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Ngo D, Palmer GM, Gorrie A, Kenmuir T, Crawford M, Jaaniste T. Caregiver Burden Associated With Pediatric Chronic Pain: A Retrospective Study Using the Pediatric Electronic Persistent Pain Outcomes Collaboration Database. Clin J Pain 2024; 40:137-149. [PMID: 38149451 DOI: 10.1097/ajp.0000000000001189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/27/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVES This retrospective, cross-sectional study investigated the nature and extent of burden experienced by caregivers of children and adolescents with chronic pain, and factors associated with increased caregiver burden. METHODS The Pediatric Electronic Persistent Pain Outcomes Collaboration database provided prospectively collected data from 1929 families attending 9 pediatric chronic pain services across Australia and New Zealand. Data included demographic information, responses to child pain and functioning measures, caregiver work impairment, and psychosocial functioning. RESULTS Caregivers of children with chronic pain reported work impairment associated with their child's pain (mean: 15% ± SD 25 absenteeism; 38% ± SD 29 productivity lost), significantly worse than published international population norms (large-scale community survey data), most other caregiver samples of adults and children with other chronic conditions, and adult samples with various pain conditions. Caregivers reported considerable burden in multiple psychosocial functioning domains, particularly leisure functioning, pain-related catastrophizing, and adverse parenting behaviors (with greater pain-related avoidance). Caregiver psychosocial burden was significantly associated with child psychosocial functioning (β = -0.308, P < 0.01), school absenteeism (β = 0.161, P < 0.01), physical disability (β = 0.096, P < 0.05), and pain duration (β = 0.084, P < 0.05), but not pain intensity. Caregiver work productivity loss was significantly associated with school absenteeism (β = 0.290, P < 0.01), child physical disability (β = 0.148, P < 0.01), child health care utilization (β = 0.118, P < 0.05), and worst pain intensity (β = 0.101, P < 0.05). DISCUSSION These results highlight the significant and varied impacts experienced by caregivers of children with chronic pain. This work is novel in reporting significant work impairment and confirms psychosocial burden in a larger sample than previous studies.
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Affiliation(s)
- Danny Ngo
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
| | - Greta M Palmer
- Children's Pain Management Service, Royal Children's Hospital, Melbourne
- Department of Pediatrics, University of Melbourne
- Murdoch Children's Research Institute, VIC, Australia
| | - Andrew Gorrie
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
| | - Tracey Kenmuir
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
| | | | - Tiina Jaaniste
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
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Wan J, Vaughan A, Shepherd E, Coombs S, Trethewie S, Jaaniste T. Evaluation of paediatric palliative care ambulance plans: A retrospective study. J Child Health Care 2024:13674935231225714. [PMID: 38262591 DOI: 10.1177/13674935231225714] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Paediatric Palliative Care Ambulance Plans ('Plans') are used by New South Wales Ambulance (Australia) to support the care needs of children with life-limiting conditions. We aimed to describe the population of children with Plans and provide details regarding Plan completion, paramedic responses during ambulance callouts, and correspondence between Plan recommendations and paramedic responses. Plans lodged in January 2017-December 2019 were retrospectively coded for demographic information, completeness and care preferences. Associated paramedic callout notes (January 2018-December 2019) were coded for paramedic responses. Of 141 Plans retrieved, 38 (41.3% of those providing suggested medications) suggested medication use outside general paramedic scope of practice. Of 199 associated ambulance callouts, reasons for callout included symptom management, planned transfer, death notification and end-of-life care. Over two-thirds of callouts (n = 135, 67.8%) occurred after-hours. Most paramedic callouts (n = 124, 62.3%), excluding planned transfers, resulted in children being transported. Paramedic interventions corresponded with interventions suggested in Plans. However, only 24 (25.3%) of paramedic callout notes documented Plans being sighted. This study provided detailed information about children with palliative care needs for whom Plans were being used, the nature of these Plans and associated paramedic callouts. However, it is not known how paramedics were influenced by Plans.
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Affiliation(s)
- Julianna Wan
- Department of Palliative Care, Sydney Children's Hospital Network, Randwick, NSW, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Elizabeth Shepherd
- Department of Palliative Care, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Sandra Coombs
- Department of Palliative Care, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Susan Trethewie
- Department of Palliative Care, Sydney Children's Hospital Network, Randwick, NSW, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Tiina Jaaniste
- Department of Palliative Care, Sydney Children's Hospital Network, Randwick, NSW, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
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Tiong K, Palmer GM, Jaaniste T. Attrition from Face-to-Face Pediatric Outpatient Chronic Pain Interventions: A Narrative Review and Theoretical Model. Children (Basel) 2024; 11:126. [PMID: 38275436 PMCID: PMC10814025 DOI: 10.3390/children11010126] [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: 12/21/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
There is limited understanding of attrition (premature treatment withdrawal and non-completion) from pediatric chronic pain services. This narrative review aimed to summarize attrition prevalence from face-to-face pediatric outpatient chronic pain interventions, identify associated factors and develop a theoretical model to account for attrition in this setting. A comprehensive search of the published literature revealed massive variability (0-100%) in the reported attrition rates from pediatric chronic pain interventions that varied in type and format (individual vs. group, single discipline vs. interdisciplinary, psychological only vs. multiple combined interventions, of different durations). The factors associated with attrition from pediatric chronic pain programs varied between the studies: some have assessed patient sex, psychological and other comorbidities, avoidance strategies, missed schooling, family composition/tensions, caregiver catastrophizing, scheduling, caregiver leave and clinic access. A theoretical model is presented depicting youth, caregiver and service factors that may impact attrition from pediatric chronic pain interventions. Where available, literature is drawn from the pediatric chronic pain context, but also from adult chronic pain and pediatric weight management fields. The implications for research and clinical practice are discussed, including improved reporting, patient screening and targeted supports to promote intervention completion. This review contributes to a better understanding of attrition, which is crucial for optimizing pediatric chronic pain service outcomes.
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Affiliation(s)
- Kristen Tiong
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2052, Australia;
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Greta M. Palmer
- Children’s Pain Management Service, Department of Anaesthesia and Pain Management, Royal Children’s Hospital, Melbourne, VIC 3052, Australia;
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Tiina Jaaniste
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2052, Australia;
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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Ng NKY, Dudeney J, Jaaniste T. Parent-Child Communication Incongruence in Pediatric Healthcare. Children (Basel) 2023; 11:39. [PMID: 38255353 PMCID: PMC10814587 DOI: 10.3390/children11010039] [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: 11/09/2023] [Revised: 12/12/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
Parents play a key role in providing children with health-related information and emotional support. This communication occurs both in their homes and in pediatric healthcare environments, such as hospitals, outpatient clinics, and primary care offices. Often, this occurs within situations entailing heightened stress for both the parent and the child. There is considerable research within the communication literature regarding the nature of both verbal and nonverbal communication, along with the way in which these communication modalities are either similar (i.e., congruent) or dissimilar (i.e., incongruent) to one another. However, less is known about communication congruency/incongruency, specifically in parent-child relationships, or within healthcare environments. In this narrative review, we explore the concept of verbal and nonverbal communication incongruence, specifically within the context of parent-child communication in a pediatric healthcare setting. We present an overview of verbal and nonverbal communication and propose the Communication Incongruence Model to encapsulate how verbal and nonverbal communication streams are used and synthesized by parents and children. We discuss the nature and possible reasons for parental communication incongruence within pediatric settings, along with the consequences of incongruent communication. Finally, we suggest a number of hypotheses derived from the model that can be tested empirically and used to guide future research directions and influence potential clinical applications.
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Affiliation(s)
- Nancy Kwun Yiu Ng
- Departments of Pain & Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (N.K.Y.N.); (J.D.)
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2033, Australia
| | - Joanne Dudeney
- Departments of Pain & Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (N.K.Y.N.); (J.D.)
