Racial Differences in Parental Responses to Children’s Chronic Pain

El‐Behadli, Ana F.; Gansert, Patricia K.; Logan, Deirdre E.

doi:10.1097/ajp.0000000000000424

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…One limitation that has been briefly discussed is the internal reliability of the ARCS. Although the internal reliabilities are consistent with previously published research [23,58], the distraction and minimizing subscales demonstrated low internal consistency, making it difficult to draw conclusions from the results. Further instrument development and psychometric testing are necessary to contribute more meaningful research that examines a full complement of parent responses beyond protectiveness.…”

Section: Strengths Limitations and Future Directionssupporting

confidence: 72%

Quality of Life in Youth With Chronic Pain

Lee

McMurtry

Summers

et al. 2020

The Clinical Journal of Pain

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Objectives: Pediatric chronic pain has often been examined from a risk perspective, and relatively less is known about the individual and family-level resilience factors that help youth with chronic pain maintain their quality of life. This cross-sectional study: a) examined the relations among purported youth and parent resilience (youth pain acceptance and pain selfefficacy, parent psychological flexibility) and risk (youth pain intensity, parent protectiveness) factors with youth quality of life, and b) tested exploratory statistical mechanisms that may explain relations between parent and youth variables. Methods: Participants included 122 youth (10 to 17 years; M=14.26, SD=2.19) seen in an interdisciplinary pediatric chronic pain program and a parent. Youth completed measures of their average pain, quality of life, pain acceptance, and pain self-efficacy. Parents completed measures of their pain-related psychological flexibility and behavioral responses to pain (i.e., protectiveness, distraction, monitoring, minimizing).Results: Youth pain acceptance, pain self-efficacy, and parent psychological flexibility were highly positively correlated with each other, and with overall youth quality of life. Evidence for a buffering effect of pain acceptance and pain self-efficacy on the association between pain intensity and quality of life was not found. Protectiveness was found to be a significant mediator of the relation between parental psychological flexibility and youth quality of life. Discussion:The results are discussed in the context of the resilience-risk framework and current understandings of the role of parental factors for pediatric chronic pain.

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Section: Strengths Limitations and Future Directionssupporting

confidence: 72%

Quality of Life in Youth With Chronic Pain

Lee

McMurtry

Summers

et al. 2020

The Clinical Journal of Pain

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“…With respect to study design, the cross‐sectional design limits our ability to determine causal relation among study variables. Additionally, given the growing data that suggest that parents who identify as an ethnic minority may respond to children's pain differently, 19 possibly in response to different lived experiences (e.g., racism in medical contexts), 22 parents of children with SCD may respond to their children's pain differently than parents of children with other chronic pain. The ARCS has not yet been validated in a pediatric SCD sample, and therefore, may not capture culturally relevant parenting strategies.…”

Section: Discussionmentioning

confidence: 99%

“…With respect to study design, the crosssectional design limits our ability to determine causal relation among study variables. Additionally, given the growing data that suggest that parents who identify as an ethnic minority may respond to children's pain differently, 19 possibly in response to different lived experiences (e.g., racism in medical contexts), 22 In response to the COVID-19 pandemic's disproportionate negative impact on the Black community, coupled with the Black community's longstanding experience of racism in medical contexts, 22 it possible that rates of pain catastrophizing in youth with SCD have increased in response to elevated stress levels 39,40 and a possible increased need to magnify their pain experience to receive medical care. Relatedly, parent responses to pediatric SCD may have shifted in response to these stressors to ensure the safety of their children and communicate the severity and urgency of medical needs to providers.…”

Section: Discussionmentioning

confidence: 99%

“…11 Studies of parent responses to pediatric pain or catastrophizing have been conducted predominantly with White, affluent populations; cultural factors likely contribute to differences in parent responses to pediatric pain. 19 Indeed, data indicate that parents, who identify as an ethnic minority, may experience different emotional and behavioral responses to children's pain, related to different stress-coping mechanisms, 20,21 which may be activated by increased challenges, stress, and discrimination that minority communities encounter in medical settings. 22 Given that SCD predominantly affects the Black and African American community in the United States, data are needed to understand parent responses to pain and catastrophizing in this population.…”

Section: Introductionmentioning

confidence: 99%

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The influence of child pain catastrophizing and parent behavior on health‐related quality of life in pediatric sickle cell disease

