European journal of pain : EJP
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Review Meta Analysis
Prognostic factors for pain and functional disability in children and adolescents with persisting pain: a systematic review and meta-analysis.
The aim of this study was to investigate prognostic factors for pain and functional disability in children and/or adolescents with persisting pain. ⋯ Prognostic factors from across the biopsychosocial spectrum are important to consider in paediatric pain clinical practice. However, most prognostic factors that experts have previously agreed upon have not been assessed in prospective cohort studies to date. The findings may help with prioritising data to collect during clinical assessments of children presenting with pain, in the context of pain and functional disability outcomes.
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Children of individuals with chronic pain have an increased vulnerability to experience pain problems, possibly through observation of pain in their parents. As pain-related fear (PRF) is a critical factor in the development and maintenance of chronic pain, the current experimental study examined the acquisition of PRF through observational learning and subsequent extinction after first-hand experience of the feared stimulus. ⋯ Children may acquire pain-related fear by observing pain in others and this learned fear can diminish after first-hand experience. Remarkably, observational learning did not depend on the children's relationship with the model, but it did depend on the intensity of pain that is perceived. A better understanding of the impact of observing (parental) pain may help clarify the intergenerational transmission of risk for pain and inform the development of preventive programs.
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Chronic pain is a common issue in adolescents. Prevalence of pain and associated factors present differently in sex and age subgroups; however, the interaction of sex and age combined has not been thoroughly assessed. This study aimed to identify psychosocial and health factors associated with chronic pain in younger and older adolescent girls and boys. ⋯ We report evidence that negative psychosocial and health factors are related to a higher prevalence of chronic pain in adolescents. Furthermore, the relationships between anxiety, socioeconomic status, lower school satisfaction and lower school performance with pain may vary between adolescents of differing sexes and ages. Understanding how possible risk factors for chronic pain contribute differently to the pain experience of adolescent girls and boys is an important step towards lowering the prevalence of this common health condition.
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Paediatric pain remains one of the most misunderstood, under-diagnosed and under-treated medical problems in children. ⋯ This is one of the few studies in the Baltic region analysing changes in children's pain assessment and management in the PED after systemic and local adjustments. Our data show an impact of systemic changes and a specialized education focused on improving knowledge in acute pain diagnostics and management of medical professionals leading to better patient care.
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A number of observational tools are available to assess pain in cognitively impaired older adults, however, none of them can yet be regarded as a "gold standard". An international research initiative has created a meta-tool compiling the facial, vocalization and body movement items of the majority of available tools. Objective of this study was to investigate the pain specificity and the validity of these items. ⋯ Only few items stemming from observational pain assessment tools were found to be pain sensitive and specific as well as valid in this study. The investigation of existing tools not only on tool but additionally on item-level can provide helpful insights and thereby can help to improve the original tools and establish a gold standard for nonverbal pain assessment in older adults with cognitive impairments.