Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 1;44(9):1111-1119.
doi: 10.1093/jpepsy/jsz067.

Parent Pain Cognitions and Treatment Adherence in Juvenile Idiopathic Arthritis

Yvonne N Brandelli  1   2 , Christine T Chambers  1   2   3 , Perri R Tutelman  1   2 , Jennifer N Stinson  4   5 , Adam M Huber  3   6 , Jennifer P Wilson  7
Affiliations

Parent Pain Cognitions and Treatment Adherence in Juvenile Idiopathic Arthritis

Yvonne N Brandelli et al. J Pediatr Psychol. .

Abstract

Objective: Given the high levels of pain and low rates of treatment adherence in children with juvenile idiopathic arthritis (JIA) and their families, this study sought to examine the relationship between parent pain cognitions (i.e., pain catastrophizing, fear of pain) and treatment adherence, and how barriers to treatment (e.g., forgetting treatments, children resisting injections) may be implicated in this relationship.

Methods: Parents of children under 18 years of age who have been diagnosed with JIA were recruited to complete an online survey. In total, 221 parents (93% mothers) of children aged 2-17 years (M = 11.10, SD = 4.25) took part, completing questions regarding their pain cognitions, perceived barriers to treatment, and their child's arthritis treatment adherence ability.

Results: Hierarchical regressions demonstrated that both pain cognitions (i.e., pain catastrophizing and fear of pain) were related to a decrease in parent-reported treatment adherence, however, pain catastrophizing was no longer significant when fear of pain was added to the model. The presence of treatment barriers partially mediated the relationship between fear of pain and treatment adherence, above and beyond the alternate model proposed.

Conclusion: These results suggest that parent pain catastrophizing and fears of pain are related to a greater difficulty following treatment plans, possibly in part because of barriers parents experience that preclude adherence. Given these findings, the identification and management of parent pain cognitions is critical to improving treatment adherence and outcomes for children with JIA and their families.

Keywords: adherence; health behavior; juvenile rheumatoid arthritis; pain; parent; rheumatology.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
The presence of barriers mediates the relationship between parent fear of pain and treatment adherence for all participants. *p < .05.
Figure 2.
Figure 2.
The presence of barriers mediates the relationship between parent fear of pain and treatment adherence for all participants receiving treatments involving procedural pain. *p < .05.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Abraham C., Sheeran P. (2005). The health belief model In Conner M., Norman P. (Eds.), Predicting Health Behaviour. Research and Practice with Social Cognition Models (2nd edn, pp. 28–80). Maidenhead: Open University Press.
    1. Bechard M. A., Lemieux J. R., Roth J., Duffy K. W., Duffy C. M., Aglipay M. O., Jurencak R. (2014). Procedural pain and patient-reported side effects with weekly injections of subcutaneous methotrexate in children with rheumatic disorders. Pediatric Rheumatology Online Journal, 12, 54–58. - PMC - PubMed
    1. Beukelman T., Patkar N. M., Saag K. G., Tolleson-Rinehart S., Cron R. Q., DeWitt E. M., Ruperto N. (2011). 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: Initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care & Research, 63, 465–482. - PMC - PubMed
    1. Cassie & Friends. (2019). Welcome to Cassie and friends Retrieved from www.cassieandfriends.ca
    1. Cavallo S., Brosseau L., Toupin-April K., Wells G. A., Smith C. A., Pugh A. G., Bigford S. (2017). Ottawa panel evidence-based clinical practice guidelines for structured physical activity in the management of juvenile idiopathic arthritis. Archives of Physical Medicine and Rehabilitation, 98, 1018–1041. - PubMed

Publication types