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2033, Australia
- School of Psychological Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Tiina Jaaniste
- Departments of Pain & Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (N.K.Y.N.); (J.D.)
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2033, Australia
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Eichholz A, Dudeney J, Jaaniste T. Caregiver Psychological Burden in Pediatric Chronic Pain: A Systematic Review and Meta-Analysis of Associations with Caregiver Sociodemographic and Biopsychosocial Variables. J Pediatr Psychol 2023; 48:747-758. [PMID: 37507141 DOI: 10.1093/jpepsy/jsad041] [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: 11/22/2022] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE To investigate, via systematic review and meta-analysis, caregiver sociodemographic and biopsychosocial factors associated with anxiety, depression, posttraumatic stress symptoms, and stress of caregivers in the pediatric chronic pain context. METHODS EMBASE, Medline, and PsycINFO databases were searched from their inception to the search date (April 4, 2022). Studies were included if they examined caregivers of youth with chronic pain, were published in a peer-reviewed journal and assessed at least one quantitative association between relevant variables. Qualitative and intervention studies were excluded. A total of 3,052 articles were screened. Risk of bias was assessed using the JBI Checklist for analytical cross-sectional studies. Meta-analyses were conducted using robust variance estimation for associations reported in at least three studies, as well as a narrative synthesis of the evidence. RESULTS Fourteen studies assessing 1,908 caregivers were included in this review. Meta-analytic results showed a positive pooled correlation coefficient between caregiver catastrophizing about their child's pain and caregiver anxiety (r = 0.51; 95% CI: 0.35-0.65; p<.01) and depression (r = 0.45; 95% CI: 0.29-0.58; p < .01). Self-blame and helplessness were related to increased caregiver anxiety (r = 0.55; 95% CI: 0.40-0.67; p<.01), but not depression. No significant relationship was found for pain-promoting behavior and anxiety or depression. The qualitative synthesis of all other eligible studies showed associations between relevant psychological burden variables and various caregiver factors, which were mainly psychosocial. CONCLUSION Results should be interpreted with caution due to the small number of studies. Further research is needed to get a better understanding of these relationships and to examine the causal direction of effects.
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Affiliation(s)
| | - Joanne Dudeney
- Department of Pain, Sydney Children's Hospital, Australia
- Discipline of Paediatrics and Child Health, Clinical School of Medicine, University of New South Wales, Australia
- School of Psychological Sciences, Macquarie University Australia
| | - Tiina Jaaniste
- Department of Pain, Sydney Children's Hospital, Australia
- Discipline of Paediatrics and Child Health, Clinical School of Medicine, University of New South Wales, Australia
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Champion J, Crawford M, Jaaniste T. Predicting the Need for Transition from Pediatric to Adult Pain Services: A Retrospective, Longitudinal Study Using the Electronic Persistent Pain Outcome Collaboration (ePPOC) Databases. Children (Basel) 2023; 10:children10020357. [PMID: 36832486 PMCID: PMC9955863 DOI: 10.3390/children10020357] [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: 01/10/2023] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Abstract
A proportion of youth with chronic pain do not respond to interdisciplinary pain management and may require transition to adult pain services. This study sought to characterize a cohort of patients referred to pediatric pain services who subsequently required referral to an adult pain service. We compared this transition group with pediatric patients eligible by age to transition but who did not transition to adult services. We sought to identify factors predicting the need to transition to adult pain services. This retrospective study utilized linkage data from the adult electronic Persistent Pain Outcomes Collaboration (ePPOC) and the pediatric (PaedePPOC) data repositories. The transition group experienced significantly higher pain intensity and disability, lower quality of life, and higher health care utilization relative to the comparison group. Parents of the transition group reported greater distress, catastrophizing, and helplessness relative to parents in the comparison group. Three factors significantly predicted transition: compensation status (OR = 4.21 (1.185-15)), daily anti-inflammatory medication use (OR = 2 (1.028-3.9)), and older age at referral (OR = 1.6 (1.3-2.17)). This study demonstrated that patients referred to pediatric pain services who subsequently need transition to adult services are a uniquely disabled and vulnerable group beyond comparative peers. Clinical applications for transition-specific care are discussed.
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Affiliation(s)
- Joel Champion
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Correspondence: (J.C.); (T.J.); Tel.: +61-2-93825423 (J.C.); +61-2-93825422 (T.J.)
| | - Matthew Crawford
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Tiina Jaaniste
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- School of Clinical Medicine, University of New South Wales, Kensington, NSW 2052, Australia
- Correspondence: (J.C.); (T.J.); Tel.: +61-2-93825423 (J.C.); +61-2-93825422 (T.J.)
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Ngo D, Aouad P, Goodison-Farnsworth M, Gorrie A, Kenmuir T, Jaaniste T. Impacts of paediatric chronic pain on parents: A qualitative study. Child Care Health Dev 2022. [PMID: 36355344 DOI: 10.1111/cch.13079] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/18/2022] [Accepted: 11/05/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Paediatric chronic pain adversely impacts the child's functioning, health-related quality of life and development. However, there is a need for a holistic assessment of parental impacts of caring for a child with chronic pain. This qualitative study aimed to investigate the possible psychosocial, functional and work impacts of caring for a child with chronic pain on parents, including any positive effects of the experience. METHODS Ten parents (eight mothers and two fathers), whose child attended the Sydney Children's Hospital Interdisciplinary Chronic and Complex Pain Clinic, participated in semi-structured interviews exploring the impact of caring for a child with chronic pain. Interviews were audio-recorded, transcribed, coded (with good inter-coder agreement) and analysed using thematic analysis. RESULTS The parental experience of caring for a child with chronic pain was encapsulated by four overarching themes: (1) 'the constant and all-consuming nature of pain' - parents described the unpredictable, yet constant nature of chronic pain, contributing to wide-reaching impacts in various areas of their life; (2) 'dealing with uncertainty' - their experience was commonly characterized by a sense of uncertainty, stress, hopelessness and fear; (3) 'importance of support and self-care' - strong support networks and prioritizing self-care were crucial in alleviating the negative effects of paediatric chronic pain; and (4) 'a revitalized and optimistic view on life and relationships' - some parents identified unique and positive effects, such as stronger relationships, personal growth and a reformed view on life. CONCLUSIONS This study provided rich data on the various impacts of caring for a child with chronic pain, highlighting the need for the development of holistic, family-centred interventions addressing both child and parental functioning.
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Affiliation(s)
- Danny Ngo
- Department of Pain, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Phillip Aouad
- Department of Pain, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | | | - Andrew Gorrie
- Department of Pain, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Tracey Kenmuir
- Department of Pain, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Tiina Jaaniste
- Department of Pain, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Clinical Medicine, University of New South Wales, Kensington, New South Wales, Australia
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Aouad P, Bui M, Sarraf S, Donnelly T, Chen Y, Jaaniste T, Eden J, Champion GD. Primary dysmenorrhoea in adolescents and young women: A twin family study of maternal transmission, genetic influence and associations. Aust N Z J Obstet Gynaecol 2022; 62:725-731. [PMID: 35754341 PMCID: PMC9796909 DOI: 10.1111/ajo.13560] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/21/2022] [Indexed: 01/07/2023]
Abstract
AIMS The extent to which maternal transmission of primary dysmenorrhoea is genetically determined in adolescents and young women has yet to be determined. We aimed to assess heritability and associations relevant to primary pain syndromes using a twin family study. METHODS Participants were young menstruating female twins, and their oldest sisters and mothers, whose families were registered with Twins Research Australia and previously participated in a twin family study of primary paediatric pain disorders. Questionnaire packs were mailed, assessing current maximum and average menstrual pain intensity, current pain interference with activities and retrospective dysmenorrhea secondary symptoms. RESULTS The sample comprised 206 twin individuals (57 monozygous (MZ) and 46 dizygous (DZ) pairs) aged 10-22 years, eldest siblings (n = 38) aged 13-28 years and mothers (n = 101) aged 32-61 years. The estimated regression coefficient of the relationship between mother-daughter and twin-sibling dyads indicated significant associations for the measures of dysmenorrhea and supported heritability. Adjusted for age, the within twin-pair correlation for MZ twins was generally more than twice that of DZ twins. Heritability estimates were maximal pain intensity 0.67 (P = 3.8 × 10-11 ), average pain intensity 0.63 (P = 3.7 × 10-10 ), pain interference 0.57 (P = 1.8 × 10-8 ) and retrospective symptoms 0.57 (P = 1.8 × 10-8 ). Twin individuals with a lifetime (three-month) history of iron deficiency and those with painless restless legs syndrome (RLS) were significantly more likely to have more intense pain associated with menstruation. CONCLUSION Primary dysmenorrhea in adolescents and young women was shown to be relatively strongly genetically influenced and associated especially with a history of iron deficiency and painless RLS which have potential therapeutic implications.
