay of therapy. The majority of the participants think that "unnecessary" movements should be avoided when having LBP (58% of the respondents), and that they should "take it easy" until the pain goes away (69%). Most respondents also had maladaptive/wrong expectations, for example, a systematic worsening with time (65%) and a need for surgery in case of disc herniation (54%). CONCLUSIONS The present study suggests that in 2020 several LBP-related misbeliefs are still current in Belgium, particularly regarding the vulnerability of the spine. Therefore, further efforts to improve LBP-related beliefs/knowledge in the general population are necessary.
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Affiliation(s)
- Christophe Demoulin
- Department of Sport and Rehabilitation Sciences, University of Liege, Liege, Belgium.,Spine Clinics, Liege University Hospital Center, Liege, Belgium.,Faculty of Motor Sciences, UCLouvain, Université Catholique de Louvain-La-Neuve, Louvain, Belgium
| | - Laura Gabriel
- Faculty of Motor Sciences, UCLouvain, Université Catholique de Louvain-La-Neuve, Louvain, Belgium
| | | | - Laura Henket
- Department of Sport and Rehabilitation Sciences, University of Liege, Liege, Belgium
| | - Nathalie Roussel
- Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Marc Vanderthommen
- Department of Sport and Rehabilitation Sciences, University of Liege, Liege, Belgium.,Spine Clinics, Liege University Hospital Center, Liege, Belgium
| | - Laurent Pitance
- Faculty of Motor Sciences, UCLouvain, Université Catholique de Louvain-La-Neuve, Louvain, Belgium
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17
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Caes L, van Gampelaere C, Van Hoecke E, Van Winckel M, Kamoen K, Goubert L. Parental Catastrophizing and Goal Pursuit in the Context of Child Chronic Pain: A Daily Diary Study. Front Psychol 2021; 12:680546. [PMID: 34276501 PMCID: PMC8281243 DOI: 10.3389/fpsyg.2021.680546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Despite daily variability in children's chronic pain experiences, little is known about how parents' emotions and goals toward their child's pain are influenced by these daily changes. This diary study examined how daily child pain intensity (as perceived by parents) moderates the associations between parental catastrophic thoughts about child pain on the one hand, and daily parental distress and parents' goals with regard to their child's pain (pain control vs. activity engagement) on the other hand. Method: Participants were 25 parents of 20 different children (N = 18; 90% girls). Children, aged 8–14 years (M = 9.5, SD = 2.09), experienced either chronic headache or functional abdominal pain with an average pain duration of 22.5 months (SD = 24.5 months). Daily parental responses (i.e., perceived child pain intensity, distress and goal endorsement) were collected through a 3-week daily diary (resulting in 413 valid diary reports). Parents completed the Pain Catastrophizing Scale for Parents prior to starting the diary (PCS-P general) and a daily measure (PCS-P daily) included in the diary. To account for the interdependence of the data, the data were analyzed using multilevel modeling. Results: Perceived daily child pain intensity moderated the impact of parental general and daily catastrophic thoughts on parents' daily distress. Only for parents experiencing low general catastrophic thoughts an increase in distress was observed on days when they perceived their child's pain intensity as high. For all parents, high levels of perceived child pain intensity were related to more distress on days where parents reported high levels of catastrophic thinking (i.e., PCS-P daily). Perceived daily child pain intensity also moderated the impact of parental general catastrophic thinking on parents' daily endorsement of goals. Parents with high levels of general catastrophic thinking reported a lower focus on child pain control on days when child pain intensity was perceived to be low. Parents with low general catastrophic thinking reported lower endorsement of the activity engagement goal on days where the child's pain intensity was perceived to be low. Conclusion: These findings highlight the complexity of daily fluctuations in parental distress and goals regarding their child's pain. Clinical implications and future directions are critically assessed.
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Affiliation(s)
- Line Caes
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Cynthia van Gampelaere
- Department of Experimental, Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Eline Van Hoecke
- Pediatric Psychology, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - Myriam Van Winckel
- Department of Internal Medicine and Pediatric, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | | | - Liesbet Goubert
- Department of Experimental, Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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18
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Van Alboom M, De Ruddere L, Kindt S, Loeys T, Van Ryckeghem D, Bracke P, Mittinty MM, Goubert L. Well-being and Perceived Stigma in Individuals With Rheumatoid Arthritis and Fibromyalgia: A Daily Diary Study. Clin J Pain 2021; 37:349-358. [PMID: 33734147 DOI: 10.1097/ajp.0000000000000929] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The presence or absence of clearly defined symptoms and underlying pathophysiology may be a crucial variable related to variability in well-being and stigmatization in individuals with chronic pain (ICPs). In the context of pain, absence of clearly defined symptoms and pathophysiology deviates from the widely endorsed biomedical model and as such, may lead to stigmatization, which in turn could be related to ICPs' well-being. OBJECTIVES The present study compared physical, psychological, social well-being, and perceived stigmatization in individuals with clearly defined symptoms and underlying pathophysiology (rheumatoid arthritis, RA) and individuals with less well understood symptoms and pathophysiology (fibromyalgia, FM) using daily diaries. Furthermore, the association between daily perceived stigmatization and daily well-being was examined. MATERIALS AND METHODS Seventy-nine participants with FM, 86 participants with RA, and 33 participants with both diagnoses completed a diary for 14 consecutive days. RESULTS Compared to individuals with RA, individuals with FM and individuals with both diagnoses reported worse daily well-being. After controlling for age, pain duration, and daily pain, differences between FM and RA remained significant for social well-being and completion of plans. Differences between RA and the dual diagnosis group remained significant for completion of plans, negative affect, and isolation. Furthermore, results suggested more stigmatization in individuals with FM than in individuals with RA. Individuals with both diagnoses reported equal stigmatization as individuals with FM, but more stigmatization than individuals with RA. Finally, increased levels of perceived stigma were associated with lower well-being. DISCUSSION Findings highlight that the absence of clearly defined symptoms and pathophysiology could be contributing to greater feelings of stigmatization, which may be detrimental for ICPs' well-being.
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Affiliation(s)
| | | | - Sara Kindt
- Department of Applied Health and Lifestyle Sciences, University of Applied Sciences, Bruges, Belgium
| | | | - Dimitri Van Ryckeghem
- Departments of Experimental-Clinical and Health Psychology
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - Manasi M Mittinty
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia
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19
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Van Schoors M, Sels L, Goubert L, Verhofstadt LL. Siblings Dealing with Pediatric Cancer: A Family- and Context-oriented Approach. J Pediatr Oncol Nurs 2021; 38:166-175. [PMID: 33792425 DOI: 10.1177/1043454221992303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Pediatric cancer is a severe life-threatening disease that poses significant challenges to the life of the siblings. Based on the social ecology model, the current study is aimed at exploring the association between intrafamilial (family functioning, family support) and contextual (network support) resources, and the individual adjustment of siblings facing cancer in their brother/sister. Methods: Participants were 81 siblings of children with leukemia or non-Hodgkin lymphoma. The mean siblings' age was 10.32 years. Siblings completed the Family Environment Scale, the Social Support Questionnaire for Children, the Situation-Specific Emotional Reactions Questionnaire, and the Pediatric Quality of Life Inventory. Data were analyzed using a multi-level approach. Results: Family functioning, family support, and network support proved to be related to siblings' cancer-related emotional reactions post-diagnosis. In addition, the present study suggests taking into account the gender of the ill child and the age of the siblings. Discussion: Our findings led to the conclusion that resources at both the intrafamilial level and the contextual level are important for explaining sibling adjustment post-diagnosis. Interventions targeting the sibling, the family, and the external network are warranted to enhance sibling adjustment.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
| | - Laura Sels
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
| | - Lesley L Verhofstadt
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, 26656Ghent University, Ghent, Belgium
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20
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Beeckman M, Simons LE, Hughes S, Loeys T, Goubert L. A Network Analysis of Potential Antecedents and Consequences of Pain-Related Activity Avoidance and Activity Engagement in Adolescents. Pain Med 2021; 21:e89-e101. [PMID: 31498397 DOI: 10.1093/pm/pnz211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain. METHODS Adolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor. RESULTS Activity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement. CONCLUSIONS This study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.
