scholarly journals Evaluating Telehealth Implementation in the Context of Pediatric Chronic Pain Treatment during COVID-19

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 764
Author(s):  
Patricia A. Richardson ◽  
Delana M. Parker ◽  
Krystal Chavez ◽  
Kathryn A. Birnie ◽  
Elliot J. Krane ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Data Collection ◽  
Pain Treatment ◽  
Clinical Symptoms ◽  
Healthcare Delivery ◽  
Data Sources ◽  
Implementation Outcomes ◽  
Pediatric Chronic Pain ◽  
Pain Clinics ◽  
Existing Data

Telehealth has emerged as a promising healthcare delivery modality due to its ability to ameliorate traditional access-level barriers to treatment. In response to the onset of the novel coronavirus (COVID-19) pandemic, multidisciplinary pain clinics either rapidly built telehealth infrastructure from the ground up or ramped up existing services. As the use of telehealth increases, it is critical to develop data collection frameworks that guide implementation. This applied review provides a theoretically-based approach to capitalize on existing data sources and collect novel data to inform virtually delivered care in the context of pediatric pain care. Reviewed multisource data are (1) healthcare administrative data; (2) electronic chart review; (3) clinical health registries; and (4) stakeholder feedback. Preliminary telehealth data from an interdisciplinary pediatric chronic pain management clinic (PPMC) serving youth ages 8–17 years are presented to illustrate how relevant implementation outcomes can be extracted from multisource data. Multiple implementation outcomes were assessed, including telehealth adoption rates, patient clinical symptoms, and mixed-method patient-report telehealth satisfaction. This manuscript provides an applied roadmap to leverage existing data sources and incorporate stakeholder feedback to guide the implementation of telehealth in pediatric chronic pain settings through and beyond COVID-19. Strengths and limitations of the modeled data collection approach are discussed within the broader context of implementation science.

scholarly journals What Do the Parents of Children Who Have Chronic Pain Expect from Their First Visit to a Pediatric Chronic Pain Clinic?

2010 ◽  
Vol 15 (3) ◽  
pp. 158-162 ◽  
Author(s):  
Kathy Reid ◽  
Janice Lander ◽  
Shannon Scott ◽  
Bruce Dick
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Treatment Options ◽  
Tertiary Care ◽  
Pain Clinic ◽  
Treatment Modalities ◽  
Care Providers ◽  
Treatment Needs ◽  
Pediatric Chronic Pain ◽  
Pain Clinics

BACKGROUND: Chronic pain in childhood is increasingly recognized as a significant clinical problem. Best-practice management of pediatric chronic pain in a multidisciplinary pain clinic involves a variety of treatment modalities. It is important that parents of children treated in these settings understand the different treatment options available for their children. By involving parents more effectively, care providers may more efficiently address unmet treatment needs and improve tailoring of treatment programs aimed at increasing function, reducing pain-related disability and improving quality of life.OBJECTIVES: To explore the expectations held by parents for their first visit to a pediatric multidisciplinary pain clinic.METHODS: Fourteen parents completed a paper-based survey exploring their expectations immediately before their first visit to a multidisciplinary pediatric pain clinic in a tertiary care children’s hospital.RESULTS: Responses from parents suggest a clear desire for information about the causes of their child’s pain, treatment options available at the pain clinic, effective strategies to enhance children’s ability to cope with pain, and the effects of pain on both body and mood. Most parents rated the various treatment options as important for their child. All parents indicated it was very important to have the pain team ‘be there’ for them.CONCLUSIONS: These findings indicate that parents want more information about chronic pain and treatment options. Pediatric chronic pain clinics have the ability to assist children with chronic pain and their families considerably by providing information about chronic pain and the various treatment options available to them.

scholarly journals Biomarkers of Allostatic Load as Correlates of Impairment in Youth with Chronic Pain: An Initial Investigation

