Division of Pain Medicine, Department of Anesthesiology, Pain, and Perioperative Medicine, Boston Children's Hospital.
Department of Psychiatry, Harvard Medical School.
Clin J Pain. 2022 Nov 1;38(11):651-658. doi: 10.1097/AJP.0000000000001068.
An extensive body of research has highlighted the impact that parent/caregiver factors have on functioning and treatment outcomes among youth with chronic pain. However, parent/caregiver expectations in pain treatment have been largely understudied, despite strong evidence that treatment expectations are associated with treatment engagement and overall outcomes in nonpain populations. Accordingly, the primary aim of this investigation was to preliminarily examine the manifestation and measurement of parent/caregiver treatment expectations in an intensive interdisciplinary pediatric pain treatment (IIPT) setting.
Participants in this study (N=328) included children and adolescents who attended an IIPT program for chronic pain between August 2013 and March 2020 and their parent/caregiver(s). Outcomes examined include parent/caregiver self-report of treatment expectations for their child upon admission to the IIPT in addition to pain-related and psychosocial factors at admission and discharge.
Findings revealed a high level of expectations (ie, belief that the treatment will be helpful) on average, with higher parent/caregiver expectations associated with poorer functioning at admission to and discharge from the IIPT program.
Extremely high treatment expectations among parents of more disabled youth may be indicative of unrealistic hopes or the "need" for IIPT to help their child; tempering parental expectations with psychoeducation about IIPT goals and realistic outcomes may indirectly improve treatment outcomes for their children. Future research should examine the potentially unique and important role that treatment expectations, of both parent/caregivers and their children, may have in overall IIPT outcomes.
大量研究强调了父母/照顾者因素对慢性疼痛青少年的功能和治疗结果的影响。然而，尽管有强有力的证据表明治疗期望与非疼痛人群的治疗参与度和总体结果相关，但在疼痛治疗中父母/照顾者的期望很大程度上仍未得到充分研究。因此，本研究的主要目的是初步检查密集型跨学科儿科疼痛治疗（IIPT）环境中父母/照顾者治疗期望的表现和测量。
本研究的参与者（N=328）包括 2013 年 8 月至 2020 年 3 月期间参加慢性疼痛 IIPT 计划的儿童和青少年及其父母/照顾者。检查的结果包括父母/照顾者在孩子进入 IIPT 时对孩子治疗期望的自我报告，以及入院和出院时与疼痛相关和心理社会因素。
研究结果显示，平均而言，期望水平较高，父母/照顾者的期望越高，他们在进入和离开 IIPT 计划时的功能越差。
残疾程度较高的青少年的父母期望过高，可能表明他们的希望不切实际或对 IIPT 的“需求”过高，以帮助他们的孩子；通过对 IIPT 目标和现实结果进行心理教育来缓和父母的期望，可能会间接改善他们孩子的治疗结果。未来的研究应该检查治疗期望（父母和孩子）在整体 IIPT 结果中可能具有的独特而重要的作用。
