Pain in children: A review of the literature from a developmental perspective

Abstract

This article presents a review of the current psychological literature about pediatric pain. Prevalence and types of pain problems encountered in children are considered briefly, followed by a developmental perspective on the experience of pain in children, encompassing physical, cognitive, social and behavioral factors. A discussion of the clinical significance of pain in children includes its use in differential diagnosis and the impact of pain on a developing child. Recommendations are made for assessing pain and factors relevant to managing its effects in children. The review concludes with an overview of clinical techniques for management, and recommendations for future research.     

Self-presentational determinants of health risk behavior among college freshmen

Abstract

This study examined adolescents' use of unhealthy and potentially dangerous behaviors for self-presentational reasons. At the start of their first semester at college, 110 freshmen (M age = 18.2) completed trait measures of self-presentational concern. At the end of the semester they were asked about their use of health risk behaviors as impression management tactics. Seventy-five percent of respondents reported performing at least 1 risky behavior for self-presentational reasons during their first college semester. The most common behaviors were smoking, drinking, driving recklessly and performing dangerous stunts. The desire to be perceived as “cool” or a “risk-taker” often prompted healdi risks. Modest correlations between the trait measures and health risk behaviors provided additional evidence that self-presentational motives sometimes play a role in adolescent health risk behavior.     

The PDQ-8: Development and validation of a short-form parkinson's disease questionnaire

Abstract

The Parkinson's Disease Questionnaire (PDQ-39) is a disease specific measure of health status which covers eight dimensions of ill-health, and contains 39 questions. The development of the questionnaire has been outlined in full elsewhere and is briefly outlined in this paper. Psychometric techniques are used here to derive a single index figure from the PDQ-39, transformed to a score range from 0 (good health) to 100 (poor health). A sub-set of items is then selected from the PDQ-39 to create a shorter form version, the PDQ-8. Each item selected is the one most highly correlated with the overall domain score to which it contributes: in cases where more than one item correlated equally strongly with the total then the item which received the highest completion rate was selected. The items were summed together and transformed onto a score from 0 to 100. The results gained from the single index gained from the PDQ-39 are compared with that gained from the PDQ-8, and are found to be remarkably similar. The use of the PDQ-8 is recommended over the PDQ-39 where a shorter form measure is required and where a single index measure of overall health status is acceptable or desirable.     

Health Related Quality of Life in Children with Congenital Heart Disease

Health-related quality of life in children with congenital heart disease (CHD) was compared to that of healthy children. Furthermore, agreement between child and parent reports was examined. In addition, differences in quality of life related to the severity of CHD were evaluated. One hundred children with CHD aged between 8-18 years and their parents answered a health-related quality of life-questionnaire during their visit to the paediatric cardiology outpatient department. CHD children reported reduced motor functioning and autonomy compared to healthy children. Parents of children with CHD reported their children to have a reduced quality of life in the domains of: motor functioning, autonomy and cognitive functioning. Agreement between child and parent reports was moderate. Children systematically reported lower health related quality of life on the domain of positive emotions than did parents. Health related quality of life in children with CHD appeared not to be influenced by severity of the disease. In conclusion, regardless of the severity of the disease, children with CHD reported their health related quality of life on several domains to be lower than that of healthy children. This means that on several domains, the emotional impact of problems in health status is greater for children with CHD than for healthy children. When CHD patients visit the clinic, it is important that physicians actively ask patients as well as parents about the child's motor functioning, autonomy and cognitive functioning. Children with problems in these domains can then be identified, and psychological interventions can take place at an early stage.     

Vital exhaustion measures and their associations with coronary heart disease risk factors in a sample of spanish-speakers

Abstract

The main purpose of this research was to study the reliability and conceptual validity of two Spanish language measures of Vital Exhaustion (VE), a short-term risk factor for coronary artery disease (CAD). The English version of the Maastricht Questionnaire for Vital Exhaustion was used to make a Spanish language questionnaire (VEQ) and a Spanish language interview (VEI) whose scoring systems were equal to the original version. These instruments were administered to a sample of healthy working men (n = 100) and women (n = 130) in Caracas, Venezuela. Participants also completed questionnaires designed to measure anger-expression and social support and were assessed by means of the Structured Interview to measure Type A Behaviour Pattern (TABP). Information about other CAD-risk factors, such as age, smoking behavior, and health habits, were collected.

High reliability coefficients, .85 and .91, were found for the VEI and VEQ, respectively. Principal component analysis provided one-factor solutions for each instrument. The pattern of correlations between VE, assessed by the VEI, and other personality characteristics was rather similar to the pattern observed in other cultures. In general significant, but modest, correlations were observed between VE and TABP, anger expression, a negative self-concept, and low social support. We conclude that VE appears to be a meaningful construct in this particular cultural context.     