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Affiliation(s)
- Melanie Beeckman
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Laura E Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sean Hughes
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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21
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Abstract
INTRODUCTION Prevention and treatment of pain in pediatric patients compared with adults is often not only inadequate but also less often implemented the younger the children are. Children 0 to 17 years are a vulnerable population. OBJECTIVES To address the prevention and treatment of acute and chronic pain in children, including pain caused by needles, with recommended analgesic starting doses. METHODS This Clinical Update elaborates on the 2019 IASP Global Year Against Pain in the Vulnerable "Factsheet Pain in Children: Management" and reviews best evidence and practice. RESULTS Multimodal analgesia may include pharmacology (eg, basic analgesics, opioids, and adjuvant analgesia), regional anesthesia, rehabilitation, psychological approaches, spirituality, and integrative modalities, which act synergistically for more effective acute pediatric pain control with fewer side effects than any single analgesic or modality. For chronic pain, an interdisciplinary rehabilitative approach, including physical therapy, psychological treatment, integrative mind-body techniques, and normalizing life, has been shown most effective. For elective needle procedures, such as blood draws, intravenous access, injections, or vaccination, overwhelming evidence now mandates that a bundle of 4 modalities to eliminate or decrease pain should be offered to every child every time: (1) topical anesthesia, eg, lidocaine 4% cream, (2) comfort positioning, eg, skin-to-skin contact for infants, not restraining children, (3) sucrose or breastfeeding for infants, and (4) age-appropriate distraction. A deferral process (Plan B) may include nitrous gas analgesia and sedation. CONCLUSION Failure to implement evidence-based pain prevention and treatment for children in medical facilities is now considered inadmissible and poor standard of care.
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Affiliation(s)
- Stefan J Friedrichsdorf
- Center of Pain Medicine, Palliative Care and Integrative Medicine, University of California at San Francisco (UCSF), Benioff Children's Hospitals in Oakland and San Francisco, Kalifornien, USA.
- Department of Pain Medicine, Palliative Care and Integrative Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA.
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Gent, Belgien
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22
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Kindt S, Goubert L, Ruddere LD, Cano A, Vansteenkiste M. "What Should I Do First?" The Effect of Manipulated Goal Conflict on Affect, Motivation, and Helping Behavior in Chronic Pain Couples. J Pain 2020; 21:1187-1197. [PMID: 32544601 DOI: 10.1016/j.jpain.2020.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 12/20/2019] [Accepted: 01/26/2020] [Indexed: 10/24/2022]
Abstract
Although support provision by a partner is an important resource for individuals with chronic pain (ICPs), it poses a challenge for partners because it competes with other important personal goals of partners. The current study examined the impact of experimentally induced goal conflict in partners on their motives for helping, quality of provided help, and on partners' and ICPs' affect. Sixty-eight couples, with at least one person having chronic pain, performed 2 series of household activities, with partners either asked to be simply available for help (ie, control condition) or to additionally work on a puzzle task (ie, goal conflict condition). Couples reported on interpersonal (eg, helping motives) and intrapersonal (eg, affect) outcomes. In addition, quality of partners' helping behavior and ICPs' pain behavior were videotaped and coded afterward. In the goal conflict condition, ICPs were less satisfied with the received help and they experienced more pain. Also, the quality of the provided help was lower and partners experienced less positive and more negative affect. Addressing partners' goal conflict in clinical practice may help to avoid its negative impact on both ICPs and partners. Perspective: This article provides a compelling argument to include partners in chronic pain treatment by demonstrating the detrimental effects of partners' experienced conflicts in goals upon the quality of help they provide, partners' affective functioning, and ICPs' pain-related outcomes.
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Affiliation(s)
- Sara Kindt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Lies De Ruddere
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Annmarie Cano
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Maarten Vansteenkiste
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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23
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Beeckman M, Hughes S, Van Ryckeghem D, Van Hoecke E, Dehoorne J, Joos R, Goubert L. Resilience Factors in Children with Juvenile Idiopathic Arthritis and Their Parents: The Role of Child and Parent Psychological Flexibility. Pain Med 2020; 20:1120-1131. [PMID: 30256982 DOI: 10.1093/pm/pny181] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Chronic pain is central to juvenile idiopathic arthritis (JIA) and is predictive of impaired functioning. Whereas most work has focused on identifying psychosocial risk factors for maladaptive outcomes, we explored the idea that child and parental psychological flexibility (PF) represent resilience factors for adaptive functioning of the child. We also explored differences between general vs pain-specific PF in contributing to child outcomes. METHODS Children with JIA (age eight to 18 years) and (one of) their parents were recruited at the Department of Pediatric Rheumatology at the Ghent University Hospital in Belgium. They completed questionnaires assessing child and parent general and pain-specific PF and child psychosocial and emotional functioning and disability. RESULTS The final sample consisted of 59 children and 48 parents. Multiple regression analyses revealed that child PF contributed to better psychosocial functioning and less negative affect. Child pain acceptance contributed to better psychosocial functioning, lower levels of disability, and lower negative affect, and also buffered the negative influence of pain intensity on disability. Bootstrap mediation analyses demonstrated that parental (general) PF indirectly contributed to child psychosocial functioning and affect via the child's (general) PF. Parent pain-specific PF was indirectly linked to child psychosocial functioning, disability, and negative affect via child pain acceptance. CONCLUSIONS Our findings indicate that child and parental PF are resilience factors and that pain acceptance buffers the negative impact of pain intensity. Implications for psychosocial interventions that target (pain-specific) PF in children and parents are discussed.
