POS0335 IMPROVED PAIN COPING SCALE FOR CHILDREN AND THEIR CAREGIVERS

Abstract

BackgroundPain can be a problem in a subgroup of juvenile idiopathic arthritis (JIA) patients even though in clinical remission. This can at least partly be due to their pain coping strategy of catastrophizing [1]. In a chronic disease such as JIA, the quality of coping with pain is crucial. The importance of coping with pain is well recognized in children [2]. The understanding of the parental role in supporting the child in pain is growing [3]; yet measuring the precise mechanism of parental pain coping is less studied. Thus, it seems important to measure also parental coping quality.ObjectivesThe aim of this study was to develop a pain coping scale (PCSpar) for assessing the parents’ coping strategies to their child´s pain and a shorter improved PCSped for children feasible for use in clinical practice.MethodsThe original pain coping questionnaire (PCQ) [4] has been validated in Finnish [5] resulting in a 38-item, eight-factor structured PCQ. The items in the new version of PCQ were reduced into twenty by an interdisciplinary team (mPCQped). A corresponding scale was created for parental use (mPCQpar). Consecutive patients aged 8-16 years, visiting pediatric rheumatology outpatient clinic, reporting musculoskeletal pain during the last week before visit or longer, were recruited to participate in this study. Both the patient and the caregiver rated the child’s pain VAS from 0 to 100, completed the mPCQped /the mPCQpar and Children´s Depression Inventory (CDI) [6]/the Beck´s depression Inventory (BDI) [7] as appropriate. The selection process of pain questionnaire items was performed with factor analyses. The construct validity, the associations of the mPCQ factors, CDI, BDI and pain VAS, were tested by Spearman´s correlation coefficient.ResultsThe study was conducted in all five tertiary and four secondary hospitals evenly distributed throughout Finland. Of the 153 families invited to the study, 130 attended. The average (SD) age of the attending patients was 13.0 (2.3) years. Of the patients, 91 (70%) were girls. Several steps in the exploratory factor analyses preceded the final factor analyses mPCQped and mPCQpar results. The four factors retained in the new improved Pain Coping Scale for children (iPCSped) were named positive cognitive distraction, catastrophizing (CATped), seeking social support (SSSped) and behavioral distraction. The factors in the improved Pain Coping Scale for caregivers (iPCSpar) were positive self-statement, catastrophizing (CATpar), seeking social support and distraction. In both iPCSped and iPCSpar there are a total of 15 items, 2-5 items/factor. The factor´s Cronbach´s alpha reliability coefficients were satisfactory, and the goodness-of-fit statistics were good. The CATpar correlated to BDI Rs= 0.33, p<0.05 and parent’s assessment of the child’s pain Rs= 0.23, p<0.05 in caregivers. The CATped correlated to CDI Rs= 0.49, p<0.05 and SSSped Rs= 0.26, p=0.05 but not to patient pain VAS Rs= 0.08, p>0.05.ConclusionIn this study, we created a shorter pain coping scale for children (iPCSped) and a novel scale for caregivers (iPCSpar). Both showed good validity and reliability.