Protective parental pain responses in pediatric chronic pain

Abstract

Background: Pediatric chronic pain is embedded in a broader social context, especially within parent-youth relationships. Research delineating adaptive parental pain responses in the context of pediatric chronic pain remains limited. Purpose: The current study aims to 1) examine the associations between adaptive parental responses to youth's pain related functional disability and 2) examine the level of agreement between parent-proxy and youth's self-reported functional disability. Methods: This study includes a sample of 127 youth (66.1% female) with mixed etiology chronic pain, ranging in age from 8 to 17 (M=12.24; SD = 1.598), and their parent or guardian. Data is collected at an interdisciplinary pediatric pain clinic within a local hospital setting as well as online pain peer support groups. Measures of demographic and pain characteristics, youth's functional disability, youth pain acceptance, parent pain acceptance, and parental psychological flexibility were collected. Results: Results show that youth's pain intensity [B = 2.98, SE = 0.439, p < .0005], parent psychological flexibility [B = -.01, SE = .004, p = .010], and parent pain acceptance [B = -.131, SE = .060, p = .030] have independent main effects predicting youth's self-reported functional disability. The results do not support a mediational effect of youth pain acceptance. Additionally, means of parent proxy-reports were significantly lower than means of youth self-reports of pain related functional disability (p < 0.05). Results further show a statistically significant association between the youth's self-reported pain intensity (β=0.953, P<0.05) and the difference between the youth self-reported and parent proxy-reported functional disability. Conclusion: Findings underscore the importance of assessing parental factors when examining pain related functional disability in youth with chronic pain. Findings, thus, support the inclusion of parents as targets for change in clinical interventions to optimize pediatric pain-related functional outcomes. Implications also highlight the need to assess preadolescent and adolescent youth's self-reports as well as their parents' proxy reports of pain related functional disability to offer a more comprehensive clinical perspective. Keywords: Pediatric chronic pain, coping and adaptation, parental pain influences, ecological framework, pain acceptance, psychological flexibility, parent-youth ratings concordance. --Author's abstract