Novel Pain Coping Scales for Children and Their Caregivers

Two new pain-coping scales, 1 for children with musculoskeletal pain and 1 for their caregivers, were developed, validated, and published in Pediatric Rheumatology.

Investigators from centers in Finland evaluated the Finnish version of the Pain-Coping Questionnaire (PCQ) for children and adolescents and reduced the number of items from 39 to 20. The remaining items were adapted for caregivers. The 2 resulting instruments — the modified PCQ paediatric (mPCQped) and modified PCQ parental (mPCQpar) — were translated and back translated into Swedish and English. The instruments were validated in a pediatric rheumatology outpatient clinic between 2020 and 2021 using a cross-sectional experimental design.

A total of 130 families participated in the validation of the instruments. The mean age of participating children was 13.0 (standard deviation [SD], 2.3) years, 70% were girls, and median duration of pain was 14.0 (interquartile range [IQR], 3.0-54.5) months. Diagnoses prompting visits to the rheumatology clinic included juvenile idiopathic arthritis (n=72), other musculoskeletal pain conditions (n=41), unspecified or postinfectious arthritis (n=7), orthopedic or orthognathic diagnoses (n=4), systemic connective tissue disease (n=3), and chronic nonbacterial osteomyelitis (n=3).

The median patient-reported visual analogue scale (VAS) pain score was 37 (IQR, 15-55) points, and the median parent-reported pain score was 40 (IQR, 20-59) points.

Significant correlations were observed between patient and parent VAS scores (r, 0.70), Children’s Depression Inventory (CDI) scores and children disease-related stress (r, 0.65) and children other stress (r, 0.56) scores, Beck Depression Inventory (BDI) scores and parental disease-related stress (r, 0.46) and parental other stress (r, 0.50) scores, and parent VAS scores and BDI scores (r, 0.30).

During validation, 5 items were removed from both the mPCQped and mPCQpar questionnaires. The remaining items for the children’s instrument (Cronbach’s α range, 0.72-0.85) and the caregiver’s instrument (Cronbach’s α range, 0.70-0.86) were determined to be reliable and accounted for 66.2% and 68.36% of the observed variance, respectively.

The final scales were renamed the pain-coping scale for children (PCSped) and the pain-coping scale for parents (PCSpar).

Within the final scales as stratified by age (<13.0 vs ≥13.0 years) and gender, child positive cognitive distraction, parent positive self-statement, and parent distraction subscores depended on age (all P <.05), and child catastrophizing and child seeking social support scores depended on gender (both P <.05).

A limitation of this validation study is that its cross-sectional design did not allow for causal inferences to be made.

Study authors conclude, “The current study demonstrated the feasibility of the PCSpar and PCSped scales. The questionnaires can be used as qualitative clinical instruments to identify pain-coping strategies of children and adolescents and their parents. In clinical work, PCSped and PCSpar may serve as a visualization of different types of coping resources for pediatric patients with pain and their parents and facilitate the identification of families in need of psychological support.”

This article originally appeared on Clinical Pain Advisor