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Affiliation(s)
- Phillip Aouad
- Department of PainSydney Children's HospitalRandwickNew South WalesAustralia,School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia,Central Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Minh Bui
- School of Population and Global HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Sara Sarraf
- Department of PainSydney Children's HospitalRandwickNew South WalesAustralia
| | - Theresa Donnelly
- Department of PainSydney Children's HospitalRandwickNew South WalesAustralia
| | - Yuxi Chen
- Department of PainSydney Children's HospitalRandwickNew South WalesAustralia
| | - Tiina Jaaniste
- Department of PainSydney Children's HospitalRandwickNew South WalesAustralia,School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - John Eden
- School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - G. David Champion
- Department of PainSydney Children's HospitalRandwickNew South WalesAustralia,School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
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Champion GD, Bui M, Sarraf S, Donnelly TJ, Bott AN, Goh S, Jaaniste T, Hopper J. Improved definition of growing pains: A common familial primary pain disorder of early childhood. Paediatric and Neonatal Pain 2022; 4:78-86. [PMID: 35719219 PMCID: PMC9189907 DOI: 10.1002/pne2.12079] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/08/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022]
Abstract
Background Commonly applied diagnostic criteria for growing pains (GP) have evolved without determination by an authoritative representative body. GP and restless legs syndrome (RLS) share anatomical, distributional, temporal, and other clinical features and are associated in individuals over time, in families, and in population samples. In this study, we tested the hypothesis that GP, diagnosed by widely used criteria, is confounded by cases of painful restless legs syndrome (RLS‐Painful). Methods A twin family study of genetic influence and associations of GP using questionnaires was administered by Twins Research Australia. Twins (3–18 years; monozygous 503, dizygous 513), their oldest siblings, mothers, and fathers were randomly selected from the twin registry. Family members completed the questionnaires assessing lifetime prevalence of GP by commonly applied criteria and covariates including the history of iron deficiency and pediatric pain disorders. A GP‐Specific phenotype was defined as GP without urge to move the legs. We determined similarities in twin pairs for the GP and GP‐Specific phenotypes, family associations, and estimated familial and individual‐specific associations for each phenotype. Results Lifetime prevalence was one‐third lower for GP‐Specific than for GP among the twin and family members. Monozygous twin pairs were more similar than dizygous twin pairs for GP and for the derived GP‐Specific phenotype by three methods, consistent with genetic influence. There were familial associations, but the essential evidence for genetic influence was the twin‐cotwin data. GP was associated, in multivariable analyses, with migraine, headaches, recurrent abdominal pain, and iron deficiency, while GP‐Specific associations were limited to migraine and headaches. Conclusions GP is hybrid, one‐third of cases having symptoms and associations of RLS, necessarily RLS‐Painful. GP‐Specific (without symptoms and associations of RLS) could have a genetic etiology. We propose new criteria to facilitate etiological and therapeutic research. Growing pains, a highly prevalent primary pain disorder of childhood, has been associated with restless legs syndrome in individuals over time, in families and in population samples. This conundrum has been clarified by the evidence in this twin family study that growing pains, as previously defined, has been confounded by symptoms of restless legs syndrome. An exclusion clause of urge to move the legs has resulted in criteria for a purer phenotype which retains evidence of heritability.
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Affiliation(s)
- G. David Champion
- Department of Pain Sydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's Health UNSW Medicine, University of NSW Sydney New South Wales Australia
| | - Minh Bui
- Centre for Epidemiology and Biostatistics School of Population and Global Health University of Melbourne Melbourne Victoria Australia
| | - Sara Sarraf
- PwC Australia Sydney New South Wales Australia
- Formerly at Department of Pain Sydney Children's Hospital Sydney New South Wales Australia
| | - Theresa J. Donnelly
- Formerly at Department of Pain Sydney Children's Hospital Sydney New South Wales Australia
- University of Technology Sydney Sydney New South Wales Australia
| | - Aneeka N Bott
- Formerly at Department of Pain Sydney Children's Hospital Sydney New South Wales Australia
- Aneeka Bott Psychology Randwick New South Wales Australia
| | - Shuxiang Goh
- Clinical Genetics Sydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's Health University of NSW Kensington New South Wales Australia
| | - Tiina Jaaniste
- Pain & Palliative Care Research Sydney Children's Hospital Randwick New South Wales Australia
- School of Women's and Children's Health UNSW Medicine, University of New South Wales Kensington New South Wales Australia
| | - John Hopper
- Twins Research Australia, Centre for Epidemiology and Biostatistics School of Population and Global Health University of Melbourne Melbourne Victoria Australia
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Jaaniste T, Chin WLA, Tan SC, Cuganesan A, Coombs S, Heaton M, Cowan S, Potter D, Aouad P, Smith PL, Trethewie S. Parent and Well-Sibling Communication in Families With a Child Who Has a Life-Limiting Condition: Quantitative Survey Data. J Pediatr Psychol 2022; 47:606-616. [PMID: 35552431 DOI: 10.1093/jpepsy/jsab128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/27/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Living with a child with a life-limiting condition (LLC), for which there is no hope of cure and premature death is expected, places much stress on a family unit. Familial communication has the potential to serve as a buffer when children are faced with stressful situations. The overall aim of the study was to learn more about illness-related communication between parents and well-siblings, giving particular consideration to the amount of illness-related communication, and sibling satisfaction with familial communication. METHODS Participants included 48 well-siblings (aged 6-21 years) of children with LLCs and their parents. Parents and well-siblings independently completed validated measures of familial communication and sibling functioning. Parents also provided demographic information and completed a questionnaire assessing amount of illness-related information provided to well-siblings. RESULTS Parents reported that 47.8% of well-siblings never or rarely initiated conversations about their sibling's illness. Moreover, 52.2% of well-siblings never or rarely spoke about death. Amount of illness-related communication between parents and well-siblings was most strongly predicted by parental resilience and well-sibling age. Parents engaged in significantly more illness-related communication with girls than boys (t(44)=-2.28, p = .028). Well-siblings (p < .01) and parents (p < .05) rated satisfaction with familial communication significantly higher than published norms. The only significant predictor of well-sibling satisfaction with familial communication was greater familial cohesion. Family communication variables were not significantly correlated with measures of sibling functioning (all p's>.05). CONCLUSIONS This study provides new information regarding parent and well-sibling communication in families who have a child with a LLC.
