Pain coping strategies in children with cerebral palsy.

Abstract

To describe coping strategies in children and adolescents with cerebral palsy (CP), relative to age. Patients were prospectively recruited from two paediatric rehabilitation centres in France. The Pediatric Pain Coping Inventory - French and Structured Pain Questionnaire were completed by an experienced professional for each child. One hundred and forty-two children with CP were included (80 males, 62 females; median age 12y; IQR=8-15y). They generally used fewer coping strategies than typically developing children ('Seeks social support and action': 12.47 vs 12.85, p=0.477; 'Cognitive self-instruction': 9.28 vs 10.90, p<0.001; 'Distraction': 4.89 vs 7.00, p<0.001; 'Problem solving': 4.43 vs 5.19, p<0.001). In the CP group, 'Seeks social support and action' decreased with age (p=0.021) and 'Cognitive self-instruction' increased with age (p<0.001). 'Problem solving' and 'Distraction' did not change with age. Coping strategies were influenced by Gross Motor Function Classification System level (p=0.022) and history of surgery (p=0.002). Children with CP generally used fewer coping strategies than typically developing children and tended to rely on social support. Use of active strategies increased with age; however, they appeared later than in typically developing children and were used to a lesser extent. Children with cerebral palsy (CP) use fewer pain-coping strategies than typically developing children. Children with CP tend to use social support to cope with pain. Children with CP learn more appropriate strategies from previous painful experiences. Active coping strategies appear later but remain underused in children with CP.