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 709
Author(s):  
Sarah Nelson ◽  
Samantha Bento ◽  
Michelle Bosquet Enlow
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Allostatic Load ◽  
Functional Disability ◽  
Pain Treatment ◽  
Pediatric Pain ◽  
Childhood Experiences ◽  
High Exposure ◽  
Pediatric Chronic Pain ◽  
Study Results

Pediatric chronic pain is common and responsible for significant healthcare burden. However, the mechanisms underlying the development and/or maintenance of pediatric chronic pain remain poorly understood. Allostatic load (AL), or wear and tear on the nervous system following significant or prolonged stress, has been proposed to play a role in the maintenance of chronic pain, but minimal research has examined this possibility. This gap in research is particularly notable given the high exposure to adverse childhood experiences (ACEs; abuse/neglect, etc.) and psychological stress in this population. Accordingly, the current study aimed to preliminarily examine the measurement of AL in a treatment-seeking pediatric pain population. Biomarkers were collected during an already scheduled new patient pain evaluation and included salivary cortisol, dehydroepiandrosterone (DHEA), and C-reactive protein, in addition to waist–hip ratio, body-mass index, and blood pressure. A total of 61 children and adolescents with chronic pain (Mage = 14.47 years; 88.5% female and white/Caucasian) completed study procedures and were included in analyses. Preliminary results indicated that a multifactorial AL composite is feasible to assess for in a tertiary pain treatment setting and that over 50% of youth with chronic pain were classified as high risk for AL (two or more risk factors). Further, it was found that individual AL risk factors were significantly associated with functional disability and that AL may moderate the association between psychosocial and functional outcomes. Given the pilot nature of this study, results should be used to inform future investigations with larger and more diverse pediatric pain samples.

scholarly journals Complementary Parent Components for Pediatric Pain Families: Innovations in Treatment

Children ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 4 ◽  
Author(s):  
Beth S. Russell ◽  
Jessica W. Guite ◽  
Kendra J. Homan ◽  
Rebecca M. Tepe ◽  
Sara E. Williams
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Control Sample ◽  
Intervention Development ◽  
Treatment Programs ◽  
Pediatric Pain ◽  
Parent Intervention ◽  
Pediatric Chronic Pain ◽  
Interdisciplinary Pain Treatment ◽  
Caregiver Needs

For families with a child with chronic pain, the home environment is the context in which adaptive or maladaptive illness behaviors are developed. Supporting families to effectively cope with their child’s chronic pain is a critical need. This work analyzes intervention approaches from emerging treatment programs to support families coping with pediatric pain that diverge from traditional treatment models by specifically targeting parents. Two novel parent intervention programs are presented that consider caregiver needs in both outpatient and inpatient pain treatment settings: Parents as Coping Coaches and Putting Parents FIRST. These programs are evaluated through comparing parental training components across different stages of treatment. Additionally, the efficacy of Putting Parents FIRST in promoting maintenance of children’s functional gains achieved in intensive interdisciplinary pain treatment is presented, and compared to previous results of the efficacy of Putting Parents FIRST. Specifically, outcomes of 36 children whose parents received the intervention in Putting Parents FIRST were compared to a matched control sample of children whose parents did not receive the parent intervention. Similar to the findings from Parents as Coping Coaches, results indicated that patients whose parents received the intervention maintained/improved program gains in disability, coping, and pain significantly more than patients whose parents did not receive the intervention. Implications for parent-focused intervention development efforts targeting parent and youth functioning in the context of pediatric chronic pain are considered.

scholarly journals Management of chronic pain

1997 ◽  
Vol 3 (2) ◽  
pp. 86-93 ◽  
Author(s):  
Stephen P. Tyrer
Keyword(s):  
Chronic Pain ◽  
Acute Treatment ◽  
Pain Treatment ◽  
Medical Condition ◽  
Washington State ◽  
Pain Clinic ◽  
Pain Clinics ◽  
The Usa ◽  
Treatment Facilities ◽  
The Many