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Affiliation(s)
- Melanie Beeckman
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sean Hughes
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Dimitri Van Ryckeghem
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Institute for Health and Behaviour, INSIDE, University of Luxembourg, Maison des Sciences Humaines, Esch-sur-Alzette, Luxembourg
| | - Eline Van Hoecke
- Department of Pediatric Psychology, Ghent University Hospital, Ghent, Belgium
| | - Joke Dehoorne
- Department of Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Rik Joos
- Department of Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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24
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Mittinty MM, Kindt S, Mittinty MN, Bernardes S, Cano A, Verhofstadt L, Goubert L. Corrigendum to: A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study. Pain Med 2020; 21:880. [PMID: 31758691 DOI: 10.1093/pm/pnz332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Manasi M Mittinty
- Pain Management Research Institute, The University of Sydney, Sydney, Australia.,Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sarah Kindt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Murthy N Mittinty
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Sonia Bernardes
- Department of Social and Organisational Psychology, Instituto Universitario de Lisboa, Lisbon, Portugal
| | - Annmarie Cano
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Lesley Verhofstadt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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25
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Van Gampelaere C, Luyckx K, Van Ryckeghem DML, van der Straaten S, Laridaen J, Goethals ER, Casteels K, Vanbesien J, den Brinker M, Cools M, Goubert L. Mindfulness, Worries, and Parenting in Parents of Children With Type 1 Diabetes. J Pediatr Psychol 2020; 44:499-508. [PMID: 30590544 DOI: 10.1093/jpepsy/jsy094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/31/2018] [Accepted: 11/05/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Parents of children with type 1 diabetes (T1D) often experience distress and worries, which may negatively impact their parenting behaviors. The current study investigates parental mindfulness (i.e., an enhanced attention to and awareness of current experiences or present reality) as a resilience mechanism. Using a daily diary approach, the predictive role of parental mindfulness for daily diabetes-related worries was examined, its impact upon protective parenting behaviors, and its buffering role in the relationship between daily worries and protective parenting behaviors. METHODS Participants were 56 parents of 40 children with T1D (2-12 years). Trait mindfulness was assessed with the Mindful Attention Awareness Scale. Subsequently, parents completed a diary for 14 consecutive days, assessing parental worries about hypo- and hyperglycemia and general and diabetes-specific parental protective behavior. RESULTS Multilevel analyses showed that parental diabetes-related worries fluctuated substantially across days and positively predicted daily protective behavior. Higher levels of parental mindfulness predicted less daily worries about hypoglycemia and lower engagement in general protective behavior and hypoglycemia avoidance behavior. In addition, the relationship between worries about hyperglycemia and general protective behavior was moderated by parental mindfulness. CONCLUSIONS The present findings highlight the importance of daily parental worries in explaining parental protective behaviors on a daily basis. Mindfulness emerged as a promising resilience factor in parents of children with T1D, resulting in less daily worries and protective parenting. These results have important clinical implications and point to the promising role of mindfulness interventions in this context.
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Affiliation(s)
| | - Koen Luyckx
- Department of School Psychology and Development in Context, University of Leuven.,UNIBS, University of the Free State
| | - Dimitri M L Van Ryckeghem
- Department of Experimental, Clinical and Health Psychology, Ghent University.,Institute for Health and Behavior, INSIDE, University of Luxembourg
| | | | - Jolien Laridaen
- Department of Medical Child and Adolescent Psychology, Ghent University Hospital
| | - Eveline R Goethals
- Department of School Psychology and Development in Context, University of Leuven.,Department of Pediatric Diabetes, University Hospital Leuven.,Joslin Diabetes Center, Harvard Medical School, Boston, United States of America
| | - Kristina Casteels
- Department of Pediatric Diabetes, University Hospital Leuven.,Department of Development and Regeneration, University of Leuven
| | | | | | - Martine Cools
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital.,Department of Internal Medicine and Pediatrics, Ghent University
| | - Liesbet Goubert
- Department of Experimental, Clinical and Health Psychology, Ghent University
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26
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Van Gampelaere C, Luyckx K, van der Straaten S, Laridaen J, Goethals ER, Casteels K, Vanbesien J, den Brinker M, Depoorter S, Klink D, Cools M, Goubert L. Families with pediatric type 1 diabetes: A comparison with the general population on child well-being, parental distress, and parenting behavior. Pediatr Diabetes 2020; 21:395-408. [PMID: 31697435 DOI: 10.1111/pedi.12942] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/18/2019] [Accepted: 10/28/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS The aim of this study was to compare families with a child (2-12 years) with type 1 diabetes (T1D) to families which are not confronted with chronic illness, with regard to children's well-being, parental distress, and parenting behavior. In addition, differences were explored between families whose child has optimal vs suboptimal glycemic control. METHODS Mothers, fathers, and children of 105 families with pediatric T1D completed questionnaires assessing child well-being, parental distress, and parenting. The control group consisted of 414 families without chronic illness. RESULTS With regard to child well-being, children with T1D had more adjustment difficulties (as reported by mothers) and lower quality of life (QoL) (as reported by mothers and fathers), whereas children themselves (8-12 years) reported higher QoL compared to controls. In terms of parental distress, mothers, but not fathers, of children with T1D reported more stress, anxiety symptoms, and depressive symptoms than controls. With regard to parenting behavior, parent reports revealed less protectiveness in fathers and less autonomy support and responsiveness in both parents as compared to controls. No differences were found in parent-reported psychological control between parents of children with and without T1D, but children with T1D perceived lowered parental psychological control. Lastly, secondary analyses indicated that especially families with suboptimal child glycemic control showed more maternal distress and worse child well-being (according to parents). CONCLUSIONS Families confronted with pediatric T1D differ from families without chronic illness: childhood T1D impacts parental perceptions of child well-being and differentially affects mothers' and fathers' distress levels and behaviors.
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Affiliation(s)
- Cynthia Van Gampelaere
- Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Koen Luyckx
- Department of School Psychology and Development in Context, University of Leuven, Leuven, Belgium.,UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Saskia van der Straaten
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Jolien Laridaen
- Department of Medical Child and Adolescent Psychology, Ghent University Hospital, Ghent, Belgium
| | - Eveline R Goethals
- Department of School Psychology and Development in Context, University of Leuven, Leuven, Belgium.,Department of Pediatric Diabetes, University Hospital Leuven, Leuven, Belgium.,Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Kristina Casteels
- Department of Pediatric Diabetes, University Hospital Leuven, Leuven, Belgium.,Department of Development and Regeneration, University of Leuven, Leuven, Belgium
| | - Jesse Vanbesien
- Department of Pediatrics, University Hospital Brussels, Brussel, Belgium
| | - Marieke den Brinker
- Department of Pediatrics Division of Pediatric Endocrinology and Diabetology, University Hospital Antwerp, Edegem, Belgium
| | - Sylvia Depoorter
- Department of Child Endocrinology, General Hospital Sint-Jan Bruges-Ostend, Bruges, Belgium
| | - Daniel Klink
- Department of Child Endocrinology, Queen Paola Children's Hospital, Antwerp, Belgium
| | - Martine Cools
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium
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27
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Van Lierde E, Goubert L, Vervoort T, Hughes G, Van den Bussche E. Learning to fear pain after observing another's pain: An experimental study in schoolchildren. Eur J Pain 2019; 24:791-806. [PMID: 31886912 DOI: 10.1002/ejp.1529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 11/14/2019] [Accepted: 12/24/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Children of individuals with chronic pain have an increased vulnerability to experience pain problems, possibly through observation of pain in their parents. As pain-related fear (PRF) is a critical factor in the development and maintenance of chronic pain, the current experimental study examined the acquisition of PRF through observational learning and subsequent extinction after first-hand experience of the feared stimulus. METHODS Healthy children (8-16 years) observed either their mother or a stranger performing two cold pressor tasks (CPT) filled with coloured water. In a differential conditioning procedure, one colour (CS+) was combined with genuine painful facial expressions and the other colour (CS-) with neutral facial expressions. Following this observation phase, children performed both CPTs (10°C) themselves. RESULTS Children expected the CS+ to be more painful than the CS- and they reported being more afraid and hesitant to immerse in the CS+ compared to the CS-. Moreover, this fear was reflected in children's level of arousal in anticipation of CPT performance. This learned association extinguished after performing both CPTs. Effects were not moderated by whether the child observed their mother or a stranger, by the child's pain catastrophizing, trait PRF or trait anxiety. Remarkably, learning effects increased when the child perceived a larger difference between the model's painful and neutral facial expressions. CONCLUSIONS This study provides evidence for observational learning of PRF and subsequent extinction in schoolchildren. This acquisition of PRF by observing parental pain may contribute to vulnerabilities in children of parents with chronic pain. SIGNIFICANCE Children may acquire pain-related fear by observing pain in others and this learned fear can diminish after first-hand experience. Remarkably, observational learning did not depend on the children's relationship with the model, but it did depend on the intensity of pain that is perceived. A better understanding of the impact of observing (parental) pain may help clarify the intergenerational transmission of risk for pain and inform the development of preventive programs.
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Affiliation(s)
- Elke Van Lierde
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tine Vervoort
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Gethin Hughes
- Department of Psychology, University of Essex, Colchester, UK
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28
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Van Schoors M, De Mol J, Verhofstadt LL, Goubert L, Van Parys H. The family practice of support-giving after a pediatric cancer diagnosis: A multi-family member interview analysis. Eur J Oncol Nurs 2019; 44:101712. [PMID: 31838320 DOI: 10.1016/j.ejon.2019.101712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 11/26/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Pediatric cancer presents many challenges to the life of the child diagnosed with cancer and his/her family. Among the studies investigating risk and protective factors, social support has emerged as an important construct. However, little is known on how family members support each other in this particular context. METHOD In order to further explore this process, interviews were performed separately with mothers, fathers and siblings. For the purpose of this study (as this is part of a larger project), data from four families in which both parents and at least one sibling participated, were used. Multi Family Member Interview Analysis was used as the methodological framework to analyze the individual interviews, allowing a detailed and systematic analysis of shared family experiences. RESULTS The analysis of the data revealed three themes: Being together matters: the families identified the need of being physically together; Finding support in (not) talking: the complexity of sharing emotions was explained and Working together as a team: the families described working together as a team in order to get everything organized. CONCLUSIONS This study broadens our understanding of the interpersonal process of family support-giving when facing pediatric cancer. When meeting with families, families should be invited as a unit in order to best capture family level experiences. Also, clinicians should be sensitive to the different cancer-related communication needs within the family (i.e., the need to talk or not to talk) and incorporate this knowledge into their care.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Jan De Mol
- Department of Clinical Psychology Université Catholic de Louvain, Louvain-la-Neuve, Belgium.
| | - Lesley L Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Hanna Van Parys
- Department of Psychiatry Ghent University Hospital, Ghent, Belgium.
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29
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Van Schoors M, De Paepe AL, Lemiere J, Morez A, Norga K, Lambrecht K, Goubert L, Verhofstadt LL. Family Adjustment When Facing Pediatric Cancer: The Role of Parental Psychological Flexibility, Dyadic Coping, and Network Support. Front Psychol 2019; 10:2740. [PMID: 31920799 PMCID: PMC6914864 DOI: 10.3389/fpsyg.2019.02740] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/20/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Pediatric cancer is a life-threatening disease that poses significant challenges to the life of all family members (diagnosed child, parents, and siblings) and the family as a whole. To date, limited research has investigated family adjustment when facing pediatric cancer. The aim of the current study was to explore the role of protective factors at the individual (parental psychological flexibility), intrafamilial (dyadic coping) and contextual level (network support) in explaining family adjustment as perceived by parents of children with leukemia or non-Hodgkin lymphoma. In addition, we were interested to see whether these protective factors could be predictive for family adjustment at a later time point. METHOD Participants were 70 mothers and 53 fathers (80 families) of children with leukemia or non-Hodgkin lymphoma. Mean time since diagnosis was 5.26 (T1) and 18.86 (T2) months post-diagnosis. Parents completed the Acceptance and Action Questionnaire II (to assess psychological flexibility), Dyadic Coping Inventory, a network support questionnaire, Impact on Family Scale and the Family Adjustment Scale. Both concurrent and prospective association models were tested. RESULTS Psychological flexibility, dyadic coping and network support proved to be cross-sectionally and positively related to parents' perception of family adjustment post-diagnosis; psychological flexibility and dyadic coping proved to predict better family adjustment over time. CONCLUSION Our findings led to the conclusion that protective factors at all three levels (individual, intrafamilial and contextual) are important for explaining family adjustment as perceived by parents facing a diagnosis of cancer in their child. Interventions targeting the individual, couple, as well as family level are warranted to enhance family adjustment.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Annick Lena De Paepe
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium
- KU Leuven, Leuven, Belgium
| | - Ann Morez
- Department of Pediatric Hemato-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Koenraad Norga
- Department of Pediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
| | - Karolien Lambrecht
- Department of Pediatric Hemato-Oncology and Immunology, University Hospital Brussels, Brussels, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Lesley L. Verhofstadt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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30
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Mittinty MM, Kindt S, Mittinty MN, Bernardes S, Cano A, Verhofstadt L, Goubert L. A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study. Pain Medicine 2019; 21:e102-e113. [DOI: 10.1093/pm/pnz267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract
Objective
Dyadic coping is a process of coping within couples that is intended not only to support the patient with chronic pain but also to maintain equilibrium in the relationship. This study aims to investigate the effect of patient-perceived and spouse-reported dyadic coping on both the patient and their partner’s relationship quality and anxiety, stress, and depression over time.
Methods
One hundred thirty-nine couples, with one partner experiencing chronic pain, participated in this study. Spanning three measurements over six months, couples reported on their anxiety, stress, depression, relationship quality, and dyadic coping.
Results
Patient-perceived supportive dyadic coping was positively associated with both partners’ relationship quality but was negatively associated with spouses’ stress over time. Patient-perceived negative dyadic coping was negatively associated with both partners’ relationship quality and positively associated with patients’ depression and spouses’ depression and stress over time. Spouse-reported supportive dyadic coping showed a positive association with their own relationship quality and a negative association with spouses’ depression at baseline and patients’ depression at three-month follow-up. Spouse-reported negative dyadic coping was negatively associated with their relationship quality at baseline and positively associated with their partner’s anxiety and stress at six-month and three-month follow-up, respectively. Similar inference was observed from the findings of growth curve model.
Conclusions
As compared with spouse report, patient perception of dyadic coping is a better predictor of both partners’ relationship quality and psychological outcomes over time. Both partners may benefit from early psychosocial intervention to improve their dyadic coping, relationship quality, and psychological outcomes.
