Early childhood risk factors for later onset of pediatric chronic pain: a multi-method longitudinal study.

BACKGROUND: Pediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years. METHODS: Available longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child's pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models. RESULTS: Gut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11. CONCLUSIONS: Some, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.

Pain perception of patients in intensive care unit after cardiac surgery: A qualitative study using Roy's Adaptation Model.

AIM: This study was conducted to examine the pain perceptions of intensive care patients after cardiac surgery according to Roy's Adaptation Model (RAM). STUDY DESIGN: A qualitative design with a phenomenological approach was used in the study. The research data were collected by using a "descriptive information form", a "semi-structured interview form", and the "numerical rating scale" through the "in-depth interview method". The study sample consisted of 16 patients who were aged 18 years or older, had undergone cardiac surgery, experienced pain post-operatively in the intensive care unit at least once, and had intensive care experience. Patients with neuropathic or chronic pain or neurological or psychiatric disorders were not included in the study. Data were classified into physiologic, self-concept, and interdependence modes according to RAM. RESULTS: The themes and sub-themes that emerged included physiologic modes (pain responses), self-concept modes (pain self-management), role-function modes (effects of pain), and interdependence modes (support systems in pain). CONCLUSIONS: The results of our study can enable patients and nurses to communicate effectively about pain. In future studies, the effect of model-based pain management programs on cardiac surgery patients can be investigated. RELEVANCE TO CLINICAL PRACTICE: Examining the pain perceptions of intensive care patients after cardiac surgery according to RAM will guide the improvement and development of pain management. It is thought that the model addresses intensive care patients experiencing pain holistically.

Living with pain in ankylosing spondylitis: a qualitative study.

BACKGROUND: Despite various quantitative studies reporting that pain is among the most serious problem in ankylosing spondylitis (AS), no detailed qualitative studies address how pain affects the life of patients with AS. AIM: To explore AS patients' experiences with pain and its effect on their lives. DESIGN: Descriptive qualitative study. METHODS: Data were collected by individual in-depth interviews. Colaizzi's phenomenological data analysis was performed. RESULTS: During periods of pain, participants indicated that they experienced difficulty with performing their daily routine activities and meeting their personal needs. Pain also prevented them from fulfilling their responsibilities in their families, inhibited their social relations, and posed problems at their workplace. Due to the negative effects of pain in their lives, the participants felt helplessness, fear, stress, sadness, and unhappiness. CONCLUSIONS: Added to being asked about the quantity of pain, patients with AS should be questioned about how pain affects their lives.

Lived experiences of musicians with pain: an interpretative phenomenological analysis of performance-related pain of professional violinists.

The purpose of this interpretative phenomenological analysis (IPA) is to explore how five professional South African violinists make sense of their lived experiences of performance-related pain. The research problem this study investigates is multifaceted. It includes examining the career implications for violinists who play despite experiencing pain and are afraid to speak up because of the stigma associated with being injured. There is a lack of support and understanding from fellow musicians, doctors and other specialists when faced with diagnosing injuries and recommending treatment options. In South Africa, there is limited research on these aspects. In this IPA study, the data were collected through semi-structured interviews with five professional South African violinists with performance-related pain.The six subordinate themes that emerged from the data analysis were: (i) Playing through the pain; (ii) Lack of identity; (iii) Depression when unable to play because of pain; (iv) Growth through faith and spirituality; (v) Support and lack of support from family, friends, management, doctors and other experts; and (vi) Lack of awareness and understanding of performance-related injuries. Heightened awareness of musicians' lived experience of performance-related pain could bring about much-needed change and support advocacy for pain-prevention initiatives and assistance for violinists.