Brandelli Yvonne N, Mackinnon Sean P, Chambers Christine T, Parker Jennifer A, Huber Adam M, Stinson Jennifer N, Johnson Shannon A, Wilson Jennifer P
Dalhousie University and IWK Health, Halifax, Nova Scotia, Canada.
Dalhousie University, Halifax, Nova Scotia, Canada.
Arthritis Care Res (Hoboken). 2025 Mar;77(3):309-321. doi: 10.1002/acr.25439. Epub 2024 Oct 26.
Although juvenile idiopathic arthritis (JIA) is often associated with pain, this experience does not necessitate negative outcomes (eg, depression, functional impairment). Little research has explored youth and parent resilience resources (ie, stable traits) and mechanisms (ie, dynamic processes) in this context, and studies have focused on their contributions independently rather than collectively. This study, informed by the Ecological Resilience-Risk Model in Pediatric Chronic Pain, sought to (1) explore the relationships among youth and parent resilience resources and mechanisms and (2) identify the relative importance (RI; ie, independent contributions when entered simultaneously) of evidence-based youth and parent resources and mechanisms in contributing to youth-reported recovery, sustainability, and growth outcomes.
Youth (13-18 years) with JIA and their parents (156 dyads) completed a battery of online questionnaires assessing resilience resources (optimism, resilience), mechanisms (psychological flexibility, pain acceptance, self-efficacy), recovery and sustainability (pain intensity, functional disability, health-related quality of life), and growth (benefit finding) outcomes.
Analyses demonstrated significant positive correlations across within-person resources and mechanisms and weaker correlations across within-dyad resources and mechanisms. Although the RI of predictors varied by outcome, youth pain acceptance was the most robust predictor across models (RI = 0.03-0.15). Some predictors (eg, parent psychological flexibility and pain acceptance) were generally categorized as "Not Important," whereas others (eg, youth resilience) had "Inconclusive" results, suggesting construct overlap.
Although additional research is needed to further understand resilience, results highlight the importance of fostering pain acceptance in youth and incorporating parents in psychosocial interventions to optimize living with JIA.
尽管幼年特发性关节炎（JIA）常伴有疼痛，但这种经历并不一定会导致负面结果（如抑郁、功能障碍）。在这种背景下，很少有研究探讨青少年及其父母的复原力资源（即稳定特质）和机制（即动态过程），并且研究主要关注它们各自的作用，而非共同作用。本研究以儿童慢性疼痛的生态复原力-风险模型为依据，旨在（1）探讨青少年及其父母的复原力资源与机制之间的关系，以及（2）确定基于证据的青少年及其父母的资源和机制对青少年报告的康复、可持续性和成长结果的相对重要性（RI；即同时纳入时的独立作用）。
患有JIA的青少年（13 - 18岁）及其父母（156对）完成了一系列在线问卷，评估复原力资源（乐观、复原力）、机制（心理灵活性、疼痛接纳、自我效能感）、康复和可持续性（疼痛强度、功能残疾、健康相关生活质量）以及成长（益处发现）结果。
分析表明，个体内部的资源与机制之间存在显著正相关，而二元组内部的资源与机制之间的相关性较弱。尽管预测因素的RI因结果而异，但青少年的疼痛接纳在所有模型中都是最有力的预测因素（RI = 0.03 - 0.15）。一些预测因素（如父母的心理灵活性和疼痛接纳）通常被归类为“不重要”，而其他因素（如青少年的复原力）结果“不明确”，这表明存在结构重叠。
尽管需要更多研究来进一步理解复原力，但研究结果强调了培养青少年疼痛接纳能力以及让父母参与心理社会干预以优化JIA患者生活的重要性。
