Soeun Lee

Objectives: Limited research has investigated parent-targeted interventions in pediatric chronic pain, though these interventions may be an important part of family-centered care. Further, parent perspectives and feedback regarding these interventions are scant in the literature, even though they are crucial for developing, refining, and optimizing treatment options. This study aimed to understand how parents experience and perceive their participation in a Cognitive Behavioral Therapy (CBT) based, parent-targeted group intervention that was delivered either in-person or virtually, with a focus on the treatment components they found most important. Methods: Data from semi-structured focus groups/interviews within one week post-treatment with 32 parents (n=11 in-person, n=21 virtual) were analyzed using an inductive reflexive thematic analysis. Results: Three overarching themes were generated from the thematic analysis: building a foundation of knowledge, finding normalization and hope through connection and lived experiences, and sharing a collective responsibility for pain management. Discussion: Parents perceived a range of benefits from participating in a CBT-based, parent-targeted group intervention, both on themselves and for their youth. Overall, parent perceptions across in-person and virtual intervention delivery were consistent, except for a drawback of virtual participation for developing a deeper social connection among parents. Thus, a relatively brief parent-targeted group intervention was perceived to be a positive experience for parents, though considerations for adapting to virtual delivery and facilitating social connection among parents appears to be important.

학술논문검색사이트 KISS는 학술논문,연구논문,연구자료,학술지 등 다양한 자료를 서비스하며, 주제별, 등재별, 인용지수, 인기논문, 이슈논문 등 다양한 키워드의 논문을 제공하여 빠른 학술검색 및 인용이 가능하도록 서비스합니다.

Pediatric recurrent abdominal pain is commonly associated with negative impacts on quality of life (QOL). Positive schemas (core beliefs about the self with subthemes of self-efficacy, optimism, trust, success, and worthiness) are a resilience factor that has not yet been examined within a pediatric recurrent pain context. This cross-sectional study examined (a) associations between positive schemas, pain coping, and youth QOL, and (b) exploratory analyses to investigate whether specific positive schema subthemes predicted QOL outcomes in youth with recurrent abdominal pain. Participants were 98 youth with recurrent abdominal pain (i.e., pain related to a disorder of gut–brain interaction [DGBI] or organic cause) who completed measures on positive schemas, QOL, and pain coping. Age and diagnostic status were controlled for in analyses. Positive schemas were significantly positively correlated with emotional, social, school, and overall QOL, as well as with approach and problem-focused avoidant coping, and significantly negatively correlated with emotion-focused coping. Worthiness was the strongest and only significant predictor of youth social functioning. Positive schemas may be an important cognitive resilience factor to consider within interventions for pediatric recurrent pain.

Objectives: Parents play integral roles in their youth’s chronic pain and can experience elevated distress related to caregiving. This study examined a cognitive-behavior therapy-based parent-targeted group intervention, including understudied/novel resilience/risk (eg, distress, parenting self-regulation), and compared the effect of in-person versus virtual delivery format. Hypotheses: (1) Adequate feasibility and acceptability (enrolment>33%, attendance >60%, attrition 90%), with higher indicators of feasibility in the virtual groups; (2) Significant improvements in parent psychological flexibility, protectiveness, distress, and parenting self-regulation at posttreatment that were maintained at follow-up, with no difference between delivery type. Methods: Parents were enroled from an outpatient pediatric chronic pain clinic and participated in the group intervention in-person or virtually; questionnaires were completed at baseline, posttreatment, and 3-month follow-up. Results: Enrolment (55% in-person, 65% virtual) and attendance (86% in-person, 93% virtual) were higher, and attrition was lower than expected (4% in-person, 7% virtual). Satisfaction was high (4.95/5 in-person, 4.85/5 virtual); on written feedback, parents enjoyed connecting with other parents (27/56, 48%) the most. The least preferred were the virtual format (5/36, 14%) and timing of the group (6/52, 12%). There were no differences between delivery formats in feasibility/acceptability. The intervention significantly improved parents’ psychological flexibility, protectiveness, distress, and parenting self-regulation over time. A small group difference favored the in-person format for psychological flexibility, and an interaction effect for parenting self-regulation was found. Discussion: This standalone parent-targeted group intervention had positive effects on parent outcomes delivered either in-person or virtually.

Objective: Parents are integral to their youth’s chronic pain experiences, and intervening with parents may improve parent and youth functioning. Existing systematic reviews are not specific to pain or do not systematically report critical aspects to facilitate implementation of parent interventions in diverse settings. Thus, this scoping review aimed to map published parent interventions for pediatric chronic pain to summarize the participant and intervention characteristics, treatment components, methods, outcomes, feasibility, and acceptability, as well as identify gaps for future research. Methods: Four databases were searched (PubMed, PsycINFO, CINAHL, and Google Scholar). Studies of any design reporting psychological interventions including parents of youth (0 to 18 y) with chronic pain were included. Data on study characteristics, treatment components, effectiveness, and feasibility/acceptability were extracted. Results: Fifty-four studies met inclusion criteria from 9312 unique titles. The majority were nonrandomized cognitive-behavioral therapy interventions delivered individually. The degree of parent participation ranged from 17% to 100%; the average enrollment rate was 68%. Reported parent and youth outcomes were variable; 26% of studies did not include any parent-related outcomes. Discussion: Parent interventions may be a helpful and feasible way to support parents and youth with chronic pain. There is variability across study characteristics, treatment content/aims, parent participation, and parent/youth outcomes.

