Pain coping strategies in children with cerebral palsy

Abstract

To describe coping strategies in children and adolescents with CP, and determine the effect of age on choice of strategy. Patients were recruited from two pediatric rehabilitation centers in France. The Pediatric Pain and Coping Inventory - French (PPCI-F) and Structured Pain questionnaire (SPQ) were completed by an experienced professional with each child. In total, 142 patients were included (median age: 12, 5–19 years; 57% boys). Comparison of the means from the 4 factorial scales showed that children with CP generally used fewer coping strategies than TD children (seeking social support: 12.47 versus 12.85; cognitive self-instruction: 9.28 vs. 10.90; distraction: 4.89 vs. 7.00; seeking effectiveness: 4.43 vs. 5.19). Some coping strategies used by the children with CP depended on age (decrease in seeking social support and increase in cognitive self-instruction with age), while others did not (seeking effectiveness and distraction). The strategies were also influenced by GMFCS level ( P = 0.01), history of surgery ( P < 0.01), sibling rank ( P < 0.05), and pain reported in the SPQ ( P < 0.05). Children with CP generally use fewer coping strategies than TD children although similarly to TD children, they mostly look for social support to cope with pain. Even if past experiences of pain suggest that coping strategies need to be changed, active coping strategies were only used in older children and remained less used than by TD children of the same age.