Journal of pediatric psychology
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Validated the use of the Behavioral Approach-Avoidance and Distress Scale (BAADS; Hubert, Jay, Saltoun, & Hayes, 1988), which was reported to be easily completed and scored in an analog situation, for measuring children's distress and coping style during actual painful medical procedures. 60 preschool children who were receiving immunizations at a health department were subjects. Objective measures (Observational Scale of Behavioral Distress and Child-Adult Medical Procedure Interaction Scale-Revised) and subjective measures (child-, parent-, and nurse-report) were used. Results of the current study support the internal consistency and concurrent validity of the Distress subscale of the BAADS; however, some caution is suggested in interpreting the Approach-Avoidance subscale. Discussion focuses on the utility of this scale in clinical settings and the cost-effectiveness of this measure for assessing pediatric patients.
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Examined predictors of children's ratings of postoperative pain intensity based on a model of children's expectations for surgery developed from the Children's Health Belief Model (Bush & Iannotti, 1990) and McGrath's (1990) model of children's pain experiences. Prior to their inpatient surgeries, 28 children (ages 7-17 years) and their parents completed ratings of children's expected surgery pain, anticipatory anxiety, and expected helpfulness of pain medicine. ⋯ Age, total analgesics administered, and anticipatory anxiety emerged as significant predictors of children's postoperative pain ratings. Methodological issues concerning the measurement of children's expectations for surgery are discussed.
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Evaluated the validity, stability, and clinical utility of the Pediatric Pain Questionnaire (PPQ), a comprehensive, multidimensional instrument for assessing childhood pain. Previous studies demonstrated adequate psychometric properties of the PPQ using small samples. Results of the current study, using a large sample (N = 100) of children and adolescents with chronic pain associated with rheumatic disease, were consistent with initial validation studies. ⋯ Significant correlations also were found between pain ratings and measures of disease activity and functional status. VAS ratings evidenced moderate stability over a 6-month period in this sample of youth with relatively stable disease activity. Other components of the PPQ provide comprehensive information that is clinically useful for treatment planning and evaluation.
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Investigated physician-parent communication styles and the effects of concordance between parent's desired communication styles and the communication style exhibited by physicians. Subjects were 107 parents of children scheduled for an appointment with a pediatrician at a general medical clinic. Parents and physicians completed rating forms indicating the degree to which parents desired each of four communication styles (information giving, interpersonal sensitivity, partnership, and directing one's own treatment). ⋯ Results indicated that physicians underestimated the degree of interaction desired by the parents. Parent desires for particular communication styles were not predicted by characteristics of the parents. Interaction variables predicted parent perceptions and subsequent need for contact with the physician.
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Examined correspondence between mother and child reports of child anxiety immediately preceding a scheduled invasive medical procedure. The State-Trait Anxiety Inventory for Children (STAIC) was administered to 101 children ages 10-18 years. Mothers completed the STAIC and the State-Trait Anxiety Inventory to assess their perceptions of the child's anxiety and their own level of anxiety, respectively. ⋯ Results also revealed low overall mother-child correspondence on child anxiety, particularly for mothers reporting more anxiety in themselves. Additionally, while age, gender, and socioeconomic status were not associated with mother-child correspondence, an unexpected relationship between race and correspondence emerged. Overall, our findings indicate that reliance on parents' perceptions of child anxiety prior to an invasive medical procedure is not sufficient.