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Affiliation(s)
- Tiina Jaaniste
- Department of Palliative Care, Sydney Children's Hospital, Australia
- School of Women's and Children's Health, University of New South Wales, Australia
| | - Wei Ling Audrey Chin
- Department of Palliative Care, Sydney Children's Hospital, Australia
- School of Women's and Children's Health, University of New South Wales, Australia
| | - Sarah Caellainn Tan
- Department of Palliative Care, Sydney Children's Hospital, Australia
- School of Women's and Children's Health, University of New South Wales, Australia
| | - Anjali Cuganesan
- Department of Palliative Care, Sydney Children's Hospital, Australia
- School of Women's and Children's Health, University of New South Wales, Australia
| | - Sandra Coombs
- Department of Palliative Care, Sydney Children's Hospital, Australia
| | - Maria Heaton
- Department of Palliative Care, Sydney Children's Hospital, Australia
| | - Sue Cowan
- Department of Palliative Care, Sydney Children's Hospital, Australia
- Bear Cottage, Australia
| | - Denise Potter
- Department of Palliative Care, Children's Hospital at Westmead, Australia
| | - Phillip Aouad
- Department of Palliative Care, Sydney Children's Hospital, Australia
- School of Women's and Children's Health, University of New South Wales, Australia
| | | | - Susan Trethewie
- Department of Palliative Care, Sydney Children's Hospital, Australia
- School of Women's and Children's Health, University of New South Wales, Australia
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11
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Jaaniste T, Cuganesan A, Chin WLA, Tan SC, Coombs S, Heaton M, Cowan S, Aouad P, Potter D, Smith PL, Trethewie S. Living with a child who has a life-limiting condition: The functioning of well-siblings and parents. Child Care Health Dev 2022; 48:269-276. [PMID: 34766366 DOI: 10.1111/cch.12927] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/22/2021] [Accepted: 10/30/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Living with a child who has a life-limiting condition (LLC) is likely to have a major impact on all family members. There is a need to have a clearer understanding of the nature and extent of this impact on parents and well-siblings. The current study aimed to investigate the psychosocial functioning of well-siblings and parents living with a child with an LLC. Further, the study aimed to assess the resilience resources of both well-siblings and parents, giving consideration to how these relate to psychosocial functioning. METHODS Participants included 48 well-siblings (6-21 years) and 42 parents of children with LLCs. Parents and well-siblings independently completed validated measures of child and adult functioning and personal resilience. Parents provided demographic information about the patient and family. RESULTS The emotional, social and school functioning of well-siblings in the current study was found to be significantly poorer than published norms (all p's < .01). Parental self-reported depression, anxiety and stress scores were also all significantly poorer than published norms (all p's < .01). There was negligible agreement between well-sibling self-reported functioning and parental proxy-report of the well-siblings functioning (all r's < .126, all p's > .464). Sibling self-reported resilience was positively correlated with each of the measures of psychosocial functioning (all r's > .318, p's < .05). Parental resilience was significantly negatively correlated with depressive symptoms (r = -.369, p < .05) and anxiety symptoms (r = -.473, p < .01) but not stress scores (r = -.074, p = .644). CONCLUSION Family members living with a child who has an LLC were found to have significantly poorer psychosocial functioning than published norms. Although one cannot infer a causal direction from the current study, greater self-reported well-sibling and parental resilience were associated with aspects of better self-reported psychosocial functioning. Future studies should assess the impact of psychosocial interventions aimed at enhancing the resilience and functioning of both well-siblings and parents.
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Affiliation(s)
- Tiina Jaaniste
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Anjali Cuganesan
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Wei Ling Audrey Chin
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Sarah Caellainn Tan
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Sandra Coombs
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Maria Heaton
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Sue Cowan
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Bear Cottage, Manly, NSW, Australia
| | - Phillip Aouad
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Denise Potter
- Department of Palliative Care, Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Susan Trethewie
- Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
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12
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Jaaniste T, Wood JG, Johnson A, Nguyen H, Chan DB, Powell A, Pfeiffer G, Wong B, Champion GD. Trajectory of Pain, Functional Limitation, and Parental Coping Resources Following Pediatric Short-stay Surgery: Factors Impacting Rate of Recovery. Clin J Pain 2021; 37:698-706. [PMID: 34369414 DOI: 10.1097/ajp.0000000000000966] [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: 08/27/2020] [Accepted: 04/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although there are many benefits of short-stay hospital admissions for high volume, pediatric surgical procedures, this model of care places greater responsibility on parents for the management of children's pain. This study aimed to document the trajectory of child pain outcomes and a range of parent-reported functional outcomes following discharge from a short-stay surgical admission. Moreover, we aimed to document the trajectory of parental perceived personal coping resources. Second, we assessed whether parental dispositional factors, assessed before hospital discharge, predicted the child's pain intensity and parent-reported functional recovery. METHODS Participants included children (aged 4 to 14 y) admitted for a short-stay tonsillectomy or appendectomy, and their parents. Parents completed a questionnaire before discharge from hospital. Demographic and surgical information was recorded from medical records. Following discharge, daily assessments of pain and functioning were carried out over a 10-day period using iPods or mobile phones. Predischarge and postdischarge data were obtained for 55 child and parent dyads. RESULTS Pain intensity scores returned to low levels (2/10 or less) by day 5 for appendectomy and day 10 for tonsillectomy. Parents' perceived personal coping resources increased more slowly following tonsillectomy than appendectomy. Controlling for time since surgery and parental coping resources, parental pain-related catastrophizing was a significant predictor of child pain and functional recovery. DISCUSSION Short-stay surgery results in parents facing considerable burden in managing their child's pain and functional impairment over a 10-day period. The potential value of screening for parental pain-related catastrophizing before discharge from hospital warrants further consideration and may enable identification of children likely to experience poorer recovery.
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Affiliation(s)
- Tiina Jaaniste
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Jordan G Wood
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Anya Johnson
- Work and Organisational Studies, University of Sydney Business School, Darlington, NSW, Australia
| | - Helena Nguyen
- Work and Organisational Studies, University of Sydney Business School, Darlington, NSW, Australia
| | - David Bertrand Chan
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Alexandra Powell
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Genevieve Pfeiffer
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Brandon Wong
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - G David Champion
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
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13
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Jaaniste T, Burgess A, Mohanachandran M, von Baeyer CL, Champion GD. Ability of 3- to 5-year-old children to use simplified self-report measures of pain intensity. J Child Health Care 2021; 25:442-456. [PMID: 32853050 DOI: 10.1177/1367493520951302] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Little is known about self-report pain intensity scales best suited for young children. We tested the ability of preschool children to use two simplified scales (concrete ordinal and faces). Three- to 5-year-olds (n = 123) were asked to make binary discriminations ('less' vs 'more' pain) between response options using the Simplified Faces Pain Scale and Simplified Concrete Ordinal Scale and to complete a seriation task. Eighty participants were also asked to use the Simplified Concrete Ordinal Scale, with modified verbal anchors, to rate the loudness of tones and to assess practice effects. Binary discrimination accuracy and seriation ability improved with age. When using the Simplified Concrete Ordinal Scale to rate the loudness of tones, even the 3-year-olds performed significantly better than chance, and performance was better in 4- and 5-year-olds. Little evidence supported the ability of 3-year-olds to use either of the simplified tools in the pain context. The 4-year-olds demonstrated greater accuracy in using the Simplified Concrete Ordinal Scale than the Simplified Faces Pain Scale, suggesting that the Simplified Concrete Ordinal Scale may be more appropriate for this age group.
