The efficacy of an educational movie to improve pain and dysfunctional behavior in school children: A randomized controlled trial

Abstract

Background: Chronic pain in children is a serious issue, therefore calling for effective prevention/intervention measures. This study aimed to evaluate the efficacy of an educational movie on pain knowledge in school children in general and on pain-related behaviours and pain intensity in those who are affected by chronic pain.Regarding those affected, the association between pain knowledge and intensity, as well as the potential mediating effect of pain-related behaviours, were investigated. Methods: Recruited from four schools, N = 381 students (51.7% female; M age = 11.4, SD = 0.95) participated, of which n = 108 reported chronic pain. Each school was randomly allocated to the intervention or control group (cluster-randomization). At two time points spaced 4-5 weeks apart, students provided information on their pain knowledge, pain-related behaviour (passive pain coping, pain-related disability, missed school days, medication use) and pain intensity. After the first assessment, students in the intervention group watched an educational movie. Multilevel linear models for all outcomes were calculated as well as a mediation analysis. Results: Pain knowledge increased significantly in the intervention group (β = 2.76 [95% CI 2.20, 3.31]). However, no significant time-by-group interactions were found for pain-related behaviour or pain intensity. The mediation model identified that the indirect effect of pain knowledge on pain intensity was mediated by pain-related behaviour (β = −0.18, p = 0.014 and β = 0.38, p < 0.001, respectively). Conclusions: Educational movies may be an effective tool for educating students about pain management. However, the knowledge gained may not be sufficient to improve pain behaviour and intensity overall. Significance: A 10-min educational movie on chronic pain management was tested in school children (N = 381). Following the intervention, knowledge of chronic pain concepts was statistically greater in the intervention group compared to the control group not watching the movie. Furthermore, a mediation model theoretically determined whether an association between pain knowledge and pain intensity exists, and whether this is explained by level of dysfunctional pain-related behaviorisms. Full mediation was confirmed.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Spreading the word: pediatric pain education from treatment to prevention

“…On the true preventative side, very recently, pain education is being delivered to and studied in a one-on-one format in healthy children [36,37] as well as in larger groups at middle schools [31,[38][39][40][41][42][43]. Rheel et al [36] found that healthy children (aged 8-15 years) who watched a 15minute pain education video before an experimental heat pain task had higher pain knowledge and higher heat pain thresholds after watching the video compared to a group of children who did not watch this video.…”

“…No pre-post differences however, were found regarding parental pain catastrophizing or parental pain vigilance and awareness. Studies examining whether delivering pain education to larger groups of children (age range: 10-15 years) in a school/classroom setting (i.e., group sizes ranging from 15 to 70 students) via a lecture and/or a video demonstrate beneficial changes in pain knowledge, healthier beliefs regarding pain [32,[39][40][41][42][43][44], and ultimately positive behavioral outcomes such as less pain medication use [41]. Positive behavioral results were larger when the initial pain education session was supplemented by short video booster sessions after a few months [41].…”

Pain science education for children living with and beyond cancer: Challenges and research agenda

“…PSE comprises one or more patient-tailored educational sessions, typically face-to-face between a therapist and patient, and supported by educational materials. Evidence in children and adolescents in clinical 43,44 and nonclinical [45][46][47][48] settings shows that PSE results in increased pain knowledge, 43,[45][46][47][48][55][56][57] more functional pain beliefs, 46,56,57 less catastrophic worry about pain, 58 less pain-related fear, 44 less functional disability, 44 less medication use, 45 higher pain thresholds, 44,48 higher school attendance, 45 and decreased fear of physical activity. 56 There is less evidence that PSE for both adults and children results in reduced pain intensity, 43,44,59 pressure pain thresholds, 60,61 or anxiety.…”

Schmerz-Know-How für Kids und Teenager

“…Lea Höfel, Anja Schramm, Bianca Roth, Mathias Georgi und Johannes-Peter Haas Altersgerechte Informationsvermittlung Eine ansprechende Gestaltung und Didaktik in schriftlicher, auditiver oder visueller Form kann zum Wissenserwerb beitragen [5]. Beispiele hierfür sind die YouTube-Videos "Wissenswertes zum Schmerz" des ‚Zentrums für Schmerztherapie junger Menschen' oder "Den Schmerz verstehenund was zu tun ist in 10 Minuten!"…”