• Clin J Pain · Sep 2014

    Parental Distress and Catastrophic Thoughts About Child Pain: Implications for Parental Protective Behavior in the Context of Child Leukemia Related Medical Procedures.

    • Line Caes, Tine Vervoort, Patricia Devos, Joris Verlooy, Yves Benoit, and Liesbet Goubert.
    • *Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada †Department of Experimental-Clinical and Health Psychology, Ghent University ‡Department of Pediatric Oncology/Hematology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium.
    • Clin J Pain. 2014 Sep 1;30(9):787-99.

    ObjectivesTreatment for childhood leukemia requires frequent lumbar punctures (LP) and bone marrow aspirations (BMA), often described by children and parents as more distressing than the disease itself. Findings in schoolchildren and chronic pain samples indicate that increased parental distress may increase parental protective, pain-attending behavior, which is associated with more child pain and distress. However, in the context of invasive medical procedures, it is unknown which parents are likely to become most distressed and engage in pain-attending behavior, and how this impacts the children's experiences. The present study investigated the impact of parental catastrophic thoughts upon parental distress and pain-attending behavior (verbal and nonverbal). Furthermore, the association between parental responses and the children's pain behavior, pain, and distress was examined.Materials And MethodsA total of 46 parents of children with leukemia (range, 0.6 to 15 y) who underwent a LP/BMA procedure participated in this study. Parental catastrophizing was assessed before and parental and child distress was assessed after the LP/BMA procedure. Parental pain-attending behavior and the child's pain behavior were observed before and after the LP/BMA procedure.ResultsFindings indicated that heightened parental catastrophic thinking contributed to increased parental distress during LP/BMA and less pain-attending behavior before the LP/BMA procedure, especially in young children. In contrast, heightened distress in parents with high levels of catastrophizing contributed to increased engagement in postprocedural pain-attending behavior. For young children, increased preprocedural pain-attending behavior was related to more child distress, pain, and pain behavior.DiscussionThe findings demonstrate the importance of parental catastrophic thinking in understanding their caregiving responses and preparing parents and children for painful invasive medical procedures.

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