![]() Therefore, interventions applied to parent caregivers for the purpose of reducing distress, anxiety, and depressive symptoms would be hypothesized to have downstream effects on improving child experiences with chronic pain. Parental distress is considered as a family level variable where the child’s response to pain is influenced under the conditions of the family or parent’s overall functioning. In this model, parent and family factors are hypothesized to increase the risk for pain and disability, and in turn, pain and disability are expected to impact parent and family life. Palermo and Chambers (2005) proposed a conceptual model of a bidirectional relationship between parent and family factors (e.g., parental responses to pain behavior family environment) and children’s pain experience. Parent and family factors, in particular, have been identified as important in understanding the context in which pain treatment is provided. There has been a renewed research focus on the broader contextual factors relevant to the management of pediatric chronic pain. In one of the few qualitative studies in this area, Jordan, Eccleston, and Osborn (2007) interviewed 17 parents of youth with chronic pain about their experience, finding that parents reported struggling for control over their lives, experienced considerable strain at being unable to help their child in pain, and judged their lives fundamentally changed. (2008) found a negative impact of chronic pain on maternal social and emotional functioning. Moreover, anxiety and depressive symptoms were commonly reported by parents (Eccleston, et al., 2004). ![]() In a clinical sample of youth with chronic pain, Eccleston, Crombez, Scotford, Clinch & Connell (2004) found that average levels of parental role stress were high, with 31% of parents reporting clinically significant distress. In particular, parents report restrictions in their own lives, unwelcome dependency, marital and financial difficulties, and feelings of hopelessness (Hunfeld et al., 2002). The consequences of chronic pain extend beyond children themselves to potentially include widespread social, relational, emotional and financial impact on parents. A subgroup (i.e., 5-10% of otherwise healthy youth) report severe pain associated with functional impairment (Huguet & Miro, 2008). ![]() Findings from this feasibility study suggest that PSST can be implemented with parents of youth with chronic pain, and they find the treatment acceptable.Ĭonservative estimates suggest that at least 15% of children and adolescents report chronic pain during childhood, that is, pain lasting up to 3 months (Stanford, Chambers, Biesanz, & Chen, 2008). In an exploratory manner we examined change in parent distress and child physical function and depression from pre- to post-treatment. This phase included piloting the PSST intervention and all outcome measures at pre-treatment and immediately post-treatment. In the second phase, the intervention was tested in a small group of parents to evaluate feasibility, determined by response to treatment content, ratings of acceptability, and ability to enroll and deliver the treatment visits. ![]() In the first phase, the intervention was adapted based on expert review of the literature and review of parent responses on a measure of pain-related family impact. Our aim was to adapt an intervention, Problem-Solving Skills Training, previously proven effective in reducing parental distress in other pediatric illness conditions to the population of caregivers of youth with chronic pain. Therefore, intervening with parents of youth with chronic pain may, in turn, result in positive outcomes for children in their ability to engage in positive coping strategies, reduce their own distress, and to function competently in their normal daily lives. Moreover, parental distress adversely influences child adjustment to chronic pain. Research on the experience of parents caring for a child with chronic pain indicates that high levels of parental role stress, feelings of frustration over an inability to help, and psychological distress are common.
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