Predicting Multiple Facets of School Functioning in Pediatric Chronic Pain Examining the Direct Impact of Anxiety
Predicting Multiple Facets of School Functioning in Pediatric Chronic Pain Examining the Direct Impact of Anxiety
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DOI：
10.1097/ajp.0000000000000181
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发表时间：
2015-10-01
影响因子：
2.9
通讯作者：
Hainsworth, Keri R.
中科院分区：
文献类型：
--
作者：
Khan, Kim Anderson;Tran, Susan T.;Hainsworth, Keri R.
目的：慢性疼痛，焦虑和学校功能之间的关系是复杂的，学校功能往往是负面影响的青年慢性疼痛。本研究的目的是实证检验模型之间的关联结构预测学校功能的青少年慢性疼痛检查的直接影响，焦虑对上学和其他指标的学校相关disability.Materials和方法：参与者包括349名青年和他们的父母（311母亲和162父亲）谁参加了多学科的疼痛诊所。青年，母亲，父亲和临床医生完成了重要的家庭和临床医生的看法，学校运作的临床结果的评估;青年，母亲和父亲完成了青年焦虑的评估。使用结构方程模型来检查预测因素之间的相互关系。结果：预测青少年学校运作的测量和结构模型提供了与概念模型非常好的数据拟合。焦虑是直接相关的问题，上学和回避，浓度，并保持与schoolwork.Discussion：焦虑是一个强大的预测在一系列领域的学校运作。评估儿童慢性疼痛的焦虑症状可能有助于病例概念化和治疗计划。这项研究支持将重点从疼痛转移到焦虑，作为慢性疼痛青少年学校障碍的驱动力。
Objectives:The relationships among chronic pain, anxiety, and school functioning are complex, and school functioning is often negatively impacted in youth with chronic pain. The objective of this study was to empirically test a model of associations between constructs predicting school functioning in youth with chronic pain to examine the direct effect of anxiety on school attendance and other indicators of school-related disability.Materials and Methods:Participants included 349 youth and their parents (311 mothers and 162 fathers) who attended a multidisciplinary pain clinic. Youth, mothers, fathers, and clinicians completed assessments of clinical outcomes important to family and clinician perceptions of school functioning; youth, mothers, and fathers completed an assessment of youth anxiety. Structural equation modeling was used to examine interrelations among predictors.Results:Measurement and structural models for predicting youth school functioning provided a very good fit of the data to the conceptual model. Anxiety was directly related to problems with school attendance and avoidance, concentration, and keeping up with schoolwork.Discussion:Anxiety was a robust predictor of school functioning across a range of domains. Evaluating anxiety symptoms in pediatric chronic pain will likely facilitate case conceptualization and treatment planning. This study supports a shift in focus from pain to anxiety as the driving force of school impairment in youth with chronic pain.