Mobilizing the psychology evidence base for the treatment of pediatric chronic pain: The development, implementation, and impact of the Comfort Ability Program

Coakley, Rachael; Bujoreanu, Simona

doi:10.1002/pne2.12019

Cited by 8 publications

(10 citation statements)

References 38 publications

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“…Children who had chronic pain (and their parents) reported different pain-related needs and expectations in the hospital setting than children who underwent painful medical procedures, without having an underlying chronic pain condition. Children who have chronic pain often require multimodal interventions to help manage their longstanding pain and to improve function [ 27 , 28 ]. Interestingly, participants with chronic pain in this study noted that the procedural pain associated with diagnostic or therapeutic interventions such as needle pokes became less distressing over time.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Study of the Pain Experiences of Children and Their Parents at a Canadian Children’s Hospital

et al. 2022

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Current literature is lacking in describing families’ experiences in being involved in children’s pain management. This study sought to understand children and their parents’ experiences with pain management at a tertiary care children’s hospital. Twelve child–parent dyads were recruited to participate in the study from January to August 2022. Children and their parents chose whether to be interviewed together or separately. Transcripts were analyzed using inductive, data-driven codes. Codes and themes were developed using a codebook and member-checking. Three main themes were identified: a. Painful experiences can have a significant positive or negative effect on families’ lives and healthcare trajectories; b. There can be a mismatch between families’ expectations of pain management and how they perceive the pain was managed; c. Families feel that they must advocate for better pain care, but often feel too intimidated to do so, or worry that their concerns will be dismissed by healthcare professionals. Families want healthcare professionals to proactively manage their children’s pain, supporting the shaping of early positive memories of the child’s healthcare interactions. Healthcare providers must further recognize that poorly treated pain can significantly impact families’ lives and should both seek and be receptive to child and parent input for better pain care.

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Section: Discussionmentioning

confidence: 99%

A Qualitative Study of the Pain Experiences of Children and Their Parents at a Canadian Children’s Hospital

et al. 2022

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“…Yet there remains a significant gap in pediatric health care and few parents gain access to this critical component of treatment. The Comfort Ability Program (CAP), a novel intervention developed to cotreat parents along with pediatric patients who have chronic or persistent pain, was designed to address this gap in care by fully integrating a targeted parent-focused intervention into the care pathway of a child with chronic pain (Coakley & Bujoreanu, 2020). Previous research has established the feasibility and acceptability of the intervention and a single-arm study broadly reported treatment benefit (Coakley et al, 2018).…”

Section: Pediatric Chronic Painmentioning

confidence: 99%

Parent training through the comfort ability program for pediatric chronic pain management: Self-reported expectations and outcomes.

Burns¹,

Hale²,

Riley³

et al. 2023

Clinical Practice in Pediatric Psychology

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Objective: Targeted parent interventions are known to improve outcomes in pediatric pain, but systematic delivery of this type of training for parents is a challenge. The Comfort Ability Program (CAP) is a well-established, manualized intervention, delivered in a single-day intensive workshop format that includes 6 hr of parent training. The primary goal of this article is to systematically evaluate the impact of the parent training arm of this program on parent expectations and outcomes. Method: A sample of parents who attended CAP (n = 130) and a control sample (n = 74) completed self-report questionnaires at baseline, 30, and 90 days after baseline. Separately, a sample of parents attending CAP (n = 537) completed quality improvement (QI) assessments evaluating pretreatment expectations and posttreatment perceived benefits. Results: Preliminary linear mixed model analysis indicate parents who attended CAP demonstrated significant reductions in pain catastrophizing (PCS; b-estimate = -2.57, SE = 1.1, p , .05) and improvements in pain self-efficacy (PSES, b-estimate = À2.14, SE = .63; p , .01) as compared with controls. Parent over protectiveness (ARCS) and parent-report of child pain severity (PPST) did not differ between groups. Coding of parents' qualitative assessments suggest that parents who attend CAP are actively seeking skills-based training. Postintervention, parents report immediate benefit from an array of program-specific targets, including how to construct a plan for a child's return to function, social support, and pain neuroscience education. Conclusion: Parents who attend CAP demonstrate significant changes in research-identified parenting practices over time as compared to controls. Additionally, parent report of posttreatment benefit extends beyond pretreatment expectations (i.e., skills training) to include social support and pain education.

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“…While classes co-led by parents may have produced a sense of comradery and satisfaction, higher reports of knowledge gained from clinician-only led classes may be related to perception of a higher sense of importance of those topics and/or participant's perception of an opportunity to receive specialized instruction from a clinician. However, the relationship between perceptions of knowledge gained and instructor may also be confounded A previous study documented a reduction in no-show rates of participants in group-based interventions when a small, out-of-pocket registration fee was implemented, hypothesizing that payment may enhance the participants' commitment to the service (Coakley & Bujoreanu, 2020). Similar to those findings, when a small participant registration fee was implemented for classes after August 2019, the team noted an increase in the register-to-attendance rate (61.36% to 91.84%) overall.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study documented a reduction in no‐show rates of participants in group‐based interventions when a small, out‐of‐pocket registration fee was implemented, hypothesizing that payment may enhance the participants' commitment to the service (Coakley & Bujoreanu, 2020). Similar to those findings, when a small participant registration fee was implemented for classes after August 2019, the team noted an increase in the register‐to‐attendance rate (61.36% to 91.84%) overall.…”

Section: Discussionmentioning

confidence: 99%

Caregiver education programme on intellectual and developmental disabilities: An acceptability and feasibility study in an academic medical setting

Stone‐Heaberlin,

Blackburn,

Qian

2023

Child

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BackgroundChildren and adolescents with intellectual and developmental disabilities (I/DD), including autism spectrum disorder, benefit from a variety of specialized interventions. However, there are barriers that impact families' ability to access such services for their children. While not intended as a replacement for individualized or group‐based interventions, educational classes may be an option in providing supplemental resources and support to families of individuals with I/DD. This study was a programme evaluation that examined the feasibility and acceptability of a Caregiver Education Program that was created in an outpatient specialty clinic of an academic medical centre, designed to provide educational information on a variety of topics relevant to children and adolescents with I/DD (e.g., toilet training, understanding behaviour and managing anxiety).MethodThe review included 1027 participants from 40 classes led by licensed clinicians, trainees, and/or experienced caregivers. Classes occurred approximately one time per month over the course of three‐and‐a‐half years and targeted caregivers of children and adolescents with I/DD and community‐based professionals in the field of I/DD. Participants were able to attend one or multiple classes, based on their interest in the given topic. Participants were asked to complete post‐training surveys at the end of each session as part of ongoing programme evaluation.ResultsParticipants reported a high level of satisfaction and increased knowledge as a result of participating in classes, and higher knowledge gained and higher satisfaction for in‐person classes compared to virtual classes.ConclusionsThis programme is one model of education delivery with high acceptability and feasibility, designed to support families and increase access to information beyond specialized interventions. Future directions include improving the model of programme data collection, examination of the programme's generalization to practice and to other communities, and an emphasis on culturally responsive curricula.

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Mobilizing the psychology evidence base for the treatment of pediatric chronic pain: The development, implementation, and impact of the Comfort Ability Program

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 8 publications

References 38 publications

A Qualitative Study of the Pain Experiences of Children and Their Parents at a Canadian Children’s Hospital

A Qualitative Study of the Pain Experiences of Children and Their Parents at a Canadian Children’s Hospital

Parent training through the comfort ability program for pediatric chronic pain management: Self-reported expectations and outcomes.

Caregiver education programme on intellectual and developmental disabilities: An acceptability and feasibility study in an academic medical setting

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