Enhancing pediatric pain management in Turkey: A modified Delphi study on culturally adapted pain neuroscience education for chronic pain in children.

ABSTRACT

BACKGROUND: Pain Neuroscience Education (PNE) is a commonly used technique applied by physical therapists in the rehabilitation of chronic pain. OBJECTIVE: The aim of this study was to culturally adapt an existing PNE for children with chronic pain (PNE4Kids) to Turkish children with chronic pain (PNE4Kids-Turkish). METHODS: A three-round modified Delphi-study was conducted between September 2023 and February 2024. Experts completed questionnaire with 5 items to elicit demographic data and 16 closed and 7 open-ended questions to assess relevance of information, feasibility of stories, visual information, and clarity of message in the 4 main areas of 'normal pain biology', 'pain modulation', 'chronic pain, adaptations, central sensitization', and 'the application and implications of PNE4Kids. MAXQDA software was used for qualitative analysis of open-ended questions. A total of 38 experts (mean age 36.6 ± 9.05 years, 6 male, 32 female) were recruited for this study. RESULTS: The results of the first round indicated that 84-100 % of Delphi experts strongly agreed or agreed on the relevance of information, feasibility of stories, visual information, and clarity of message in respect of the 4 main areas. During second and third round, an acceptable degree of agreement with clinical usefulness of PNE4Kids-Turkish materials was obtained. CONCLUSIONS: PNE4Kids was culturally adapted for Turkish children suffering from chronic pain. The findings of this study mainly highlight the viewpoints of the experts. IMPLICATION TO PRACTICE This is the first study to have developed and culturally adapted the PNE4Kids for Turkish children with chronic pain. The PNE4Kids-Turkish is crucial, valuable, helpful, and understandable for Turkish children with chronic pain. In addition, the PNE4Kids-Turkish has the potential to close the gap in research and clinical areas for Turkish children with chronic pain.