Problem Solving Skills Training for Parent Caregivers of Youth with Chronic Pain

慢性疼痛青少年家长照顾者解决问题的技能培训

• 批准号: 8188864
• 负责人: Tonya M Palermo
• 金额: $ 20.18万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-25 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8188864
• 关键词: Adolescent; Affect; Aftercare; Anxiety; Caregivers; Caring; Child; Childhood; Complement; Control Groups; Coping Skills; Development; Distress; Educational Intervention; Emotional; Emotional Stress; Enrollment; Environment; Family; Goals; Health; Individual; Intervention; Knowledge; Literature; Malignant Neoplasms; Measurable; Measures; Medical; Mental Depression; Mental disorders; Methods; Modification; Mothers; Outcome Study; Pain; Pain Clinics; Pain management; Parenting behavior; Parents; Phase; Play; Population; Problem Solving; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Recruitment Activity; Reporting; Research; Role; Sampling; Series; Social Functioning; Stress; Testing; Traumatic Brain Injury; Visit; Work; Youth; chronic pain; compliance behavior; coping; depressive symptoms; design; disability; effective therapy; efficacy trial; evidence base; experience; follow-up; high risk; innovation; medical specialties; parental role; programs; psychologic; psychological distress; response; satisfaction; secondary outcome; skills; skills training; social; standard care; success; therapy design; therapy development; treatment duration

DESCRIPTION (provided by applicant): Chronic pain affects 25-40% of children and adolescents, and results in a measurable decline in children's overall quality of life. Parents not only play a significant role in how their children cope with chronic pain but they also can experience their own widespread social, relational, emotional and financial impact. In particular, parents of youth with chronic pain report increased role stress, increased depressive symptoms, and reduced social functioning. Regardless of the reason for increased distress, multiple studies have found that parental psychological distress is associated with poorer child adjustment. Therefore, there is a critical need to consider methods of reducing parental distress in order to more effectively manage children's chronic pain and disability. To date, no intervention has been developed specifically to treat parents in the context of their child's chronic pain, despite need, and success in other evidence-based pain treatments in youth. The proposed project is designed to evaluate problem-solving skills training (PSST), an intervention proven effective for reducing parental distress in other caregiver populations of individuals with medical conditions. Our aims are to evaluate the feasibility and acceptability of PSST as an intervention in parent caregivers of youth with chronic pain, and to conduct a preliminary efficacy trial of PSST in parents of youth with chronic pain. In this application, we propose first testing the intervention with 5 parent-child dyads in a pilot phase and then carrying out a randomized controlled trial of PSST in 60 parent caregivers of youth (10-17 years) with chronic pain recruited from two pain clinics. All children will be receiving specialty care for chronic pain. Parents randomized to the PSST intervention will, in addition, receive 8 individual sessions of problem-solving skills training over an 8-week treatment period while parents in the Standard Care control group will continue with prescribed treatments and recommendations for chronic pain management from the pain clinics. The primary study outcomes are parental depression and anxiety, parenting stress, and problem-solving skills and child physical and emotional functioning measured at pre-treatment, immediately post-treatment, and at 3-month follow-up. Secondary outcomes include parental impact of chronic pain and treatment satisfaction and acceptability. We propose the first ever intervention designed for, and delivered directly to, parental caregivers of youth with chronic pain. Findings will increase understanding of the interrelationships among parental and child functioning, and specifically will provide knowledge of how to augment effectively child and parent focused interventions. This innovation in treatment development will significantly advance psychological therapies for pediatric pain management, and ultimately may enhance quality of life in the substantial population of youth and their families affected by chronic pain. PUBLIC HEALTH RELEVANCE: Reducing parental distress and negative affectivity may be critical to influencing children's abilities to manage chronic pain. Testing of interventions developed specifically for parents will increase understanding of how effectively to reduce parental distress, and how to complement child treatment with parental intervention strategies. The long-term goal of the research is to develop effective treatments to manage chronic pain and disability in youth through reducing parental distress and increasing their coping abilities.

描述（由申请人提供）：慢性疼痛影响25-40％的儿童和青少年，并导致儿童整体生活质量的可衡量下降。父母不仅在孩子如何应对慢性疼痛方面发挥了重要作用，而且他们还可以体验自己广泛的社会，关系，情感和经济影响。特别是，患有慢性疼痛的青年父母报告了角色压力增加，抑郁症状增加以及社交功能减少。不管遇到增加的原因是什么，多项研究发现父母的心理困扰与儿童适应性较差有关。因此，为了更有效地管理儿童的慢性疼痛和残疾，迫切需要考虑减少父母困扰的方法。迄今为止，尚未开发任何干预措施，以便在孩子的慢性疼痛中对父母的慢性疼痛进行治疗，并在青年中其他基于证据的疼痛治疗中取得成功。拟议的项目旨在评估解决问题的技能培训（PSST），该干预措施被证明有效地减少了患有医疗状况的患者的其他护理人员人群。我们的目的是评估PSST作为慢性疼痛的父母护理人员的干预，并在慢性疼痛的青年父母中对PSST进行初步疗效试验。在此应用中，我们提议在试点阶段首先测试5个亲子二元组，然后在60名年轻人的父母护理人员（10-17岁）中对PSST进行随机对照试验，并从两个疼痛诊所招募了慢性疼痛。所有儿童都将接受慢性疼痛的专业护理。此外，在为期8周的治疗期内，父母将随机进行PSST干预措施接受8个个人解决问题的技能培训，而标准护理对照组的父母将继续接受处方的治疗，并为疼痛诊所的慢性疼痛管理提供建议。主要的研究结果是父母的抑郁和焦虑，育儿压力以及解决问题的技能以及儿童在治疗前，治疗后立即衡量的身体和情感功能，以及在3个月的随访中。次要结果包括慢性疼痛和治疗满意度和可接受性的父母影响。我们提出了有史以来第一次为慢性疼痛的父母照顾者而设计的第一次干预措施，并将其直接交付给。调查结果将增加对父母和儿童功能之间相互关系的理解，特别是将提供有关如何有效增强子女和父母的干预措施的知识。治疗开发中的这种创新将大大推动小儿疼痛管理的心理疗法，最终可能会提高受慢性疼痛影响的大量青年及其家庭的生活质量。 公共卫生相关性：减少父母的困扰和负面情感对影响儿童控制慢性疼痛的能力可能至关重要。专门针对父母开发的干预措施的测试将增加对如何有效减少父母困扰的理解，以及如何通过父母干预策略对儿童待遇进行补充。这项研究的长期目标是通过减少父母的困扰和提高应对能力来开发有效的治疗方法，以控制青年人的慢性疼痛和残疾。