uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
An acceptance-based intervention for children and adolescents with cancer experiencing pain – a single subject study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Barnonkologiska forskargruppen)
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. (Applied Behavior Analysis)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Klinisk psykologi i hälso- och sjukvård)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Barnonkologiska forskargruppen)
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Children and adolescents with cancer report pain as one of their most recurrent and troublesome symptoms throughout the cancer trajectory. Pain evokes psychological distress, which in turn, has an amplifying effect on the pain experience. Acceptance-based interventions for experimentally induced acute pain predict increased pain tolerance, decreased pain intensity and decreased discomfort of pain. The aim of this study was to preliminarily evaluate an acceptance-based intervention for children and adolescents with cancer experiencing acute pain, with regards to feasibility and effect on pain intensity and discomfort of pain.

Methods: The study is a single subject study with an AB design with a non-concurrent multiple baseline. Children and adolescents aged 4-18 years undergoing cancer treatment at the Children’s University Hospital, Uppsala, Sweden, reporting sustained acute pain were offered participation. Pain intensity and discomfort of pain were measured during baseline and at post intervention. The intervention consisted of a pain exposure exercise lasting approximately 15 minutes.

Results: Five children participated in the study. All participants completed the intervention and reported that it had helped them to cope with the pain in the moment. All participants reported decreased discomfort of pain at post measurement, three of whom also reported decreased pain intensity.

Discussion: The results suggest that an acceptance-based intervention may help children and adolescents with cancer to cope with the pain that is often associated with cancer treatment in spite of pharmacological pain management. The results are tentative but promising and warrant further investigation.  

Keyword [en]
Acute pain, children, cancer, acceptance, pain intensity, discomfort of pain
National Category
Applied Psychology Other Medical Sciences not elsewhere specified
Research subject
Psychology
Identifiers
URN: urn:nbn:se:uu:diva-322400OAI: oai:DiVA.org:uu-322400DiVA: diva2:1097240
Funder
Swedish Childhood Cancer Foundation, FTJH11/002 och PR2013/0058Swedish Cancer Society, CAN2013/749
Available from: 2017-05-22 Created: 2017-05-22 Last updated: 2017-08-15Bibliographically approved
In thesis
1. Acceptance for persons suffering from pain: Evaluation of acceptance-based interventions for adults with chronic pain and children with cancer experiencing acute pain
Open this publication in new window or tab >>Acceptance for persons suffering from pain: Evaluation of acceptance-based interventions for adults with chronic pain and children with cancer experiencing acute pain
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

It is increasingly clear that pain and emotions are closely interconnected. Pain does not only cause psychological distress, but psychological distress also amplifies pain through neurological mechanisms. Treatment of both chronic and acute pain would benefit from acknowledging the psychological mechanisms of pain neurophysiology. Psychological acceptance predicts increased pain tolerance and decreased pain intensity and discomfort in experimentally induced pain and improved physical and psychosocial functioning for persons with chronic pain.

The overall aim of this thesis was to evaluate acceptance-based interventions for persons suffering from pain.

In Study I the effect of a manualised ACT-based self-help intervention for adults with chronic pain was evaluated in an RCT (n=90). The results showed improvements in satisfaction with life, physical functioning and pain intensity for the ACT group. Both the ACT and the control group improved regarding depression and anxiety. In Study II the mediating effect of acceptance for treatment change was evaluated, using data from Study I (n=64). The results showed indirect effects of treatment via acceptance for physical functioning but not for satisfaction with life. In Studies III and IV, instruments to measure psychological flexibility in relation to pain were developed for children with cancer, and their parents respectively, using factor analysis. The results showed that a two-factor solution for the child scale (n=61) and a three-factor solution for the parent scale (n=243), best represented the data. In Study V, an acceptance-based intervention was preliminarily evaluated in a single-subject study (n=5) for children reporting pain during cancer treatment. The intervention consisted of an approximately 15-minute long pain exposure exercise. All participants reported reduced discomfort of pain, and three of the participants reported reduced pain intensity.

The results suggest that a manualised ACT-based self-help intervention is a valuable addition to the treatment repertoire for persons with chronic pain and that acceptance may mediate the effect of treatment on physical functioning. Furthermore, instruments to measure acceptance in the context of acute pain in children with cancer are now available, although further validation is needed. Lastly, the results indicate that an acceptance-based intervention may help children undergoing cancer treatment to cope with pain.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. 64 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1340
Keyword
acute pain, chronic pain, acceptance, psychological flexibility, acceptance and commitment therapy, children and adolescents, cancer
National Category
Applied Psychology Other Medical Sciences not elsewhere specified
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-322401 (URN)978-91-513-0001-6 (ISBN)
Public defence
2017-09-08, Sal IX, Gamla universitetshuset, Biskopsgatan 3, 753 10 Uppsala, Uppsala, 09:00 (English)
Opponent
Supervisors
Funder
Swedish Childhood Cancer Foundation, FTJH11/002 och PR2013/0058Swedish Cancer Society, CAN2013/749
Available from: 2017-08-18 Created: 2017-05-22 Last updated: 2017-09-08
2.
The record could not be found. The reason may be that the record is no longer available or you may have typed in a wrong id in the address field.

Open Access in DiVA

No full text

Search in DiVA

By author/editor
Thorsell Cederberg, JennyDahl, JoAnnevon Essen, LouiseLjungman, Gustaf
By organisation
Department of Women's and Children's HealthDepartment of Psychology
Applied PsychologyOther Medical Sciences not elsewhere specified

Search outside of DiVA

GoogleGoogle Scholar

Total: 235 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf