O48. Development and Feasibility Testing of a New Ipad Application, this Feeling, to Aid Communication of Pain in Children with Juvenile Idiopathic Arthritis

Abstract

Background: Despite advances in pain assessment systems, questions remain over how best to help children with inflammatory musculoskeletal conditions such as JIA communicate with healthcare professionals about their pain experiences. Accurate pain communication facilitates effective pain and disease management. Standardized self-report measures including The Visual Analogue Scale (VAS) and the Faces Pain Scale, Revised (FPS-R) are considered gold standard approaches commonly used in clinic; however, they do not reflect the multidimensional nature of pain in children with JIA. With advances in technology, a new iPad application called This Feeling has been developed as an interactive tool to aid the communication of pain in children. This Feeling derives from the strong conceptual and research base of an existing somatic assessment module of a computer assisted interview programme which uses images to enable children to describe their pain. Our objectives were to explore whether This Feeling is an acceptable, usable and feasible system for communicating pain in children with JIA aged between 5 and 16; to compare children’s experiences of using this approach with traditional VAS and FPS-R; and to explore further development needs of This Feeling. Methods: Children were recruited from the Childhood Arthritis Prospective Study, the largest prospective inception JIA cohort in the world, undertaken to study outcomes in children with JIA. A cross-sectional, mixed-methods design utilized standardized measures (the VAS and FPS-R) and This Feeling, which were administered to children attending outpatient appointments. Views on completing This Feeling were obtained from children and caregivers via a semistructured interview which was audio recorded and transcribed. Results: 43 children (72% female; 31 girls and 12 boys) consented to the research. All children were able to use This Feeling. The majority of children (95%, 41/43) preferred using This Feeling to communicate their pain experiences compared with traditional pain reporting measures. Most children particularly enjoyed the easy and fun nature of the application, which took an average of 8 min to complete. Children reported that This Feeling enabled them to accurately describe pain sites and types of pain as well as their emotional responses. Children and caregivers identified points for development including the need for additional icons to describe pain; pain symbols to be labelled (particularly for younger children); and a zoom function to enable children to select specific painful joints. Conclusion: Preliminary findings indicate that This Feeling is an acceptable and feasible aid for the communication of pain in children with JIA. Further adaptions are currently under development which will address the additional functions identified by this study.