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Affiliation(s)
- Tiina Jaaniste
- Department of Pain & Palliative Care, Sydney Children's Hospital, Australia.,School of Medicine, 7800University of New South Wales, Australia
| | - Ashleigh Burgess
- Department of Pain & Palliative Care, Sydney Children's Hospital, Australia.,School of Medicine, 7800University of New South Wales, Australia
| | - Mathushinee Mohanachandran
- Department of Pain & Palliative Care, Sydney Children's Hospital, Australia.,School of Medicine, 7800University of New South Wales, Australia
| | | | - G David Champion
- Department of Pain & Palliative Care, Sydney Children's Hospital, Australia.,School of Medicine, 7800University of New South Wales, Australia
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14
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Kersch A, Perera P, Mercado M, Gorrie A, Sainsbury D, McGrath T, Aouad P, Sarraf S, Jaaniste T, Champion D. Somatosensory Testing in Pediatric Patients with Chronic Pain: An Exploration of Clinical Utility. Children (Basel) 2020; 7:children7120275. [PMID: 33291481 PMCID: PMC7762158 DOI: 10.3390/children7120275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 12/04/2022]
Abstract
We aimed to evaluate the utility of clinical somatosensory testing (SST), an office adaptation of laboratory quantitative sensory testing, in a biopsychosocial assessment of a pediatric chronic somatic pain sample (N = 98, 65 females, 7–18 years). Stimulus–response tests were applied at pain regions and intra-subject control sites to cutaneous stimuli (simple and dynamic touch, punctate pressure and cool) and deep pressure stimuli (using a handheld pressure algometer, and, in a subset, manually inflated cuff). Validated psychological, pain-related and functional measures were administered. Cutaneous allodynia, usually regional, was elicited by at least one stimulus in 81% of cases, most frequently by punctate pressure. Central sensitization, using a composite measure of deep pressure pain threshold and temporal summation of pain, was implied in the majority (59.2%) and associated with worse sleep impairment and psychological functioning. In regression analyses, depressive symptoms were the only significant predictor of pain intensity. Functional interference was statistically predicted by deep pressure pain threshold and depressive symptoms. Manually inflated cuff algometry had comparable sensitivity to handheld pressure algometry for deep pressure pain threshold but not temporal summation of pain. SST complemented standard biopsychosocial assessment of pediatric chronic pain; use of SST may facilitate the understanding of disordered neurobiology.
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Affiliation(s)
- Anna Kersch
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Panchalee Perera
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Melanie Mercado
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Andrew Gorrie
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - David Sainsbury
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
| | - Tara McGrath
- Stollery Children’s Hospital, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Phillip Aouad
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Sara Sarraf
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
| | - Tiina Jaaniste
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - David Champion
- Department of Pain, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (A.K.); (P.P.); (M.M.); (A.G.); (D.S.); (P.A.); (S.S.); (T.J.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Correspondence:
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15
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Champion D, Bui M, Aouad P, Sarraf S, Donnelly T, Bott A, Chapman C, Goh S, Ng G, Jaaniste T, Hopper J. Contrasting painless and painful phenotypes of pediatric restless legs syndrome: a twin family study. Sleep Med 2020; 75:361-367. [DOI: 10.1016/j.sleep.2020.08.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/17/2020] [Accepted: 08/21/2020] [Indexed: 01/08/2023]
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Jaaniste T, Tan SC, Aouad P, Trethewie S. Communication between parents and well-siblings in the context of living with a child with a life-threatening or life-limiting condition. J Paediatr Child Health 2020; 56:1521-1526. [PMID: 32936516 DOI: 10.1111/jpc.15138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/14/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 11/29/2022]
Abstract
Effective parent-child communication may serve to buffer the potential negative impacts of stressful situations on a child. Children who have a brother or sister with a life-threatening or life-limiting medical condition may turn to their parents for help with comprehending the situation, to help maintain their own ability to function across various life areas or to receive emotional support. There is a need for more investigation into the nature and importance of parent-child communication in the context of living with a seriously ill brother or sister. The current paper presents a framework of parent-sibling communication in the context of living with a seriously unwell child, distinguishing the focus of communication (illness-related vs. non-illness-related) and the purpose of communication (information-provision vs. emotional support). Such a framework offers a holistic approach to exploring some of the challenges of communication between parents and well-siblings. The state of current knowledge regarding the focus and purpose of communication between parents and well-siblings is reviewed, and implications for research and possible clinical applications discussed.
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Affiliation(s)
- Tiina Jaaniste
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sarah C Tan
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Phillip Aouad
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Susan Trethewie
- Department of Palliative Care, Sydney Children's Hospital, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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Abstract
Early planning and knowing which factors to consider when planning the location of death (LOD) of a palliative child, may help minimize the burden of hasty decision-making in the future, and may provide families with a sense of control. The current paper reviewed which factors were associated with pediatric LOD and further considered some emerging factors that should are important to better facilitate integrative planning. Three overarching areas of consideration related to pediatric LOD planning were identified including health service factors, familial factors and patient factors. Multiple sub-factor considerations are presented. Further, the paper presents a conceptual model of the factors found to be related to pediatric LOD planning. The limitations that exist with rigorously and empirically studying pediatric LOD preferences are apparent from the dearth of knowledge seen in the field. However, future studies should continue to examine such factors more closely to better understand the nuanced implications.
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Affiliation(s)
- Sandra Coombs
- Departments of Pain and Palliative Care, Sydney Children's Hospital - Randwick, Sydney, Australia
| | - Phillip Aouad
- Departments of Pain and Palliative Care, Sydney Children's Hospital - Randwick, Sydney, Australia
- Department of Pain, Sydney Children's Hospital - Randwick, Sydney, Australia
| | - Tiina Jaaniste
- Departments of Pain and Palliative Care, Sydney Children's Hospital - Randwick, Sydney, Australia
- Department of Pain, Sydney Children's Hospital - Randwick, Sydney, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
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18
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Jaaniste T, Noel M, Yee RD, Bang J, Tan AC, Champion GD. Why Unidimensional Pain Measurement Prevails in the Pediatric Acute Pain Context and What Multidimensional Self-Report Methods Can Offer. Children (Basel) 2019; 6:children6120132. [PMID: 31810283 PMCID: PMC6956370 DOI: 10.3390/children6120132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/22/2019] [Accepted: 11/22/2019] [Indexed: 11/29/2022]
Abstract
Although pain is widely recognized to be a multidimensional experience and defined as such, unidimensional pain measurement focusing on pain intensity prevails in the pediatric acute pain context. Unidimensional assessments fail to provide a comprehensive picture of a child’s pain experience and commonly do little to shape clinical interventions. The current review paper overviews the theoretical and empirical literature supporting the multidimensional nature of pediatric acute pain. Literature reporting concordance data for children’s self-reported sensory, affective and evaluative pain scores in the acute pain context has been reviewed and supports the distinct nature of these dimensions. Multidimensional acute pain measurement holds particular promise for identifying predictive markers of chronicity and may provide the basis for tailoring clinical management. The current paper has described key reasons contributing to the widespread use of unidimensional, rather than multidimensional, acute pediatric pain assessment protocols. Implications for clinical practice, education and future research are considered.
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Affiliation(s)
- Tiina Jaaniste
- Department of Pain and Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (R.D.Y.); (J.B.); (G.D.C.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
- Correspondence:
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T3B 6A8, Canada
- Hotchkiss Brain Institute, Calgary, AB T2N 1N4, Canada
| | - Renee D. Yee
- Department of Pain and Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (R.D.Y.); (J.B.); (G.D.C.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Joseph Bang
- Department of Pain and Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (R.D.Y.); (J.B.); (G.D.C.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
| | | | - G. David Champion
- Department of Pain and Palliative Care, Sydney Children’s Hospital, Randwick, NSW 2031, Australia; (R.D.Y.); (J.B.); (G.D.C.)
