Does Pain Intensity Matter? The Relation between Coping and Quality of Life in Pediatric Patients with Chronic Pain

Abstract

Purpose: Chronic pain is a complex and debilitating chronic health condition that negatively impacts a child's daily function. Previous investigations of coping behaviors in youth with chronic illness have suggested that secondary control/accommodative coping may be more adaptive than primary control/active coping or disengagement/passive coping. However, studies have not considered how pain intensity may change the effect of various coping strategies on functioning in this pediatric population. The current study examines how coping strategies relate to health-related quality of life (HRQOL) in youth with chronic pain at various levels of pain intensity.

Design and methods: Sixty-five children and adolescents, aged 8-18 (77% female: M=13.6years, SD=2.64) were recruited from a pediatric pain management clinic at an urban children's hospital. The Response to Stress Questionnaire examined coping behaviors of participants. The PedsQL 4.0 Generic Core Scales assessed HRQOL and a 10-cm Visual Analog Scale measured pain intensity.

Results: Primary control engagement coping had a significant main effect to predict higher HRQOL. There was a significant interaction between secondary control engagement coping and pain, and a marginal interaction between disengagement coping and pain. Specifically, secondary control engagement coping significantly related to higher HRQOL when pain was low and disengagement coping marginally related to higher HRQOL when pain was high.

Conclusions: Findings suggest that the effectiveness of specific coping strategies may vary depending on a child's level of pain.

Practice implications: These findings suggest that clinicians (e.g., nurses, psychologists) use a more tailored approach when recommending interventions for managing chronic pain.

Keywords: Adolescents; Children; Chronic pain; Coping; Quality of life.