Pediatric Rheumatology Online Journal → June 2003 → Health-Related Quality of Life, Disease Activity and Outcome Assessments→ Abstract #31
                                                                August 2003 → Pain / Health-Related Quality of Life → Abstract #31

PAIN AND COPING STRATEGIES IN CHILDREN WITH JUVENILE ARTHRITIS AND MUSCULOSKELETAL PAIN

D. M. Roberton,1 J. Whitham,3 M. P. Freeman,3 M. Gold,1 M. G. Sawyer.1,2,3

1Dept of Paediatrics, University of Adelaide, Adelaide, South Australia, Australia; 2Dept of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia; 3Research and Evaluation Unit, Womens and Childrens Hospital, Adelaide, South Australia, Australia

A prospective study of the perception of chronic pain, utilisation of coping strategies, and the health related quality of life of children with juvenile arthritis and/or chronic musculoskeletal pain was undertaken over a 2 year period. Enrolment was for children 8 - 18 years of age who had attended the Rheumatology Clinic at the Womens and Childrens Hospital for at least 6 months.
Assessments were undertaken at enrolment, 6 months and 12 months after enrolment. Assessments included functional disability (Child Health Assessment Questionnaire), a 5 point global physician severity asssessment, health related quality of life assessment (HQRL - the PedsQLTM 4.0 Generic Core Scales and the PedsQLTM 3.0 Arthritis Module of the PQL Inventory), pain perception score (VAS in the Varni-Thompson Pediatric Pain Questionnaire), and coping strategies used by children (Waldron/ Varni Pediatric Pain Coping Inventory).
Of 90 families approached, 68 (76%) agreed to participate. All assessments were completed by 92% of those enrolled.
Parents and children reported a negative relationship between the childi) Physical Functioning ii) Social Functioning iii) Treatment QoL iv) Pain QoL v) Daily Activities QoL.
Neither parents nor children reported any relationship between the level of functional disability and Communication and Emotional Functioning HRQoL subscales.Parents reported the level of pain as strongly negatively correlated with all HRQoL subscales except for Communication. The only coping mechanism to show a consistent relationship with HRQoL measures as reported by the parents was the the "Strive to rest and be alone" mechanism. As the frequency of use of this coping mechanism increased, HRQoL of decreased. Children reported that "Seek social support"and "Cognitive self-instruction" coping mechanisms showed significant negative correlations to HRQoL.