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Pain in children and adolescents in primary care: chronic and recurrent pain is common
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnonkologisk forskning/Pfeifer)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
2012 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 12, 1246-1252 p.Article in journal (Refereed) Published
Abstract [en]

Aim: 

The aim of this study was to describe a paediatric primary care pain sample and examine associations between pain, health-related quality of life and disability.

Methods: 

The study design is descriptive and cross-sectional. One hundred and fifty-four consecutive children and adolescents between the ages of 8 and 16 seeking care for a pain-related conditions participated in this study. Pain characteristics, health-related quality of life and disability were investigated.

Results: 

Eighty-seven per cent of participants had a pain duration of 3 months or more, and almost half of the group studied had a pain duration of ≥ 12 months. The disability levels in the study group as a whole were low, with a mean FDI of 10.4 (SD 7.6). However, 35% of the study group had moderate disability levels and reported a mean FDI of 18.7 (SD 4.8). Single pain location was reported in 42%, whereas 58% had two or more pain locations. The children with multiple pain locations reported lower health-related quality of life and higher disability than children with single pain location.

Conclusion:

Paediatric pain patients in primary care consist partly of patients only slightly influenced by pain and partly of patients for whom pain has a great impact on their lives.

Place, publisher, year, edition, pages
2012. Vol. 101, no 12, 1246-1252 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-187141DOI: 10.1111/j.1651-2227.2012.02829.xISI: 000310868300029PubMedID: 22924888OAI: oai:DiVA.org:uu-187141DiVA: diva2:573812
Available from: 2012-12-03 Created: 2012-12-03 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Children and Adolescents with Pain in Primary care: Biopsychosocial determinants and behavioral medicine treatment in a physical therapy framework
Open this publication in new window or tab >>Children and Adolescents with Pain in Primary care: Biopsychosocial determinants and behavioral medicine treatment in a physical therapy framework
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Pain during childhood and adolescents is prevalent and longstanding pain can have severe consequences for children, their families and in the long run for the society. Persisting pain influences many aspects of life and pain-related disability is often associated with impairment, decreased health-related quality of life, school functioning, participation in social life, emotional well-being, and with increased healthcare utilization. The overall aim was to explore, with cross-sectional design, pain conditions, to identify biopsychosocial determinants and their association with pain-related disability, and to study the feasibility of applying a behavioral medicine treatment for adolescents experiencing musculoskeletal pain using randomized controlled design and multimethod approach. Samples of children and adolescents and their parents seeking primary care physical therapy for a pain condition, and a sample of treating physical therapists were included.

The results showed that some children had profiles of biopsychosocial determinants that could increase the risk for long-term pain-related disability. Many had long pain duration and multiple pain locations. Girls reported higher levels of catastrophizing compared to boys, who in turn used more behavioral distraction generally regarded as a positive coping strategy.

Behavioral medicine treatment, based on a biopsychosocial approach, targeting adolescents with pain was shown to be feasible for use in primary care, with promising outcomes. Tailoring of the treatment was suboptimal but the effect of behavioral medicine treatment in pain-related disability exceeded the effect of the control treatment. The satisfaction with treatment content and results were high for both the control- and experimental condition, significantly higher for the experimental condition as rated by participants. Learning and delivering the behavioral medicine intervention was perceived challenging but rewarding by the treating physical therapists. The biopsychosocial approach in tailoring the treatment, and dialogs with parents were identified as key aspects in the behavioral medicine treatment program.

In conclusion, in children seeking primary care for pain, the factors associated with pain-related disability were complex and interrelated. The findings highlight the importance for primary care health care providers to apply a biopsychosocial approach in assessment and treatment, for improvement of activities and participation, and thereby helping children and adolescents regain health.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 100 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 988
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-220957 (URN)978-91-554-8920-5 (ISBN)
Public defence
2014-05-23, Universitetshuset, sal IX, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2014-04-28 Created: 2014-03-24 Last updated: 2014-04-29

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Holm, SaraLjungman, Gustaf

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