- School of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
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Kelada L, Wakefield CE, Heathcote LC, Jaaniste T, Signorelli C, Fardell JE, Donoghoe M, McCarthy MC, Gabriel M, Cohn RJ. Perceived cancer-related pain and fatigue, information needs, and fear of cancer recurrence among adult survivors of childhood cancer. Patient Educ Couns 2019; 102:2270-2278. [PMID: 31257099 DOI: 10.1016/j.pec.2019.06.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 12/18/2018] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Pain and fatigue are under-researched late effects of childhood cancer and its treatment, and may be interpreted by survivors as indicating cancer recurrence. Moreover, unmet information needs for managing pain and fatigue may be related to fear of cancer recurrence. We investigated the complex relationships between perceived cancer-related pain and fatigue, unmet information needs for managing pain and fatigue, and fear of cancer recurrence. METHODS We surveyed 404 adult survivors of any form of childhood cancer (M = 16.82 years since treatment completion). RESULTS Many survivors reported perceived cancer-related pain (28.7%) and fatigue (40.3%), and anticipated future pain (19.3%) and fatigue (26.2%). These symptomologies were all related to unmet information needs for managing pain (18.8%) and fatigue (32.2%; all p's<.001). Survivors reporting unmet information needs for managing pain (B = .48, 95% CI = 0.19-0.76, p = .001) and fatigue (B = .32, 95% CI = 0.06-0.52, p = .015) reported higher fear of cancer recurrence than survivors reporting no information needs. CONCLUSION Survivors often have unmet information needs for managing pain and fatigue, and these unmet needs are related to fear of cancer recurrence. PRACTICE IMPLICATIONS Long-term follow-up clinics should assess pain and fatigue. Information provision about pain and fatigue may be an important tool to help manage fear of cancer recurrence.
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Affiliation(s)
- L Kelada
- School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, Australia.
| | - C E Wakefield
- School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, Australia
| | - L C Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical School, Palo Alto, USA
| | - T Jaaniste
- School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Department of Pain & Palliative Care, Sydney Children's Hospital, High Street, Randwick, Australia
| | - C Signorelli
- School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, Australia
| | - J E Fardell
- School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, Australia
| | - M Donoghoe
- School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, Australia
| | - M C McCarthy
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - M Gabriel
- Cancer Centre for Children, The Children's Hospital, Westmead, Australia
| | - R J Cohn
- School of Women's and Children's Health, UNSW Sydney, Kensington, Australia; Kids Cancer Centre, Sydney Children's Hospital, High Street, Randwick, Australia
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Goymour KL, Heaton M, Coombs S, Kelk N, Estreich K, Sarraf S, Trethewie S, Jaaniste T. Developing the Comfort Care Case: An End-of-Life Resource for Pediatric Patients, Their Families, and Health Professionals. J Palliat Care 2018; 34:197-204. [PMID: 30168359 DOI: 10.1177/0825859718796791] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Caring for a child in hospital who is approaching death, in the terminal phase, requires a focus on caring for the physical, emotional, and spiritual needs of the child and family. Health professionals caring for these children and families may need to shift their focus from a treatment-focused approach aimed at cure or maintaining life to a comfort-focused approach. The Comfort Care Case (CCC) is a collection of resources designed for use in hospital to ease suffering and facilitate comfort within a pediatric end-of-life (EOL) context. The resources are intended to support the child, the family, and the health professionals involved in EOL care. This article describes the development, implementation, and education associated with the CCC in a tertiary pediatric hospital.
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Affiliation(s)
- Kirsty-Leah Goymour
- 1 Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,2 Child Life and Music Therapy Department, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Maria Heaton
- 1 Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Sandra Coombs
- 1 Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Norm Kelk
- 1 Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Kylie Estreich
- 2 Child Life and Music Therapy Department, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Sara Sarraf
- 1 Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Susan Trethewie
- 1 Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Tiina Jaaniste
- 1 Department of Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia.,3 School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
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21
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Jaaniste T, Coombs S, Donnelly TJ, Kelk N, Beston D. Risk and Resilience Factors Related to Parental Bereavement Following the Death of a Child with a Life-Limiting Condition. Children (Basel) 2017; 4:children4110096. [PMID: 29120367 PMCID: PMC5704130 DOI: 10.3390/children4110096] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/17/2017] [Accepted: 10/31/2017] [Indexed: 11/16/2022]
Abstract
This paper reviews the theoretical and empirical literature on risk and resilience factors impacting on parental bereavement outcomes following the death of a child with a life-limiting condition. Over the past few decades, bereavement research has focussed primarily on a risk-based approach. In light of advances in the literature on resilience, the authors propose a Risk and Resilience Model of Parental Bereavement, thus endeavouring to give more holistic consideration to a range of potential influences on parental bereavement outcomes. The literature will be reviewed with regard to the role of: (i) loss-oriented stressors (e.g., circumstances surrounding the death and multiple losses); (ii) inter-personal factors (e.g., marital factors, social support, and religious practices); (iii) intra-personal factors (e.g., neuroticism, trait optimism, psychological flexibility, attachment style, and gender); and (iv) coping and appraisal, on parental bereavement outcomes. Challenges facing this area of research are discussed, and research and clinical implications considered.
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Affiliation(s)
- Tiina Jaaniste
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick NSW 2031, Australia.
- School of Women's and Children's Health, University of New South Wales, Kensington, NSW 2052, Australia.
| | - Sandra Coombs
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick NSW 2031, Australia.
| | - Theresa J Donnelly
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick NSW 2031, Australia.
| | - Norm Kelk
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick NSW 2031, Australia.
| | - Danielle Beston
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick NSW 2031, Australia.
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von Baeyer CL, Jaaniste T, Vo HLT, Brunsdon G, Lao HC, Champion GD. Systematic Review of Self-Report Measures of Pain Intensity in 3- and 4-Year-Old Children: Bridging a Period of Rapid Cognitive Development. J Pain 2017; 18:1017-1026. [PMID: 28347796 DOI: 10.1016/j.jpain.2017.03.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 12/06/2016] [Revised: 03/05/2017] [Accepted: 03/13/2017] [Indexed: 11/26/2022]
Abstract
Claims are made for the validity of some self-report pain scales for 3- and 4-year-old children, but little is known about their ability to use such tools. This systematic review identified self-report pain intensity measures used with 3- and/or 4- year-old participants (3-4yo) and considered their reliability and validity within this age span. The search protocol identified research articles that included 3-4yo, reported use of any pain scale, and included self-reported pain intensity ratings. A total of 1,590 articles were screened and 617 articles met inclusion criteria. Of the included studies, 98% aggregated self-report data for 3-4yo with data for older children, leading to overestimates of the reliability and validity of self-report in the younger age group. In the 14 studies that provided nonaggregated data for 3-4yo, there was no evidence for 3-year-old and weak evidence for 4-year-old children being able to use published self-report pain intensity tools in a valid or reliable way. Preschool-age children have been reported to do better with fewer than the 6 response options offered on published faces scales. Simplified tools are being developed for young children; however, more research is needed before these are adopted. PERSPECTIVE Some self-report pain scales have been promoted for use with 3- and 4-year-old children, but this is on the basis of studies that aggregated data for younger and older children, resulting in overestimates of reliability and validity for the preschool-age children. Scales with fewer response options show promise, at least for 4-year-old children.
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Affiliation(s)
- Carl L von Baeyer
- Department of Clinical Health Psychology, and Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Tiina Jaaniste
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Henry L T Vo
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Georgie Brunsdon
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Hsuan-Chih Lao
- School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia; Department of Anesthesiology and Pain Management Center, MacKay Children's Hospital, Taipei City, Taiwan
| | - G David Champion
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia
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Donnelly TJ, Jaaniste T. Attachment and Chronic Pain in Children and Adolescents. Children (Basel) 2016; 3:children3040021. [PMID: 27792141 PMCID: PMC5184796 DOI: 10.3390/children3040021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/12/2016] [Accepted: 10/17/2016] [Indexed: 11/16/2022]
Abstract
Although attachment theory is not new, its theoretical implications for the pediatric chronic pain context have not been thoroughly considered, and the empirical implications and potential clinical applications are worth exploring. The attachment framework broadly focuses on interactions between a child’s developing self-regulatory systems and their caregiver’s responses. These interactions are believed to create a template for how individuals will relate to others in the future, and may help account for normative and pathological patterns of emotions and behavior throughout life. This review outlines relevant aspects of the attachment framework to the pediatric chronic pain context. The theoretical and empirical literature is reviewed regarding the potential role of attachment-based constructs such as vulnerability and maintaining factors of pediatric chronic pain. The nature and targets of attachment-based pediatric interventions are considered, with particular focus on relevance for the pediatric chronic pain context. The potential role of attachment style in the transition from acute to chronic pain is considered, with further research directions outlined.
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Affiliation(s)
- Theresa J Donnelly
- Department of Pain & Palliative Care, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
| | - Tiina Jaaniste
- Department of Pain & Palliative Care, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
- School of Women's and Children's Health, University of New South Wales, Kensington, NSW 2052, Australia.
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Jaaniste T, Jia N, Lang T, Goodison-Farnsworth EM, McCormick M, Anderson D. The relationship between parental attitudes and behaviours in the context of paediatric chronic pain. Child Care Health Dev 2016; 42:433-8. [PMID: 26767347 DOI: 10.1111/cch.12312] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 08/23/2015] [Revised: 11/01/2015] [Accepted: 11/22/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Within the context of paediatric chronic pain, parental attitudes are of particular importance given that they have the potential to impact on how parents respond to their child. The current study was designed to assess whether parental attitudes, such as parental confidence and beliefs in their child's ability to function in spite of pain, and parental catastrophising about their child's pain, are associated with parental pain-related behaviours known to be associated with poor child outcomes, such as protectiveness and high levels of monitoring. METHODS Participants were 138 child-parent dyads recruited from a tertiary chronic pain clinic. Patients were aged 8- to 17-years. Prior to the initial clinic appointment, parents completed validated measures of parental pain catastrophising and parental responses to their child's pain. Patients completed measures of functional disability and pain intensity. RESULTS Parents who reported lower confidence in their child's ability to cope with the pain engaged in significantly more protective, monitoring and distracting behaviours, even when controlling for the child's recent level of functioning. They also took more days off work due to their child's pain. Parents who catastrophised more about their child's pain engaged in significantly more protective and monitoring behaviours, even when controlling for the child's recent level of functioning. CONCLUSIONS Parental behaviours in response to their child's pain are significantly related to parental confidence in their child's coping and parental pain-related catastrophising. Clinical interventions may benefit from addressing parental attitudes, especially their confidence in their child's ability to function.
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Affiliation(s)
- T Jaaniste
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - N Jia
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - T Lang
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - E M Goodison-Farnsworth
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - M McCormick
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - D Anderson
- Department of Pain and Palliative Care, Sydney Children's Hospital, Randwick, NSW, Australia
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Coenders A, Chapman C, Hannaford P, Jaaniste T, Qiu W, Anderson D, Glogauer M, Goodison-Farnsworth E, McCormick M, Champion D. In search of risk factors for chronic pain in adolescents: a case-control study of childhood and parental associations. J Pain Res 2014; 7:175-83. [PMID: 24707186 PMCID: PMC3971911 DOI: 10.2147/jpr.s48154] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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] [Indexed: 11/23/2022] Open
Abstract
Objectives This study was designed to investigate whether an individual and parental history of functional pain syndromes (FPS) is found more often in adolescents suffering from chronic pain than in their pain-free peers. Methods Our case–control study involved 101 adolescents aged 10–18 years. Cases were 45 patients of the Chronic Pain Clinic at Sydney Children’s Hospital with diverse chronic pain disorders. Controls consisted of 56 adolescent volunteers who did not have chronic pain. Adolescents and their parents filled out questionnaires assessing demographic data as well as known and potential risk factors for chronic pain. A history of FPS was assessed by questionnaire, including restless legs syndrome (RLS). Chi-squared tests and t-tests were used to investigate univariate associations between chronic pain in adolescents and lifetime prevalence of FPS. Logistic regression was used to test multivariate associations, while controlling for possible confounders. Results Migraine, non-migraine headaches, recurrent abdominal pain (RAP), and RLS were reported significantly more frequently in cases than controls (P-values of 0.01, <0.001, 0.01, and 0.03, respectively). Parental migraine, RAP, and RLS were also significantly associated with adolescent chronic pain in the multivariate analyses. Individual history of migraine, non-migraine headaches, and RAP, along with parental history of RAP and depression significantly accounted for 36%–49% of variance in chronic pain. Other associations with chronic pain were generally in accordance with previous reports. Discussion It may be helpful when assessing a child who has chronic pain or is at risk of chronic pain, to enquire about these associations. Based on the current findings, an individual history of migraine, non-migraine headaches, and RAP, as well as parental migraine, RAP, and RLS are symptoms that are of particular relevance to assess.
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Affiliation(s)
| | - Cindy Chapman
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | | | - Tiina Jaaniste
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia ; University of New South Wales, Kensington, NSW, Australia
| | - Wen Qiu
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | - David Anderson
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Maline Glogauer
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | | | - Marianne McCormick
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | - David Champion
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia ; University of New South Wales, Kensington, NSW, Australia
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Champion D, Pathirana S, Flynn C, Taylor A, Hopper JL, Berkovic SF, Jaaniste T, Qiu W. Growing pains: twin family study evidence for genetic susceptibility and a genetic relationship with restless legs syndrome. Eur J Pain 2012; 16:1224-31. [PMID: 22416025 DOI: 10.1002/j.1532-2149.2012.00130.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND Growing pains (GP) is a prevalent familial childhood disorder of unknown aetiology. Familial occurrence of GP, and individual and familial association of GP with restless legs syndrome (RLS) has been reported. METHODS We applied a twin family design to search for evidence of genetic susceptibility to GP, and for a genetic relationship between GP and RLS. The parents of 1843 twin pairs aged 3-16 years were administered a questionnaire, which identified 88 pairs with at least one twin individual fulfilling criteria for GP. Standard questionnaires for history of GP and RLS were completed for these twin pairs, their siblings and parents. RESULTS Twenty-five of 34 monozygotic (MZ) pairs were concordant for GP, compared with 12 of the 54 dizygotic (DZ) pairs. The casewise concordance was 0.85 and 0.36 for MZ and DZ pairs, respectively (p < 0.001). The lifetime GP prevalence for relatives of twins with GP was 51% for non-twin siblings, 47% for parents. Twenty-three percent of twin individuals with GP met RLS criteria compared with 8% of twin individuals without GP (p = 0.03). Of the twins with GP concordance, 19% met RLS criteria compared with 2% of twins with GP discordance (p = 0.01). In two MZ pairs, one had GP and the other RLS. The lifetime prevalence of RLS was 40% for mothers, and 24% for fathers and 18% for non-twin siblings. CONCLUSION This first twin family study of GP provides evidence for a genetic aetiology and for a genetic relationship to RLS.
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Affiliation(s)
- D Champion
- Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, Australia.
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Verhoeven K, Goubert L, Jaaniste T, Van Ryckeghem D, Crombez G. Pain catastrophizing influences the use and the effectiveness of distraction in schoolchildren. Eur J Pain 2012; 16:256-67. [DOI: 10.1016/j.ejpain.2011.06.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- K. Verhoeven
- Department of Experimental-Clinical and Health Psychology; Ghent University; Belgium
| | - L. Goubert
- Department of Experimental-Clinical and Health Psychology; Ghent University; Belgium
| | - T. Jaaniste
- Department of Anaesthesia and Pain Medicine; Sydney Children's Hospital; New South Wales; Australia
| | - D.M.L. Van Ryckeghem
- Department of Experimental-Clinical and Health Psychology; Ghent University; Belgium
| | - G. Crombez
- Department of Experimental-Clinical and Health Psychology; Ghent University; Belgium
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Abstract
PURPOSE To further the understanding of growing pains (GP), in particular, the nature of this pain disorder. METHODS This study included 33 children aged 5-12 years who met criteria for GP (cases) and 29 children without GP of similar age and sex (controls). Nineteen controls were siblings of cases. GP was diagnosed by standard consensus questionnaires. A questionnaire addressed characteristics of the pain and family history of GP. Evidence for peripheral neuropathic disorder was tested by somatosensory testing and provocation tests of peripheral nerves. Somatosensory testing by a blinded researcher involved threshold determination and/or response magnitude to nonpainful stimuli including touch, dynamic brush, cold, vibration, and deep pressure applied to limb and abdominal sites. RESULTS Distributional, temporal, and quality characteristics of the pain were in accordance with published descriptions. There was no indication of primary musculoskeletal disorder. No evidence was found that GP is a peripheral neuropathic pain syndrome. There were minor but statistically significantly increased responses to cutaneous cold, vibration, and to deep pressure stimuli in cases compared to controls, evident in a wider distribution than the symptomatic lower limbs. CONCLUSION GP is a regional pain syndrome with evidence in this study of mild widespread disorder of somatosensory processing.