Coping and physical health outcomes: an overview

The aim of the present study was to investigate longitudinally the sensitivity of optimistic beliefs (positive outcome expectancies, efficacy expectancies, and optimistic bias) to disease-related stress (measured by disease duration, depressive symptoms, physical symptoms, physical impairment, and life-events) in Type 1 diabetes (n = 90) and multiple sclerosis (n = 90). First, we examined whether chronically ill patients were less optimistic than a healthy control group (n = 60), which showed that patients reported lower levels of optimistic bias but similar levels of the two other optimistic beliefs. Next, we analyzed the stability of the three types of optimistic beliefs across time (one year) for both disease groups, which demonstrated that optimistic bias in MS patients decreased. Finally, the impact of disease-related stressors on optimistic beliefs during a one-year period was determined, showing that all three optimistic beliefs decreased when patients reported depressive symptoms. Together, these findings show that positive outcome expectancies and efficacy expectancies were unaffected by being ill and fairly stable unless patients reported depressive symptoms while optimistic bias appeared to decrease as a result of being ill. Results are discussed in terms of the role of control and depression in optimistic bias.     

A longitudinal application of three health behaviour models in the context of skin protection behaviour in individuals with occupational skin disease

Occupational skin disease (OSD) is common, associated with poor prognosis and poses a significant burden to the individual and society. We applied the theory of planned behaviour (TPB), the prototype-willingness model (PWM) and the health action process approach (HAPA) to the prediction and explanation of occupationally relevant skin protection behaviour in individuals with OSD. We used a longitudinal design. In this study, 150 individuals participating in a 3-week inpatient tertiary prevention programme completed measures assessing the constructs of the TPB, PWM and HAPA at admission (T?0), discharge (T?1) and once the individual had returned to work and worked for 4 consecutive weeks (T?2) (n?=?117). Intention was measured at T?0 and skin protection behaviour at T?2. Path analysis was used to assess the longitudinal associations of the models’ constructs with intention and skin protection behaviour. TPB as well as PWM variables accounted for 30% of variance in behaviour, HAPA variables for 33%. While not all predictions were confirmed by the data, all three models are able to inform us about the formation of skin protection intention and behaviour in individuals with OSD. The findings are discussed in light of future interventions and research.     

Flotation restricted environmental stimulation therapy (REST) as a stress-management tool: A meta-analysis

In this study we investigated the value of flotation Restricted Environmental Stimulation Therapy (REST) as a stress-management tool. We focused on the physiological effects of REST, its influence on well-being, and on performance. Twenty-seven studies published in 25 articles or book chapters were included in a meta-analysis. The total number of participants was 449, with a mean age of 29 years (ranging between 20 and 45). Sixty-four percent was male and 36% was female. The results showed that REST has positive effects on physiology (e.g., lower levels of cortisol, lower blood pressure), well-being, and performance. The pre–post mean effect size and the overall randomized control group effect size were relatively strong. This suggests that despite some limitations of the original studies, flotation REST can be a useful stress management tool in addition to or instead of other stress management tools.     

Executive function performance on the children's kitchen task assessment with children with sickle cell disease and matched controls

Objective: The aim of this study was to compare executive function abilities of 8- to 12-year-old children with sickle cell disease (SCD) with a matched control sample. The measures included the parent and teacher Behavior Rating Inventory of Executive Function (BRIEF); the Delis-Kaplan Executive Function System (D-KEFS), Free Sorting Test and Color Word Interference Test; and the Children's Kitchen Task Assessment (CKTA), a new performance measure. Methods: Twenty-two children with SCD were recruited from one hematology clinic and 22 community children, matched on characteristics of age, gender, and race, were selected from a larger sample of controls for comparison. Parents and teachers completed rating scales. Results:As hypothesized, children with SCD scored significantly lower than matched controls on Digit Span Forward; on 5 of the 9 D-KFES Color Word Interference and Sorting tasks; on CKTA organization, initiation, and task completion; and on the BRIEF's parent and teacher Metacognitive Index (MI) and Global Executive Composite (GEC) scores. Conclusion:Cognitive and performance evaluations indicate lower executive function among children with SCD. Results substantiate the need for evaluative triangulation for children with SCD: Neurocognitive testing supported by performance testing, and adult reflection of a child's daily performance compared to other children. These elements will provide rich data to create educational support for children with SCD who have frequent hospitalizations, school absences, and the potential presence of cerebral vascular accident symptomology.     

Neurocognitive Sequelae of Pediatric Sickle Cell Disease: A Review of the Literature

This literature review summarizes all studies relating neuropsychological performance to neuroimaging findings in pediatric sickle cell disease (N=28; published 1991–2005). Although inconsistencies exist within and across domains, deficits in intelligence (IQ), attention and executive functions, memory, language, visuomotor abilities, and academic achievement have been identified. Overall neurocognitive compromise was revealed to be related to the level of neurological injury and the location of silent infarct. Attentional and executive dysfunction is prevalent and related to frontal lobe abnormalities.