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Affiliation(s)
- Manasi M Mittinty
- Pain Management Research Institute, The University of Sydney, Sydney, Australia
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sara Kindt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Murthy N Mittinty
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Sonia Bernardes
- Department of Social and Organisational Psychology, Instituto Universitario de Lisboa, Lisbon, Portugal
| | - Annmarie Cano
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Lesley Verhofstadt
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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31
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Beeckman M, Simons LE, Hughes S, Loeys T, Goubert L. Investigating How Parental Instructions and Protective Responses Mediate the Relationship Between Parental Psychological Flexibility and Pain-Related Behavior in Adolescents With Chronic Pain: A Daily Diary Study. Front Psychol 2019; 10:2350. [PMID: 31681125 PMCID: PMC6811655 DOI: 10.3389/fpsyg.2019.02350] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background Parental behavior can influence how well adolescents cope with chronic pain. Previous research has largely focused on how parents negatively impact adolescent functioning. Yet more recent work suggests that parents - and particularly parental psychological flexibility - can foster better adolescent pain-related functioning. In this study we examined if parental protective responses and instructions to engage in activities in the presence of pain mediate the impact of parental psychological flexibility and acceptance of adolescent pain on adolescents' daily pain-related behavior. Method Fifty-six adolescents with chronic pain (M age = 14.5 years, 86% girls) and one of their parents (93% mothers) were recruited at initial evaluation at two pediatric pain clinics in the US. Parents completed baseline questionnaires assessing psychologically flexible parenting and acceptance of adolescent pain. Next, parents and adolescents completed a 14-day self-report diary assessing adolescent activity-avoidance and activity-engagement in the presence of pain (adolescent report), and parental protective responses and instructions for their adolescent to engage in activities (parent report). Results Psychologically flexible parenting and acceptance of adolescent pain in parents were indirectly related to lower daily adolescent activity-avoidance, via their negative association with daily parental protective responses. Positive associations also emerged between baseline psychologically flexible parenting and overall levels of adolescent activity-engagement via its negative association with overall levels of parental protectiveness across the 14-day period. Psychologically flexible parenting and parental acceptance of adolescent pain were also indirectly related to daily decreases in adolescent activity-avoidance via their association with daily increases in parental activity-engagement instructions. These baseline parental resilience factors were also positively related to overall levels of parental engagement instructions, a route via which an indirect association with both higher overall activity-engagement as well as higher overall activity-avoidance in the adolescent was observed. Conclusion Our findings suggest an (indirect) adaptive role of parental psychological flexibility on adolescent daily pain-related behavior via its impact on parental protective behavior. If our findings replicate, they would suggest that these parental behaviors could be targeted in pain treatments that include both adolescents and their parents. Future research could further examine the impact of parental instructions on pain-related behavior in adolescents with chronic pain.
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Affiliation(s)
- Melanie Beeckman
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Laura E Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Sean Hughes
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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32
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Mehok LE, Miller MM, Trost Z, Goubert L, De Ruddere L, Hirsh AT. Pain Intensity And Attribution Mediate The Impact Of Patient Weight And Gender On Activity Recommendations For Chronic Pain. J Pain Res 2019; 12:2743-2753. [PMID: 31571978 PMCID: PMC6756840 DOI: 10.2147/jpr.s218761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/30/2019] [Indexed: 11/23/2022] Open
Abstract
Background and purpose Despite the notable benefits of physical activity for chronic pain, a large proportion of patients with chronic pain report that they do not receive activity-related recommendations from their providers. Research suggests that patient factors such as weight and gender influence activity-related recommendations for chronic pain. Research also suggests that appraisals of the intensity and cause of pain may explain these weight and gender effects. We investigated the influence of patient weight and gender on observers’ likelihood of recommending activity-related treatments for pain. We also explored the mediating effects of observers’ ratings of pain severity and the extent to which pain was due to medical and lifestyle factors (pain attribution). Patients and methods Healthy young adults (N=616; 76% female) viewed videos (Ghent Pain Videos of Daily Activities) and vignettes of 4 patients with chronic back pain performing a standardized functional task. Patients varied by gender (female, male) and weight (normal, obese), but were otherwise equivalent on demographic characteristics and pain behaviors. Participants rated how much pain they perceived the patients to be experiencing, the extent to which they attributed the pain to medical and lifestyle factors, and their likelihood of recommending exercise, physical therapy (PT), and rest. Results Patient weight and gender significantly interacted to influence exercise, PT, and rest recommendations. Both pain intensity and pain attribution mediated the relationships between patient weight and activity recommendations; however, these mediation effects differed across gender and recommendation type. Conclusion Patient weight and gender influenced laypeople’s activity recommendations for chronic pain. Moreover, the results suggest that observers’ perceptions of pain intensity and pain attributions are mechanisms underlying these effects. If these findings are replicated in providers, interventions may need to be developed to reduce provider biases and increase their recognition of the benefits of physical activity for chronic pain.
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Affiliation(s)
- Lauren E Mehok
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, USA
| | - Megan M Miller
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, USA
| | - Zina Trost
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Lies De Ruddere
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Adam T Hirsh
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, USA
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Beeckman M, Hughes S, Kissi A, Simons LE, Goubert L. How an Understanding of Our Ability to Adhere to Verbal Rules Can Increase Insight Into (Mal)adaptive Functioning in Chronic Pain. The Journal of Pain 2019; 20:1141-1154. [DOI: 10.1016/j.jpain.2019.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/12/2019] [Accepted: 02/23/2019] [Indexed: 12/15/2022]
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Brandão T, Campos L, de Ruddere L, Goubert L, Bernardes SF. Classism in Pain Care: The Role of Patient Socioeconomic Status on Nurses’ Pain Assessment and Management Practices. Pain Medicine 2019; 20:2094-2105. [DOI: 10.1093/pm/pnz148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
Research on social disparities in pain care has been mainly focused on the role of race/racism and sex/sexism. Classism in pain assessment and management practices has been much less investigated. We aimed to test the effect of patient socioeconomic status (SES; a proxy of social class) on nurses’ pain assessment and management practices and whether patient SES modulated the effects of patient distress and evidence of pathology on such practices.
Design
Two experimental studies with a two (patient SES: low/high) by two (patient distress or evidence of pathology: absent/present) between-subject design.
Subjects
Female nurses participated in two experimental studies (N = 150/N = 158).
Methods
Nurses were presented with a vignette/picture depicting the clinical case of a female with chronic low back pain, followed by a video of the patient performing a pain-inducing movement. Afterwards, nurses reported their pain assessment and management practices.
Results
The low-SES patient’s pain was assessed as less intense, more attributed to psychological factors, and considered less credible (in the presence of distress cues) than the higher-SES patient’s pain. Higher SES buffered the detrimental impact of the presence of distress cues on pain assessment. No effects were found on management practices.
Conclusions
Our findings point to the potential buffering role of SES against the detrimental effect of certain clinical cues on pain assessments. This study contributes to highlighting the need for further investigation of the role of SES/social class on pain care and its underlying meanings and processes.
