Jenelle R Corey1, Lauren C Heathcote2, Farah Mahmud1,3,4, Corey Kronman2, Cora Mukerji1, Ellen McGinnis5, Melanie Noel6, Christine Sieberg1,3, Laura E Simons2. 1. Department of Psychiatry, Boston Children's Hospital, Harvard Medical School. 2. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA. 3. P.A.I.N. Group, Center for Pain and the Brain, Boston Children's Hospital, Harvard Medical School. 4. Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA. 5. Department of Psychiatry, University of Vermont Medical Center, Burlington, VT. 6. Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB, Canada.
Abstract
OBJECTIVES: Parents have a vital influence over their child's chronic pain treatment and management. Graded exposure in vivo treatment (GET) is emerging as a promising intervention for youth with chronic pain. Yet, little is known about how parents perceive GET and its impact on their child's pain condition. This study aimed to characterize caregivers' experiences over the course of their child's GET using longitudinal coding and thematic analysis of parent narratives. MATERIALS AND METHODS: Parent narratives of 15 youth who participated in GET for pediatric chronic pain (GET Living) were elicited from an unstructured dialogue at the start of each treatment session held between the parent(s) and pain psychologist. Narratives were coded for affect and content, and trends were examined in these codes across sessions. Common themes in parent narratives were developed through inductive thematic analysis. RESULTS: Parents showed an increase in positive affect, treatment confidence, and optimism over the course of treatment. Narratives also expressed more benefit-finding/growth and less anxiety and protectiveness across GET sessions, with more parents having a resolved orientation towards their child's pain by the final session. Five common themes were generated: Self-Awareness, Understanding of Their Child's Perspective, Perceived Treatment Benefit, Internalization of Treatment Principles, and Hopeful Concern for the Future. DISCUSSION: Analysis of parent narratives provides a rich and unique method for understanding a parent's journey during their child's chronic pain treatment. Clinical application of our findings can be used to guide future developments of targeted topics and interventions in the context of parenting a child with chronic pain.
OBJECTIVES: Parents have a vital influence over their child's chronic pain treatment and management. Graded exposure in vivo treatment (GET) is emerging as a promising intervention for youth with chronic pain. Yet, little is known about how parents perceive GET and its impact on their child's pain condition. This study aimed to characterize caregivers' experiences over the course of their child's GET using longitudinal coding and thematic analysis of parent narratives. MATERIALS AND METHODS: Parent narratives of 15 youth who participated in GET for pediatric chronic pain (GET Living) were elicited from an unstructured dialogue at the start of each treatment session held between the parent(s) and pain psychologist. Narratives were coded for affect and content, and trends were examined in these codes across sessions. Common themes in parent narratives were developed through inductive thematic analysis. RESULTS: Parents showed an increase in positive affect, treatment confidence, and optimism over the course of treatment. Narratives also expressed more benefit-finding/growth and less anxiety and protectiveness across GET sessions, with more parents having a resolved orientation towards their child's pain by the final session. Five common themes were generated: Self-Awareness, Understanding of Their Child's Perspective, Perceived Treatment Benefit, Internalization of Treatment Principles, and Hopeful Concern for the Future. DISCUSSION: Analysis of parent narratives provides a rich and unique method for understanding a parent's journey during their child's chronic pain treatment. Clinical application of our findings can be used to guide future developments of targeted topics and interventions in the context of parenting a child with chronic pain.
Authors: Lauren E Harrison; Joshua W Pate; Patricia A Richardson; Kelly Ickmans; Rikard K Wicksell; Laura E Simons Journal: J Clin Med Date: 2019-08-21 Impact factor: 4.241