Background: Caregiving for a youth with chronic pain is associated with unique stressors. Parents can play important roles for youth coping and functional outcomes, although parents often report uncertainty about how to support their youth and may benefit from learning evidence-based strategies. However, few parent-targeted interventions for pediatric chronic pain exist, particularly delivered within a group format. Objectives: The aims of this study were to describe the development of a parent-targeted group intervention within an outpatient interdisciplinary pediatric chronic pain clinic and to assess preliminary feasibility and effectiveness. Method: The development and content of the intervention are described in detail. Feasibility was assessed via enrollment, attendance, and attrition. Effectiveness was assessed via parent self-reported responses to pain and psychological flexibility (PF) before and after treatment. Results: Seventy parents consented and participated in the 5-week group intervention (2 hr/session). Preliminary results demonstrated adequate feasibility, with attendance rates at 61.4% and attrition rates at 24.3%. After treatment, there were significant moderate- to large-sized decreases in 3 of 4 parent behaviors assessed (protectiveness, monitoring, minimizing) and large-sized increases in PF. Conclusions: This group intervention for parents can produce positive changes in self-reported parent behavior and PF and may be a feasible way to intervene within an outpatient interdisciplinary setting. Implications for Impact Statement: Parents play important roles for supporting coping and functional outcomes in youth with chronic pain, although parents report uncertainty over how to best support their youth and may benefit from learning evidence-based strategies. This study suggests that a relatively brief parent-targeted group intervention (5 weeks, 2 hr/week) may help promote psychological flexibility and reduce unhelpful parent behaviours that may reinforce pain.

Racism exists at the individual and systemic level where power differentials and hierarchies oppress racial minorities. Canada’s auspicious history of colonialism and systemic racism puts Black, Indigenous, and People of Colour at-risk of poor psychological health, in addition to a host of other health-related concerns. As psychologists and trainees, our ethical duty, as outlined in our Code of Ethics, includes the responsibility to society. Recent sociocultural discussions and political movements (e.g., Black Lives Matter) highlight the need to confront and address issues of long-standing racism and inequity. As such, this commentary provides a brief review of the current and historical contexts of racism in psychology and highlights the need for a concrete, actionable plan to address these concerns. Consequently, we propose 18 recommendations to address the reviewed problems. We believe that these recommendations will help various settings that house and train psychologists as well as ones that regulate the profession (e.g., academic psychology departments, hospitals, private practices, governing bodies for psychology) to adopt anti-racist measures that provide a more inclusive environment.

This study aimed to investigate the relationship between aerobic capacity and health-related quality of life (HRQOL) in men with cerebral palsy (CP) by measuring aerobic capacity and using the Health-Related Quality of Life questionnaire. The subjects were ambulant men with CP (N = 34), with a mean age, height, weight, and body mass index of 36.6 ± 9.2 years, 163.9 ± 8.9 cm, 58.6 ± 9.1 kg, and 21.6 ± 2.9 kg·m-2, respectively. Aerobic capacity was measured during a graded exercise test and shuttle run test. Quality of life was evaluated using the Health-Related Quality of Life (Medical Outcomes Study Short Form-36 [SF-36]). The analysis performed using the physical scale of HRQOL as the dependent variable revealed that the contribution rate of physical functioning was 46.3%, role physical was 21.8%, bodily pain was 7.5%, general health was 27.3%, and physical component summary was 36.1%; the aerobic capacity differed significantly in terms of physical functioning, role physical, general health, and physical component summary (p < .05). Peak oxygen uptake was a particularly significant explanatory variable for role physical, and role physical (p < .05). However, the analysis performed using the mental scale of HRQOL as the dependent variable revealed that the contribution rate of vitality was 13.0%, social functioning was 17.3%, role emotional was 14.9%, mental health was 8.1%, and mental component summary was 15.3%; the aerobic capacity showed no significant difference. The aerobic capacity representing the athletic performance level of men with CP positively affected physical health satisfaction but not mental health satisfaction.

Objectives: Pediatric chronic pain has often been examined from a risk perspective, and relatively less is known about the individual and family-level resilience factors that help youth with chronic pain maintain their quality of life (QOL). This cross-sectional study: (1) examined the relations among purported youth and parent resilience (youth pain acceptance and pain self-efficacy, parent psychological flexibility) and risk (youth pain intensity and parent protectiveness) factors with youth QOL, and (2) tested exploratory statistical mechanisms that may explain relations between parent and youth variables. Methods: Participants included 122 youth (10 to 17 y; M=14.26, SD=2.19) seen in an interdisciplinary pediatric chronic pain program and a parent. Youth completed measures of their average pain, QOL, pain acceptance, and pain self-efficacy. Parents completed measures of their pain-related psychological flexibility and behavioral responses to pain (ie, protectiveness, distraction, monitoring, minimizing). Results: Youth pain acceptance, pain self-efficacy, and parent psychological flexibility were highly positively correlated with each other, and with overall youth QOL. Evidence for a buffering effect of pain acceptance and pain self-efficacy on the association between pain intensity and QOL was not found. Protectiveness was found to be a significant mediator of the relation between parental psychological flexibility and youth QOL. Discussion: The results are discussed in the context of the resilience-risk framework and current understandings of the role of parental factors for pediatric chronic pain.

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