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Affiliation(s)
- Tânia Brandão
- CIP, Departamento de Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Lúcia Campos
- ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Intervenção Social (CIS-IUL), Lisboa, Portugal
| | - Lies de Ruddere
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sónia F Bernardes
- ISCTE-Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Intervenção Social (CIS-IUL), Lisboa, Portugal
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Karos K, Meulders A, Goubert L, Vlaeyen JWS. Hide Your Pain: Social Threat Increases Pain Reports and Aggression, but Reduces Facial Pain Expression and Empathy. J Pain 2019; 21:334-346. [PMID: 31351966 DOI: 10.1016/j.jpain.2019.06.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/18/2019] [Accepted: 06/26/2019] [Indexed: 12/19/2022]
Abstract
Earlier research studying the effects of social threat on the experience and expression of pain led to mixed results. In this study, female participants (N = 32) came to the lab with 2 confederates. Both confederates administered a total of 10 painful electrocutaneous stimuli to the participant. The framing of the administration was manipulated in a within-subjects design: In the low social threat condition the participant was told that the confederate could choose between 10 and 20 pain stimuli, thus they believed that this confederate chose to administer the minimum allowed number of pain stimuli. In the high social threat condition the confederate had a choice between 1 and 10 stimuli, thus they believed that this confederate chose to administer the maximum allowed number of stimuli. Participants reported on the intensity, unpleasantness, and threat value of the painful stimuli, and their facial expression was recorded. Moreover, aggression and empathy toward the confederates were assessed. As hypothesized, participants reported increased pain intensity, unpleasantness, and threat in the high social threat condition compared to the low social threat condition, but showed less facial pain expression. Finally, participants exhibited increased aggression and reduced empathy toward the confederate in the high social threat condition. PERSPECTIVE: Social threat reduces painful facial expression, but simultaneously increases pain reports, leading to a double burden of the person in pain. Additionally, social threat affected social relationships by increasing aggression and reducing empathy for the other.
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Affiliation(s)
- Kai Karos
- Center for the Psychology of Learning and Experimental Psychopathology, KU Leuven, Belgium.
| | - Ann Meulders
- Research Group on Health Psychology, KU Leuven, Belgium; Department of Clinical Psychological Sciences, Maastricht University, The Netherlands
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Johan W S Vlaeyen
- Research Group on Health Psychology, KU Leuven, Belgium; Department of Clinical Psychological Sciences, Maastricht University, The Netherlands
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Van Schoors M, De Paepe AL, Norga K, Cosyns V, Morren H, Vercruysse T, Goubert L, Verhofstadt LL. Family Members Dealing With Childhood Cancer: A Study on the Role of Family Functioning and Cancer Appraisal. Front Psychol 2019; 10:1405. [PMID: 31275213 PMCID: PMC6594216 DOI: 10.3389/fpsyg.2019.01405] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/31/2019] [Indexed: 12/27/2022] Open
Abstract
Objectives Childhood cancer is a life-threatening disease that poses significant challenges to the life of the diagnosed child and his/her family members. Based on the ABCX-model, the aim of the current study was to explore the association between family functioning, cancer appraisal and the individual adjustment of patients, parents and siblings. Methods Participants were 60 children with leukemia or non-Hodgkin lymphoma, 172 parents and 78 siblings (115 families). Time since diagnosis varied from zero to 33 months. Patients, parents and siblings completed the Family Environment Scale (FES), Perceived Stress Scale, Situation-Specific Emotional Reactions Questionnaire and Pediatric Quality of Life Inventory/Maudsley Marital Questionnaire. Results Family functioning and the appraisal of the cancer diagnosis proved to be related to patients', parents' and siblings' cancer-related emotions and quality of life post-diagnosis. In addition, family members differed in their perception of some family functioning domains, the appraisal of the cancer diagnosis, positive feelings and quality of life. Discussion Our findings led to the conclusion that family functioning and the appraisal of the cancer diagnosis are important for the individual adjustment of patients, parents and siblings when facing a diagnosis of cancer in the child. Differences across members within one family and differences between families speak to the need of screening all family members and intervening at the level of individual as well as the family unit.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Annick Lena De Paepe
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Koenraad Norga
- Department of Pediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
| | - Veerle Cosyns
- Department of Pediatric Oncology, University Hospital Brussels, Brussels, Belgium
| | - Hanne Morren
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Trui Vercruysse
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Van Schoors M, Loeys T, Goubert L, Berghmans G, Ooms B, Lemiere J, Norga K, Verhofstadt LL. Couples Dealing With Pediatric Blood Cancer: A Study on the Role of Dyadic Coping. Front Psychol 2019; 10:402. [PMID: 30873091 PMCID: PMC6400881 DOI: 10.3389/fpsyg.2019.00402] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 02/11/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: Pediatric cancer is a life-threatening disease that poses significant challenges to the ill child and his/her parents. Among the studies investigating risk and protective factors for the individual and relationship adjustment of parents being confronted with pediatric cancer, couple factors - such as dyadic coping - gained little research attention. Therefore, the aim of the current study was to explore the association between dyadic coping and individual/relationship outcomes of parents in the context of pediatric cancer. Methods: Participants were 59 couples of children diagnosed with leukemia or Non-Hodgkin lymphoma. Time since diagnosis varied from diagnosis to 20 months. Both parents completed the DCI-short, DASS21, PIP, and MMQ. Results: Positive dyadic coping (i.e., supportive and common dyadic coping) and negative dyadic coping proved to be related to individual and relational outcomes of parents facing cancer in their child. In addition, while men and women reported to be equally satisfied with their partner and their sexual relationship, women reported higher levels of individual maladjustment. Conclusion: Our findings led to the conclusion that dyadic coping is important for both individual as well as relationship outcomes of parents when facing a diagnosis of cancer in their child. When meeting with families, both partners should be invited as a unit in order to best capture couple level experiences. Also, clinicians should be sensitive to relational and sexual issues besides individual issues, taking into account evidence-based standards for psychosocial care in pediatric oncology.
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Affiliation(s)
- Marieke Van Schoors
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Geertrui Berghmans
- Department of Pediatric Hemato-Oncology and Stem Cell Transplantation Ghent, Ghent University Hospital, Ghent, Belgium
| | - Britt Ooms
- Department of Pediatric Hemato-Oncology and Immunology, University Hospital Brussels, Brussels, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hemato-Oncology, University Hospital Leuven, Leuven, Belgium
- KU Leuven, Leuven, Belgium
| | - Koenraad Norga
- Department of Pediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
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Van Damme S, Kindt S, Crombez G, Goubert L, Debruyne J. The relation between goal adjustment, goal disturbance, and mental well-being among persons with multiple sclerosis. Psychol Health 2019; 34:645-660. [PMID: 30688085 DOI: 10.1080/08870446.2018.1556272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE This study investigated the role of goal adjustment, i.e. disengaging from blocked goals and reengaging into alternative goals, in mental well-being and goal disturbance in persons with multiple sclerosis (MS). DESIGN A cross-sectional design was used with self-report data from questionnaires and Personal Project Analysis (PPA). MAIN OUTCOME MEASURES Dependent variables were mental well-being, indicated by depression/anxiety (HADS; Hospital Anxiety and Depression Scale) and mental functioning (SF-36; Short Form Health Survey), and goal disturbance, indicated by goal manageability and goal interference (PPA). Independent variables were patient-reported physical impairment (SF-36) and goal disengagement and reengagement (GAS; Goal Adjustment Scale). RESULTS Higher goal reengagement was associated with better mental well-being, but unrelated to goal disturbance. Goal disengagement only showed a negative association with anxiety. High disengagement was associated with lower goal interference but only for those also scoring high on reengagement. Goal adjustment did not buffer the effects of physical impairment on mental well-being and goal disturbance. Contrary to expectations, higher goal reengagement increased the association between physical impairment and goal interference. CONCLUSION Although goal reengagement is associated with better mental well-being in persons with MS, it might also strengthen the perceived effect of physical impairment on goal interference.
