Caes Line, van Gampelaere Cynthia, Van Hoecke Eline, Van Winckel Myriam, Kamoen Kristien, Goubert Liesbet
Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom.
Department of Experimental, Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium.
Front Psychol. 2021 Jul 1;12:680546. doi: 10.3389/fpsyg.2021.680546. eCollection 2021.
Despite daily variability in children's chronic pain experiences, little is known about how parents' emotions and goals toward their child's pain are influenced by these daily changes. This diary study examined how daily child pain intensity (as perceived by parents) moderates the associations between parental catastrophic thoughts about child pain on the one hand, and daily parental distress and parents' goals with regard to their child's pain (pain control vs. activity engagement) on the other hand. Participants were 25 parents of 20 different children = 18; 90% girls). Children, aged 8-14 years ( = 9.5, = 2.09), experienced either chronic headache or functional abdominal pain with an average pain duration of 22.5 months ( = 24.5 months). Daily parental responses (i.e., perceived child pain intensity, distress and goal endorsement) were collected through a 3-week daily diary (resulting in 413 valid diary reports). Parents completed the Pain Catastrophizing Scale for Parents prior to starting the diary (PCS-P general) and a daily measure (PCS-P daily) included in the diary. To account for the interdependence of the data, the data were analyzed using multilevel modeling. Perceived daily child pain intensity moderated the impact of parental general and daily catastrophic thoughts on parents' daily distress. Only for parents experiencing low general catastrophic thoughts an increase in distress was observed on days when they perceived their child's pain intensity as high. For all parents, high levels of perceived child pain intensity were related to more distress on days where parents reported high levels of catastrophic thinking (i.e., PCS-P daily). Perceived daily child pain intensity also moderated the impact of parental general catastrophic thinking on parents' daily endorsement of goals. Parents with high levels of general catastrophic thinking reported a lower focus on child pain control on days when child pain intensity was perceived to be low. Parents with low general catastrophic thinking reported lower endorsement of the activity engagement goal on days where the child's pain intensity was perceived to be low. These findings highlight the complexity of daily fluctuations in parental distress and goals regarding their child's pain. Clinical implications and future directions are critically assessed.
尽管儿童慢性疼痛经历存在日常变化，但对于父母对孩子疼痛的情绪和目标如何受到这些日常变化的影响，我们知之甚少。这项日记研究考察了日常儿童疼痛强度（父母所感知的）如何调节一方面父母对孩子疼痛的灾难性想法与另一方面日常父母痛苦以及父母对孩子疼痛的目标（疼痛控制与活动参与）之间的关联。参与者为20名不同儿童的25位父母（儿童年龄 = 18岁；90%为女孩）。年龄在8 - 14岁（平均年龄 = 9.5岁，标准差 = 2.09）的儿童经历慢性头痛或功能性腹痛，平均疼痛持续时间为22.5个月（标准差 = 24.5个月）。通过为期3周的每日日记收集父母的日常反应（即感知到的儿童疼痛强度、痛苦和目标认同）（共得到413份有效日记报告）。父母在开始日记记录之前完成父母疼痛灾难化量表（PCS - P总体）以及日记中包含的每日测量量表（PCS - P每日）。为了考虑数据的相互依赖性，使用多层模型对数据进行分析。感知到的每日儿童疼痛强度调节了父母总体和日常灾难性想法对父母日常痛苦的影响。仅对于总体灾难性想法较少的父母，当他们感知到孩子疼痛强度较高时，痛苦会增加。对于所有父母而言，在父母报告高水平灾难性思维（即PCS - P每日）的日子里，感知到的高水平儿童疼痛强度与更多痛苦相关。感知到的每日儿童疼痛强度还调节了父母总体灾难性思维对父母日常目标认同的影响。总体灾难性思维水平较高的父母在感知到孩子疼痛强度较低的日子里报告对儿童疼痛控制的关注度较低。总体灾难性思维水平较低的父母在孩子疼痛强度被感知为较低的日子里报告对活动参与目标的认同度较低。这些发现凸显了父母在孩子疼痛方面每日痛苦和目标波动的复杂性。对临床意义和未来方向进行了批判性评估。