Until 50 years ago chronic pain was not considered to be a medical condition that required special evaluation and treatment facilities. Pain was considered to be an indicator of tissue damage and appropriate medical or surgical treatment was prescribed for this. The many patients who had continuing pain because of the results of disease or trauma or because acute treatment was unable to relieve the condition were not seen as suffering from a recognised pathological entity. It was not until a doctor, Sicilian-born John J. Bonica, had to pay his debts as a medical student through wrestling professionally, and later suffered persistent pain as a result, that chronic pain became a recognised condition in its own right. Bonica started a pain clinic in Tacoma, Washington State, in 1949 and wrote the first textbook on pain treatment, The Management of Pain, in 1953. There are now 2000–3000 pain clinics in the USA and almost 5000 worldwide.

scholarly journals Development and Usability Evaluation of an Art and Narrative-Based Knowledge Translation Tool for Parents With a Child With Pediatric Chronic Pain: Multi-Method Study (Preprint)

2017 ◽  
Author(s):  
Kathy Reid ◽  
Lisa Hartling ◽  
Samina Ali ◽  
Anne Le ◽  
Allison Norris ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Knowledge Translation ◽  
Pain Treatment ◽  
Qualitative Interviews ◽  
Treatment Options ◽  
Clinical Problem ◽  
Usability Evaluation ◽  
Pain Clinic ◽  
Pediatric Chronic Pain ◽  
Significant Difference

BACKGROUND Chronic pain in childhood is increasingly being recognized as a significant clinical problem for children and their families. Previous research has identified that families want information about the causes of their child’s chronic pain, treatment options, and effective strategies to help their child cope with the pain. Unfortunately, parents have reported that finding this information can be challenging. OBJECTIVE The aim of this study was to actively work together with children attending a pediatric chronic pain clinic and their parents to develop, refine, and evaluate the usability of an art and narrative-based electronic book (e-book) for pediatric chronic pain. METHODS A multiphase, multi-method research design employing patient engagement techniques was used to develop, refine, and evaluate the usability of an art and narrative based e-book for pediatric chronic pain management to facilitate knowledge translation for parents with a child with chronic pain. The multiple phases included the following: (1) qualitative interviews to compile parents’ narratives using qualitative interviews; (2) qualitative data analysis; (3) development of an e-book prototype; (4) expert clinician feedback; (5) parent usability evaluation, knowledge change, and confidence in knowledge responses using an electronic survey; (6) e-book refinement; and (7) dissemination of the e-book. RESULTS A 48-page e-book was developed to characterize the experiences of a family living with a child with chronic pain. The e-book was a composite narrative of the parent interviews and encompassed descriptions of the effects the condition has on each member of the family. This was merged with the best available research evidence on the day-to-day management of pediatric chronic pain. The e-book was vetted for clinical accuracy by expert pediatric pain clinicians. All parents that participated in the usability evaluation (N=14) agreed or strongly agreed the content of the e-book was easy to understand and stated that they would recommend the e-book to other families who have children with chronic pain. Our research identified up to a 21.4% increase in knowledge after using the e-book, and paired t tests demonstrated a statistically significant difference in confidence in answering two of the five knowledge questions (chronic pain is a disease involving changes in the nervous system; the use of ibuprofen is usually effective at controlling chronic pain); t13=0.165, P=.001 and t13=0.336, P=.002, respectively, after being exposed to the e-book. CONCLUSIONS Our results demonstrate that parents positively rated an e-book developed for parents with a child with chronic pain. Our results also identify that overall, parents’ knowledge increased after using the e-book, and confidence in their knowledge about chronic pain and its management increased in two aspects after e-book exposure. These results suggest that art and narrative-based knowledge translation interventions may be useful in transferring complex health information to parents.

scholarly journals Patients with Chronic Pain Prefer Maintenance of Pain Treatment Despite COVID-19 Pandemic Restrictions

2021 ◽  
pp. 165-173
Keyword(s):  
Chronic Pain ◽  
Pain Therapy ◽  
Pain Treatment ◽  
Mental Illnesses ◽  
Pain Clinic ◽  
Pain Clinics ◽  
Number Of Patients ◽  
Hygiene Measures ◽  
Short Period ◽  
The Impact