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Affiliation(s)
- Stefaan Van Damme
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Sara Kindt
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Geert Crombez
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Liesbet Goubert
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Jan Debruyne
- b Department of Neurology , Ghent University Hospital , Ghent , Belgium
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Prikken S, Oris L, Rassart J, Missotten LC, Weets I, Moons P, Goubert L, Luyckx K. Parental illness intrusiveness and youth glycaemic control in type 1 diabetes: intergenerational associations and processes. Psychol Health 2019; 34:438-455. [PMID: 30636450 DOI: 10.1080/08870446.2018.1538451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study examined associations between the functioning of youth with type 1 diabetes and their parents, including parenting dimensions as intervening mechanisms. The study adds to the existing literature by focusing on (1) the concept of parental illness intrusiveness; (2) the (understudied) periods of adolescence and emerging adulthood; and (3) maternal and paternal functioning. DESIGN Questionnaires were completed by 317 patient-mother dyads and 277 patient-father dyads. All patients (aged 14-25) had type 1 diabetes. The hypothesised model was compared to an alternative model using structural equation modelling. MAIN OUTCOME MEASURES Youth reported on depressive symptoms and treatment adherence; Physicians provided HbA1c-values. Parents reported on illness intrusiveness, depressive symptoms, and their child's treatment adherence. Patients and parents reported on psychological control and overprotection. RESULTS The hypothesised path model had a good fit to the data. Parental illness intrusiveness was positively associated with depressive symptoms and both were positively related to overprotection and psychological control. Psychological control was positively related to patients' depressive symptoms and negatively to treatment adherence. Poorer treatment adherence was associated with worse HbA1c-values. CONCLUSION These findings underscore the relevance of parental illness intrusiveness and emphasise the importance of mothers' and fathers' roles throughout adolescence and emerging adulthood.
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Affiliation(s)
- Sofie Prikken
- a KU Leuven , Leuven , Belgium.,b Fonds Wetenschappelijk Onderzoek Vlaanderen , Brussels , Belgium
| | - Leen Oris
- a KU Leuven , Leuven , Belgium.,b Fonds Wetenschappelijk Onderzoek Vlaanderen , Brussels , Belgium
| | - Jessica Rassart
- a KU Leuven , Leuven , Belgium.,b Fonds Wetenschappelijk Onderzoek Vlaanderen , Brussels , Belgium
| | | | - Ilse Weets
- c Free University Brussels , Brussels , Belgium
| | - Philip Moons
- a KU Leuven , Leuven , Belgium.,d University of Gothenburg , Gothenburg , Sweden
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Kindt S, Vansteenkiste M, Josephy H, Bernardes SF, Goubert L. Helping Your Partner with Chronic Pain: The Importance of Helping Motivation, Received Social Support, and Its Timeliness. Pain Med 2019; 20:77-89. [PMID: 29408960 DOI: 10.1093/pm/pny006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objective Like all intentional acts, social support provision varies with respect to its underlying motives. Greater autonomous or volitional motives (e.g., enjoyment, full commitment) to help individuals with chronic pain (ICPs) are associated with greater well-being benefits for the latter, as indexed by improved satisfaction of their psychological needs for autonomy, competence, and relatedness. The present study investigates the processes explaining why partners' autonomous or volitional helping motivation yields these benefits. Methods A total of 134 couples, where at least one partner had chronic pain, completed a 14-day diary. Partners reported on their daily helping motives, whereas ICPs reported on their daily received support, timing of help, need-based experiences, and pain. Results On days when partners provided help for volitional motives, ICPs indicated receiving more help, which partially accounted for the effect of autonomous helping motivation on ICP need-based experiences. Timing of help moderated the effects of daily received support on ICP need-based experiences. Conclusions Findings highlight the importance of ICPs of receiving support in general and the role of timing in particular, which especially matters when there is little support being received.
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Affiliation(s)
- Sara Kindt
- Department of Experimental-Clinical and Health Psychology
| | | | - Haeike Josephy
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Sonia F Bernardes
- Department of Social and Organizational Psychology, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
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Van Schoors M, De Mol J, Laeremans N, Verhofstadt LL, Goubert L, Van Parys H. Siblings’ Experiences of Everyday Life in a Family Where One Child Is Diagnosed With Blood Cancer: A Qualitative Study. J Pediatr Oncol Nurs 2018; 36:131-142. [DOI: 10.1177/1043454218818067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Childhood cancer not only presents challenges to the life of the child with cancer but also to the siblings’ daily family life. The aim of the current study was to gain a better understanding of siblings’ experiences of living in a family where one child has been diagnosed with blood cancer. Method: Ten siblings of children with leukemia or non-Hodgkin lymphoma completed a semistructured interview about their everyday family life experiences postdiagnosis. The verbatim transcripts of the interviews served as the data for an interpretative phenomenological analysis. Results: The results showed that overall the siblings experienced a continuity in many aspects of their family life: they still experienced their family as an important source of support and information/communication, as warm and loving and as a safe harbor where family members aim to protect each other. However, at the same time, the participating siblings also expressed that some things felt unmistakably different postdiagnosis: They felt that their family as a whole had been ripped apart, with a greater focus on the diagnosed child and changing responsibilities for each family member. Conclusion: This study informs parents and clinicians about the daily family life experiences from the siblings’ perspective, a perspective that is often overlooked. A focus on challenges as well as continuities within family life, the wish for connection expressed by the siblings, and the uniqueness of every sibling’s experiences is what can be taken away from this study by psychosocial workers in the field.
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Affiliation(s)
| | - Jan De Mol
- Université Catholic de Louvain, Louvain-la-Neuve, Belgium
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Kindt S, Vansteenkiste M, Brenning K, Goubert L. The Effects of Partners' Helping Motivation on Chronic Pain Patients' Functioning Over Time. J Pain 2018; 20:348-357. [PMID: 30291905 DOI: 10.1016/j.jpain.2018.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/04/2018] [Accepted: 09/21/2018] [Indexed: 10/28/2022]
Abstract
To understand when and why the provision of help by a partner of an individual with chronic pain (ICP) yields benefits, it is critical, according to self-determination theory, to consider the extent to which partners' helping responses are supportive of the basic psychological needs of the ICP, as well as the motivations underlying these helping responses. The present study (N = 141 couples), spanning 3 measurement moments over 6 months, investigated temporal associations between partners' helping motivation, ICPs' psychological needs, and ICPs' functioning across time (ie, well-being, psychological distress, and disability). Results showed that partners' autonomous or volitional helping motivation (time 1) predicted decreases in ICPs' need frustration (time 2) and ICPs' need frustration (time 2) predicted increases in ICPs' psychological distress (time 3). Further, ICPs' need satisfaction (time 2) predicted increases in well-being (time 3) and decreases in psychological distress (time 3). The link between need frustration and ICPs' well-being (time 1-time 2) was bidirectional, with both relating reciprocally to one another over time. Finally, the associations between ICPs' disability and both partners' helping motivation and ICPs' need-based experiences were nonsignificant. Implications for research and clinical practice are discussed. Perspective: Partners' helping motivations and ICPs' psychological needs seem to be important to consider when investigating the role of spousal responses, because they could (indirectly) predict changes in the well-being and psychological distress of ICPs over time.