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Affiliation(s)
- Shanthi Pathirana
- Department of Anesthesia and Pain Medicine, Sydney Children’s Hospital, Randwick, New South Wales, Australia
| | - David Champion
- Department of Anesthesia and Pain Medicine, Sydney Children’s Hospital, Randwick, New South Wales, Australia
- Department of Rheumatology, Sydney Children’s Hospital, Randwick, New South Wales, Australia
| | - Tiina Jaaniste
- Department of Anesthesia and Pain Medicine, Sydney Children’s Hospital, Randwick, New South Wales, Australia
| | - Anthony Yee
- Department of Rheumatology, Sydney Children’s Hospital, Randwick, New South Wales, Australia
| | - Cindy Chapman
- Department of Anesthesia and Pain Medicine, Sydney Children’s Hospital, Randwick, New South Wales, Australia
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Gordon BK, Jaaniste T, Bartlett K, Perrin M, Jackson A, Sandstrom A, Charleston R, Sheehan S. Child and parental surveys about pre-hospitalization information provision. Child Care Health Dev 2011; 37:727-33. [PMID: 21198777 DOI: 10.1111/j.1365-2214.2010.01190.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is little available information about what children and parents would like to know about a forthcoming hospitalization and what they currently receive. METHODS The current study was a survey of 102 children between the ages of 6 and 10 years and their parents recruited either from the Recovery Unit following day surgery or from the wards following overnight admissions at Sydney Children's Hospital, Australia. Information was obtained about each child's experience in hospital, the nature and format of information that they had received prior to the admission, and what information the child/parent thought would be helpful to receive. RESULTS Parents recorded a total of 163 questions asked by children prior to their admission. Questions related to timing (e.g. duration of admission, length of procedure), pain, procedural information, anaesthesia, needles, whether parents can be present, activities to do in hospital, seeking explanations ('Why' questions), hospital environment, seeking reassurance and miscellaneous questions. Children who were satisfied with the amount of information they received before coming to hospital subsequently reported that they would be significantly less scared should they need to come back to hospital for a future procedure. A total of 46.7% of children received information about their hospitalization from their parent(s) and a further 12% from a doctor and parent. CONCLUSIONS Children were found to have many questions about a forthcoming hospitalization. Parents were found to have a major role as information providers. Further research is needed to assess parental confidence and competence to meet their child's information needs.
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Affiliation(s)
- B K Gordon
- Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, NSW, Australia.
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Von Baeyer CL, Jaaniste T. Computer-Animated Faces Pain Scale: Commentary on Fanciullo et al. (2007). Pain Med 2009; 10:195-6; author reply 197-8. [DOI: 10.1111/j.1526-4637.2008.00480.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bustos T, Jaaniste T, Salmon K, Champion GD. Evaluation of a Brief Parent Intervention Teaching Coping-Promoting Behavior for the Infant Immunization Context. Behav Modif 2008; 32:450-67. [DOI: 10.1177/0145445507309031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was designed to investigate whether a brief intervention encouraging parental coping-promoting talk within the treatment room would have beneficial effects on infant pain responses to an immunization injection. Infant-parent dyads were recruited from a 6-month immunization clinic and randomized to an intervention group ( n = 25) or standard care control group ( n = 25). Parents in the intervention group received an information sheet describing adult verbalizations associated with better pain outcomes for infants. The immunization procedure was videotaped. Parents in the intervention condition made significantly more coping-promoting statements than parents in the control condition. Infants in the control condition cried significantly longer than infants in the intervention condition. Coping-promoting and distress-promoting statements did not differ in terms of affective quality. Infants whose parents had rated them as more difficult in temperament cried longer following the injection. Teaching parents to engage in coping-promoting behaviors within the infant treatment room is an effective, low-cost intervention.
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Affiliation(s)
- Theona Bustos
- University of New South Wales, Sydney, Australia, Sydney Children's Hospital, Australia
| | - Tiina Jaaniste
- University of New South Wales, Sydney, Australia, Sydney Children's Hospital, Australia
| | - Karen Salmon
- University of New South Wales, Sydney, Australia
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Jaaniste T, Hayes B, von Baeyer CL. Effects of preparatory information and distraction on children's cold-pressor pain outcomes: A randomized controlled trial. Behav Res Ther 2007; 45:2789-99. [PMID: 17727813 DOI: 10.1016/j.brat.2007.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [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: 03/15/2007] [Revised: 07/13/2007] [Accepted: 07/18/2007] [Indexed: 11/22/2022]
Abstract
This experimental study investigated whether preparatory sensory information was more effective in managing children's pain when coupled with a distraction technique. Seventy-eight children aged 7-12 years were randomly allocated to 1 of 4 experimental conditions. They were given either a detailed sensory description of an imminent painful event (cold-pressor arm immersion in 10 degrees C water) or control instructions lacking sensory information. During the cold-pressor task, half the sample received an imagery-based distraction intervention. Pain measures included immersion tolerance, self-reported pain intensity, and facial pain responses. Self-reported coping style was assessed using the Pain Coping Questionnaire [Reid, G. J., Gilbert, C. A., & McGrath, P. J. (1998). The pain coping questionnaire: Preliminary validation. Pain, 76, 83-96]. The effects of information provision interacted with distraction for pain intensity but not pain tolerance. Children given sensory preparation reported less intense pain when this was coupled with distraction than when it was not. Children with a distraction-based coping style showed greater tolerance when assigned to a condition congruent with their coping style. These findings suggest ways to better prepare children for painful medical procedures.
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Affiliation(s)
- Tiina Jaaniste
- Pain Medicine Unit, Sydney Children's Hospital, High Street Randwick, NSW 2031, Australia.
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Blount RL, Simons LE, Devine KA, Jaaniste T, Cohen LL, Chambers CT, Hayutin LG. Evidence-based assessment of coping and stress in pediatric psychology. J Pediatr Psychol 2007; 33:1021-45. [PMID: 17938147 DOI: 10.1093/jpepsy/jsm071] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To review selected measures of stress and coping in pediatric populations. Stress and coping are presented within a risk and resiliency framework. METHODS The Society of Pediatric Psychology (SPP) surveyed the membership to identify the most frequently used assessment instruments. Twelve measures of coping and three measures of stress were reviewed. These instruments were evaluated using the Stress and Coping workgroup's modification of the criteria developed by the SPP Assessment Task Force (SPP-ATF). RESULTS One of the three measures of stress and five of the 12 measures of coping were Well-established measures that broaden understanding. Additionally, one of the coping measures was categorized as a Well-established measure that guides treatment. Merits of the individual measures are discussed. CONCLUSIONS Recommendations for future research are provided, including suggestions for the construction and use of measures to inform treatment research.
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Affiliation(s)
- Ronald L Blount
- Department of Psychology, University of Georgia, Athens, GA 30602-3013, USA.
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Jaaniste T, Hayes B, von Baeyer CL. Providing children with information about forthcoming medical procedures: A review and synthesis. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1468-2850.2007.00072.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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