Screening Tool May Identify Distress in Parents of Children With Chronic Pain
Parents with a child between age 10 and 17 with persistent pain were asked to complete online questionnaires.
The Parent Risk and Impact Screening Measure (PRISM), a self-report screening tool designed to identify impaired psychosocial functioning and behavioral responses in parents of children with chronic pain, was found to be useful clinically, according to a study published in Pain.
Parents (n=229) with a child between age 10 and 17 (mean age, 13.9) with persistent pain were asked to complete online questionnaires on the day of their child's appointment at one of two tertiary care pediatric pain clinics. PRISM includes questions to assess protective behaviors, distress, and health in parents, as well as family impact domains. The Bath Adolescent Pain-Parental Impact Questionnaire (BAP-PIQ); Adult Responses to Children's Symptoms (ARCS); Pain Catastrophizing Scale, parent report (PCS-P); and functional disability inventory (FDI) were administered. The 29-item Patient Reported Outcomes Measurement Information System (PROMIS-29) was also used to assess parents' physical function, anxiety, depression, fatigue, limitations in social roles and activities, pain interference, and pain intensity.
Further refinement of PRISM reduced the initial 30 questions to 12 items. The PRISM was found to be associated with strong internal consistency, and higher scores on this questionnaire were associated with higher pain intensity, increased functional disability, and worse quality of life in children. A PRISM score ≥6 was associated with moderate to severe functional disability and moderate to high levels of pain catastrophizing in parents, with 58% of parents in the cohort achieving this score.
A limitation of the study was the lack of ethnic diversity in the cohort, which may reduce the generalizability of the findings.
“Study findings show that the PRISM can be used to identify parents with elevated symptoms and distress who may benefit from targeted interventions,” noted the study authors.
Simons LE, Lewandowski Holley A, Phelps E, Wilson AC. PRISM: a brief screening tool to identify risk in parents of youth with chronic pain [published online September 20, 2018]. Pain. doi:10.1097/j.pain.0000000000001403