Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical School, Palo Alto, California.
Department of Psychology, King's College London, London, UK.
Eur J Pain. 2019 Aug;23(7):1340-1350. doi: 10.1002/ejp.1403. Epub 2019 May 14.
The parent's role in the context of pediatric chronic pain is essential. There is growing evidence that parent psychological flexibility positively impacts child functioning. To assess parents' abilities to respond with psychological flexibility to their child's pain, the Parent Psychological Flexibility Questionnaire (PPFQ) was developed. Here, we aim to validate the 10-item version of the questionnaire in an English-speaking population and to evaluate associations with parent behaviour, child pain acceptance and functioning.
Five hundred and seventy-eight parent-child dyads presenting at a pediatric pain clinic were included (92% mothers, average child age 15.2 ± 1.6 years). The PPFQ was completed by the parent. Parent and child also completed other standardized questionnaires. In addition to confirmatory factor analysis and assessments of reliability and validity of the PPFQ-10, a mediation analysis was performed to examine the direct and indirect effects of parent psychological flexibility on child functioning.
Confirmatory factor analysis supported the three-factor model with subscales for Values-Based Action, Pain Willingness and Emotional Acceptance, and the PPFQ-10 demonstrated strong psychometric properties. After controlling for child pain, parent psychological flexibility indirectly affected child functioning through its association with both parent behaviour (i.e., protectiveness) and child pain acceptance.
Our findings provide further support for use of the PPFQ-10 and the importance of assessing and addressing parent psychological flexibility in the context of child chronic pain. Our data show that parent psychological flexibility has an important adaptive role and can impact child functioning through two different routes, both of which can be actively targeted in treatment.
Our findings demonstrate that the PPFQ-10 is an efficient measure of parent psychological flexibility, demonstrating strong psychometric properties. Furthermore, our analyses showed that parent psychological flexibility indirectly affects child functioning through associations with both adaptive parent behaviour and child functioning. Taken together, this study furthers the understanding of how parent psychological flexibility operates and affects children with chronic pain, and may inform and optimize treatments aimed at improving functioning by addressing child and parent coping.
在儿科慢性疼痛的背景下，父母的角色至关重要。越来越多的证据表明，父母的心理灵活性会对孩子的功能产生积极影响。为了评估父母对孩子疼痛做出心理灵活性反应的能力，开发了父母心理灵活性问卷（PPFQ）。在这里，我们旨在验证该问卷的 10 项英文版在英语人群中的有效性，并评估其与父母行为、孩子疼痛接受和功能的关联。
纳入了 578 对在儿科疼痛诊所就诊的父母-孩子（92%为母亲，孩子平均年龄 15.2±1.6 岁）。由父母完成 PPFQ。父母和孩子还完成了其他标准化问卷。除了对 PPFQ-10 进行验证性因素分析以及可靠性和有效性评估外，还进行了中介分析，以检验父母心理灵活性对孩子功能的直接和间接影响。
验证性因素分析支持三因素模型，子量表分别为基于价值观的行动、疼痛意愿和情绪接受，PPFQ-10 具有很强的心理测量特性。在控制了孩子的疼痛后，父母的心理灵活性通过与父母行为（即保护）和孩子的疼痛接受的关联，间接地影响了孩子的功能。
我们的发现进一步支持了使用 PPFQ-10 的方法，以及在儿童慢性疼痛背景下评估和解决父母心理灵活性的重要性。我们的数据表明，父母的心理灵活性具有重要的适应性作用，可以通过两种不同的途径影响孩子的功能，这两种途径都可以在治疗中被积极地针对。
我们的研究结果表明，PPFQ-10 是测量父母心理灵活性的有效工具，具有很强的心理测量特性。此外，我们的分析表明，父母的心理灵活性通过与适应性父母行为和孩子功能的关联，间接地影响孩子的功能。综上所述，这项研究进一步了解了父母心理灵活性的运作方式及其对患有慢性疼痛的儿童的影响，并可能为改善功能的治疗提供信息和优化，通过解决儿童和父母的应对方式。
