Personal and contextual factors affecting the functional ability of children and adolescents with chronic pain: a systematic review

Sinclair, Cate M, Meredith, Pamela, Strong, Jenny and Feeney, Rachel (2016) Personal and contextual factors affecting the functional ability of children and adolescents with chronic pain: a systematic review. Journal of Developmental and Behavioral Pediatrics, 37 4: 327-342. doi:10.1097/DBP.0000000000000300


Author Sinclair, Cate M
Meredith, Pamela
Strong, Jenny
Feeney, Rachel
Title Personal and contextual factors affecting the functional ability of children and adolescents with chronic pain: a systematic review
Journal name Journal of Developmental and Behavioral Pediatrics   Check publisher's open access policy
ISSN 1536-7312
0196-206X
Publication date 2016-05-01
Year available 2016
Sub-type Article (original research)
DOI 10.1097/DBP.0000000000000300
Open Access Status Not Open Access
Volume 37
Issue 4
Start page 327
End page 342
Total pages 16
Place of publication Philadelphia, United States
Publisher Lippincott Williams & Wilkins
Language eng
Abstract Objective: Chronic pain can significantly impair functioning of children and adolescents; however, evidence suggests that current psychological approaches have limited effect on functioning post treatment. The objective of this review is to present the current evidence for the personal and contextual factors that affect functioning and disability of children and adolescents with chronic pain, to support the evolution of new treatments. Method: Key word searches were conducted in PsycINFO, MEDLINE via Ovid, CINAHL, and PubMed from 1995 to October 2014. Studies were included if they (1) were written in English, (2) included children or adolescents with chronic pain (>3 mo), (3) had at least 1 personal attribute or 1 contextual factor, (4) had 1 measure of functional ability, and (5) had reported correlations between personal or contextual factors and functional measure. Results: Thirty-three studies were identified which met all inclusion criteria. Several personal factors (depression, anxiety, pain intensity, and catastrophizing) and contextual/environmental factors (parenting characteristics) were consistently associated with higher levels of disability, whereas evidence for other factors was less consistent. Complex interactions between personal and contextual factors were reported. Child physical/cognitive capacities, teacher/peer behaviors, and broader cultural and environmental social systems, received little attention. Conclusion: Several parent and child factors were consistently linked with functional disability, whereas better family functioning was associated with functional ability. Applying an ecological framework, assisted identification of areas for further research, and provides direction for treatments that may be mote effective in optimizing long-term functional outcomes, extending current psychological approches.
Formatted abstract
Objective: Chronic pain can significantly impair functioning of children and adolescents; however, evidence suggests that current psychological approaches have limited effect on functioning post treatment. The objective of this review is to present the current evidence for the personal and contextual factors that affect functioning and disability of children and adolescents with chronic pain, to support the evolution of new treatments.

Method: Key word searches were conducted in PsycINFO, MEDLINE via Ovid, CINAHL, and PubMed from 1995 to October 2014. Studies were included if they (1) were written in English, (2) included children or adolescents with chronic pain (>3 mo), (3) had at least 1 personal attribute or 1 contextual factor, (4) had 1 measure of functional ability, and (5) had reported correlations between personal or contextual factors and functional measure.

Results: Thirty-three studies were identified which met all inclusion criteria. Several personal factors (depression, anxiety, pain intensity, and catastrophizing) and contextual/environmental factors (parenting characteristics) were consistently associated with higher levels of disability, whereas evidence for other factors was less consistent. Complex interactions between personal and contextual factors were reported. Child physical/cognitive capacities, teacher/peer behaviors, and broader cultural and environmental social systems, received little attention.

Conclusion: Several parent and child factors were consistently linked with functional disability, whereas better family functioning was associated with functional ability. Applying an ecological framework, assisted identification of areas for further research, and provides direction for treatments that may be more effective in optimizing long-term functional outcomes, extending current psychological approaches.
Keyword Behavioral Sciences
Psychology, Developmental
Pediatrics
Behavioral Sciences
Psychology
Pediatrics
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
 
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