BACKGROUND: Worldwide, the COVID-19 pandemic has a significant impact on daily life. First studies describe a negative impact of pandemic stressors even on individuals without previous mental illnesses. The home lockdown and the shutdown of pain clinics make it difficult for all patients to get the healthcare they need. OBJECTIVES: The aim of this study was to investigate to what extent patients with chronic pain felt affected by the pandemic and its consequences on pain treatments, focussing on the beginning of the outbreak. STUDY DESIGN: A prospective noninterventional study. SETTING: Medical University Center . METHODS: One-hundred and forty-nine patients, suffering from chronic pain, treated at a large German interdisciplinary pain center, were studied over a period of 2 months at the beginning of the pandemic. Data from patient charts and questionnaires were evaluated. Patients were asked about postponements or cancellations of pain therapy, the possible effect on pain levels, depression, anxiety and stress, and the impact of intensified hygiene measures. Results were compared to those from standardized and validated questionnaires from the same patients (German version of the depression, anxiety, and stress scale = DASS) at the time of the first contact in the pain clinic. RESULTS: Eighty-four (56.4%) patients reported cancelled or postponed treatments during the pandemic. Those chronic pain patients with delayed or cancelled treatments reported significantly more pain and psychological distress. The delay or discontinuation of treatments resulted in a deterioration of symptoms. From the patients’ point of view this deterioration was unrelated to the timing of treatment and not secondary to increased hygiene measures. In both groups, patients showed a significant amelioration of the DASS values compared to the values they had at the beginning of treatment, despite the negative effects of the COVID-19 pandemic on care structures. The majority of the patients do not think that the quality of pain treatment was significantly affected by the intensified hygiene requirements. LIMITATIONS: The limitations of the study are the small number of patients because of the limitation to a short period of time at the beginning of the pandemic and the return rate of 40.2% of the study consents. CONCLUSIONS: Even in the event of a pandemic-related restriction of the care structures, patients with chronic pain benefit from pain therapy. Limitations such as the increased hygiene measures caused by the pandemic were not considered detrimental to the therapeutic measures. KEY WORDS: COVID-19 pandemic, hygiene measures, chronic pain, anxiety, depression, stress

scholarly journals The medicalization of chronic pain

2010 ◽  
Vol 7 (13) ◽  
Author(s):  
Peter Conrad ◽  
Vanessa Lopes Muñoz
Keyword(s):  
Chronic Pain ◽  
Control Theory ◽  
Pain Treatment ◽  
Medical Treatments ◽  
Gate Control Theory ◽  
Pain Clinics ◽  
Speciality Training ◽  
Gate Control ◽  
Chronic Pain Treatment ◽  
Medical Category

This paper presents an initial analysis of the medicalization of chronic pain, focusing on the definitions and treatment of chronic pain in recent decades. We identify several factors that contributed to this medicalization including the emergence of the gate control theory of pain, medical advocates for pain treatment and speciality training, the development of multidisciplinary pain clinics, the emergence of professional pain associations, extended medical treatments, and governmental decisions and support. The increased attention to chronic pain as a discrete medical category and innovations in chronic pain treatment have contributed to the medicalization of chronic pain in ways that suggest there may be benefits to society and pain sufferers, in contrast to many other cases of medicalization.

scholarly journals Lessons from fisheries industry-led data collection efforts in the UK

2018 ◽  
Author(s):  
OCTO
Keyword(s):  
Data Collection ◽  
Case Studies ◽  
Fisheries Management ◽  
Data Sources ◽  
Commercial Fisheries ◽  
The Uk ◽  
Existing Data

With many fisheries management organizations operating with lean budgets, finding funding to collect necessary data on how to properly manage fisheries can be difficult; let alone fill gaps in existing data collection efforts. In some instances in the UK, fishers have begun data collection projects of their own. To understand the reasoning behind and effectiveness of these projects, the authors investigated case studies engaging commercial fisheries with industry-led data collection efforts to supplement existing data sources.

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