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Affiliation(s)
- Sara Kindt
- Departments of Experimental Clinical and Health Psychology and
| | | | - Katrijn Brenning
- Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Departments of Experimental Clinical and Health Psychology and.
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Van Schoors M, De Mol J, Morren H, Verhofstadt LL, Goubert L, Van Parys H. Parents' Perspectives of Changes Within the Family Functioning After a Pediatric Cancer Diagnosis: A Multi Family Member Interview Analysis. Qual Health Res 2018; 28:1229-1241. [PMID: 29357749 DOI: 10.1177/1049732317753587] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pediatric cancer is a life-threatening disease that challenges the life of the diagnosed child, the parents, and possible siblings. Moreover, it also places considerable demands on family life. The aim of this study was to explore changes in the family functioning after a pediatric cancer diagnosis. Ten couples who had a child with leukemia or non-Hodgkin lymphoma were interviewed individually about their experiences. Interviews were semistructured, and the data were analyzed using Multi Family Member Interview Analysis. Three themes emerged from the data: (a) Family Cohesion: Strengthened Versus Fragmented; (b) Educational Norms and Values: Overindulgence Versus Being Stricter, and (c) Normality: Loss Versus Preservation. The conflicting dynamics present in these emerging themes exemplify the complexity of this process of family adaptation. This study illustrates the need to take into account the family level, as well as the conflicting feelings parents may experience after a pediatric cancer diagnosis.
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Affiliation(s)
| | - Jan De Mol
- 2 Université Catholic de Louvain, Louvain-la-Neuve, Belgium
| | | | | | | | - Hanna Van Parys
- 1 Ghent University, Ghent, Belgium
- 3 Ghent University Hospital, Ghent, Belgium
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Oris L, Luyckx K, Rassart J, Goubert L, Goossens E, Apers S, Arat S, Vandenberghe J, Westhovens R, Moons P. Illness Identity in Adults with a Chronic Illness. J Clin Psychol Med Settings 2018; 25:429-440. [DOI: 10.1007/s10880-018-9552-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Miller MM, Allison A, Trost Z, De Ruddere L, Wheelis T, Goubert L, Hirsh AT. Differential Effect of Patient Weight on Pain-Related Judgements About Male and Female Chronic Low Back Pain Patients. The Journal of Pain 2018; 19:57-66. [DOI: 10.1016/j.jpain.2017.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/12/2017] [Accepted: 09/19/2017] [Indexed: 12/19/2022]
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Matos M, Bernardes SF, Goubert L, Beyers W. Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults’ chronic pain experiences. Health Psychol 2017. [DOI: 10.1037/hea0000512] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Van Gampelaere C, Vervoort T, Luyckx K, De Paepe A, Van Aken S, Goubert L. Maternal distress in the context of their child's type 1 diabetes: exploring the role of adaptive maternal emotion regulation on child outcomes. PSYCHOL HEALTH MED 2017; 23:337-346. [PMID: 29057673 DOI: 10.1080/13548506.2017.1394475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Parents of children with Type 1 diabetes (T1D) experience high levels of distress, which may negatively impact child functioning. However, little is known about mechanisms that may buffer the adverse impact of parental distress. The current study explored the possible buffering role of maternal adaptive cognitive emotion regulation (CER) for the relationship between maternal distress and child psychological functioning. Forty-three children with T1D (8-15 years) completed measures assessing trait anxiety and depressive symptoms. Their mothers reported on general distress, illness-related parenting stress, and adaptive CER. Maternal illness-related parenting stress (but not general distress) was significantly associated with child psychological functioning. No buffering role for maternal adaptive CER was observed. As the current study is rather preliminary, future research using other methods to examine maternal adaptive CER, and examining other parental variables that may buffer against the negative impact of parental distress is warranted.
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Affiliation(s)
- Cynthia Van Gampelaere
- a Department of Experimental, Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Tine Vervoort
- a Department of Experimental, Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Koen Luyckx
- b Department of School Psychology and Development in Context , University of Leuven , Leuven , Belgium
| | - Annick De Paepe
- a Department of Experimental, Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Sara Van Aken
- c Department of Pediatrics , University Hospital Ghent , Ghent , Belgium
| | - Liesbet Goubert
- a Department of Experimental, Clinical and Health Psychology , Ghent University , Ghent , Belgium
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Kindt S, Vansteenkiste M, Cano A, Goubert L. When is your partner willing to help you? The role of daily goal conflict and perceived gratitude. Motiv Emot 2017. [DOI: 10.1007/s11031-017-9635-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
The primary objective of this paper is to discuss how a resilience approach to (chronic) pain may advance our current understanding of (mal)adaptation to pain. Different resilience perspectives are described, and future challenges for research, prevention and treatment of (chronic) pain are discussed. Literature searches were performed in Web of Science and PubMed to identify relevant literature on risk and resilience in the context of pain. Resilience can be best defined as the ability to restore and sustain living a fulfilling life in the presence of pain. The Psychological Flexibility Model, the Broaden-and-Build Theory, and Self-Determination Theory are described as theories that may provide insight into resilience within the context of (chronic) pain. We describe how a resilience paradigm shifts the outcomes to pursue in pain research and intervention and argue the need for including positive outcomes in addition to negative outcomes. Psychological flexibility, positive affect and basic psychological needs satisfaction are described as potentially important resilience mechanisms with the potential to target both sustainability and recovery from pain. A resilience approach to chronic pain may have important implications for the prevention and treatment of chronic pain problems, as it may give specific indications on how to empower patients to continue living a fulfilling life (in the presence of pain). SIGNIFICANCE The resilience approach put forward in this review spotlights sustainability of positive outcomes (e.g. engagement in meaningful activities) in the presence of pain as an outcome to pursue beyond recovery of negative outcomes. We illuminate the evidence-base and practical application of promising resilience mechanisms (positive emotions, psychological flexibility, needs satisfaction). For this article, a commentary is available at the Wiley Online Library.
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Affiliation(s)
- L Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - H Trompetter
- Department of Psychology, Health and Technology, Center for eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands
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Durand H, Birnie KA, Noel M, Vervoort T, Goubert L, Boerner KE, Chambers CT, Caes L. State Versus Trait: Validating State Assessment of Child and Parental Catastrophic Thinking About Children's Acute Pain. The Journal of Pain 2017; 18:385-395. [DOI: 10.1016/j.jpain.2016.11.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/24/2016] [Accepted: 11/24/2016] [Indexed: 11/30/2022]
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