Shneider

Cohen

Shih

2023

Pediatric Blood & Cancer

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Background: Literature suggests that a child's appraisal of pain and parent responses to pain are critical in predicting health-related outcomes. In youth with sickle cell disease (SCD), few investigations have examined child pain catastrophizing, and even fewer have examined the role that parents play in responding to SCD pain within the family context. The purpose of the current study was to examine the relationship between pain catastrophizing, parent response to child SCD pain, and health-related quality of life (HRQoL). Procedure: The sample (N = 100) included youth with SCD (ages 8-18) and their parent. Parents completed a demographic questionnaire and the Adult Responses to Child Pain Symptoms; youth completed the Pain Catastrophizing Scale and Pediatric Quality of Life Inventory-SCD Module. Results: Findings indicated that pain catastrophizing, parent minimization, and parent encouragement/monitoring significantly predicted HRQoL. Minimizing and encouragement/monitoring parent responses moderated the relationship between pain catastrophizing and HRQoL, such that parent minimizing weakened the relationship and parent encouragement/monitoring strengthened the relationship. Conclusions:Paralleling pediatric chronic pain literature, findings suggest that pain catastrophizing predicts HRQoL in youth with SCD. However, findings from moderation analyses diverge from the chronic pain literature; data suggest that encouragement/monitoring responses strengthen the negative relationship between child pain catastrophizing and HRQoL. Child pain catastrophizing and parent response to SCD pain may be appropriate targets for clinical intervention to improve HRQoL. Future studies should strive to better understand parent responses to SCD pain. K E Y W O R D Shealth-related quality of life, pain catastrophizing, sickle cell disease Abbreviations: SCD, sickle cell disease; HRQoL, health-related quality of life.

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“…Compared to other studies, the number of physician visits is rather low, while the number of students taking analgesics is higher. These differences are likely explained by differences in sample characteristics, different health care systems as well as cultural aspects (El‐Behadli et al., 2017).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with physician consultation and medication use in children and adolescents with chronic pain: A scoping review and original data

Könning

Rosenthal

Friese

et al. 2020

European Journal of Pain

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Background: Although paediatric chronic pain is common, it is not yet clear which individuals with chronic pain are likely to seek health care for their pain. The aims of this study were to summarize the current evidence of the characteristics of children and adolescents with chronic pain who consult a physician or use medication for their pain. Additionally, we aimed to expand knowledge by further investigating key and promising, factors in a large community sample of adolescents. Methods: First, using scoping review methodology, studies on health care utilisation in paediatric chronic pain were identified by the systematic literature search. Out of 1,158 articles, 12 were included for data extraction. Second, in a population-based cross-sectional survey, data of N = 2,280 adolescents (10-18 years) and their parents (N = 1,464), were analysed. Univariable logistic and multivariable LASSO regression models were calculated for adolescents with chronic pain (n = 749) to identify predictors of physician visits or analgesics intake due to pain, controlling for acute illness and injury. Results: The scoping review identified higher pain intensity, frequency, severity and pain-related disability as significant individual factors associated with physician consultation. Female sex and higher pain intensity were associated with medication consumption. Multivariable analyses with cross-sectional data revealed only painrelated school absence to be associated with physician consultation; analgesic medication use was associated with school absence and higher pain intensity. Conclusion: Original data from this study support prior findings. School absence and pain intensity, plausible surrogates for pain severity, are the most relevant factors in health care utilisation due to chronic pain. Significance: A scoping summary of existing research on predictors for physician consultation and medication use in children and adolescents with chronic pain is provided. Furthermore, the role of potential predictors for health care utilisationsociodemographic, pain, school, psychological and parent-related characteristics-is analysed in a population-based cross-sectional survey. Controlling for illness and injuries, and using a strict chronic pain definition, the cross-sectional survey allows conclusions on healthcare utilisation specific to chronic pain in adolescents.

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Racial Differences in Parental Responses to Children’s Chronic Pain

Abstract: Results highlight the need to adapt pediatric chronic pain interventions to family culture and context. Further research is needed to understand pediatric chronic pain from a cross-cultural perspective.

Cited by 7 publications

References 26 publications

Quality of Life in Youth With Chronic Pain

Quality of Life in Youth With Chronic Pain

The influence of child pain catastrophizing and parent behavior on health‐related quality of life in pediatric sickle cell disease

Factors associated with physician consultation and medication use in children and adolescents with chronic pain: A scoping review and original data

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