Online psychological treatment for pediatric recurrent pain: A randomized evaluation

Department of Psychology, University of Saskatchewan, Mental Health Services-Victoria Square, Box 3003, Prince Albert, Saskatchewan, Canada S6V 6G1.
Journal of Pediatric Psychology (Impact Factor: 2.91). 09/2006; 31(7):724-36.
Source: PubMed

ABSTRACT To evaluate the efficacy of a distance treatment delivered through Internet and telephone for pediatric recurrent pain.
Forty-seven participants (9-16 years of age) were randomly assigned to either an Internet-based treatment or a standard medical care waitlist. Treatment employed a Web-based manual for children and parents with weekly therapist contact by telephone or e-mail. At 1- and 3-month follow-ups, participants were assessed on the outcome variables of pain and quality of life. A 50% reduction in diary pain scores was considered clinically significant.
Significant between-group differences were found: 71 and 72% of the treatment group achieved clinically significant improvement at the 1- and 3-month follow-ups, respectively, whereas only 19 and 14% of the control group achieved the criterion. No significant differences were found on the quality of life variable.
Distance methods have considerable potential for making effective treatments more accessible with lower associated costs.

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Available from: Patrick J McGrath, Mar 02, 2014
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    • "Of the 35 included studies, 21 treated children and adolescents diagnosed with headache, eight treated abdominal pain, and three treated musculoskeletal pain. There were three studies that included children with multiple pain conditions: Hicks, von Baeyer, and McGrath (2006) treated children and adolescents with RAP and headache; Palermo, Wilson, Peters, Lewandowski, and Somhegyi (2009) treated children and adolescents with headache, abdominal pain, and musculoskeletal pain; and Wicksell, Melin, Lekander, and Olsson (2009) treated children and adolescents with headache, musculoskeletal pain, visceral pain, and complex regional pain syndrome. "
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    ABSTRACT: This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children. Randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions including headache, abdominal, musculoskeletal, or neuropathic pain were searched for. Pain symptoms, disability, depression, anxiety, and sleep outcomes were extracted. Risk of bias was assessed and quality of the evidence was rated using GRADE. 35 included studies revealed that across all chronic pain conditions, psychological interventions reduced pain symptoms and disability posttreatment. Individual pain conditions were analyzed separately. Sleep outcomes were not reported in any trials. Optimal dose of treatment was explored. For headache pain, higher treatment dose led to greater reductions in pain. No effect of dosage was found for other chronic pain conditions. Evidence for psychological therapies treating chronic pain is promising. Recommendations for clinical practice and research are presented.
    Journal of Pediatric Psychology 03/2014; 39(8). DOI:10.1093/jpepsy/jsu008 · 2.91 Impact Factor
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    • "The interactive Internet-based intervention proposed in this study provided knowledge and information about dysmenorrhea self-care, auricular acupressure techniques, professional counseling, and peer support. Our results are consistent with previous findings showing the efficacy of Internet-based interventions in reducing pain [35, 36, 57, 58] but are not in agreement with the findings of Trautmann and Kröner-Herwig [59]. A systematic review shows that Internet-based programs appear to relieve pain [33]. "
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    ABSTRACT: Background. Primary dysmenorrhea is prevalent in adolescents and young women. Menstrual pain and distress causes poor school performance and physiological damage. Auricular acupressure can be used to treat these symptoms, and Internet-based systems are a flexible way of communicating and delivering the relevant information. Objective. This study investigates the effects of auricular acupressure (AA) alone and combined with an interactive Internet-based (II) intervention for the management of menstrual pain and self-care of adolescents with primary dysmenorrhea. Design. This study adopts a pretest/posttest control research design with a convenience sample of 107 participants. Results. The outcomes were measured using the short-form McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS), menstrual distress questionnaire (MDQ), and adolescent dysmenorrheic self-care scale (ADSCS). Significant differences were found in ADSCS scores between the groups, and in SF-MPQ, VAS, MDQ, and ADSCS scores for each group. Conclusion. Auricular acupressure alone and a combination of auricular acupressure and interactive Internet both reduced menstrual pain and distress for primary dysmenorrhea. Auricular acupressure combined with interactive Internet instruction is better than auricular acupuncture alone in improving self-care behaviors.
    Evidence-based Complementary and Alternative Medicine 04/2013; 2013(1):316212. DOI:10.1155/2013/316212 · 1.88 Impact Factor
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    • "Palermo, Valenzuela, and Stork (2004) found that higher compliance to daily diary completion and accuracy in diary reporting occurred when youths with SCD used electronic pain diaries (e-Diaries). Advances in technology have also allowed delivery of behavioral interventions using computer-and Internetbased programs for a range of conditions including pain management in youth with chronic medical conditions (Hicks, von Baeyer, & McGrath, 2006; Ritterband et al., 2003). These e-health interventions have been reported to decrease barriers to continuity of care such as limited access to care as a result of distant location or travel difficulties and lack of trained knowledgeable healthcare providers with expertise in SCD (Devineni & Blanchard, 2005; Jerome & Zaylor, 2000). "
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    ABSTRACT: The purpose of this study was to examine (a) symptoms, (b) pain characteristics (intensity, location, quality), (c) pain medications and nonpharmacological strategies used for pain, (d) thoughts and feelings, and (e) healthcare visits. We also examined the relationship between pain and sleep. Pain and symptoms were entered on an electronic e-Diary using a smartphone and were remotely monitored by an advanced practice registered nurse (APRN). Sixty-seven children and adolescents (10-17 years) reported mild to severe pain at home that did not require healthcare visits. Symptoms reported were (a) general symptoms such as tiredness/fatigue (34.7%), headache (20.8%), yellowing of the eyes (28.4%); (b) respiratory symptoms such as sniffling (32.9%), coughing (19.1%), changes in breathing (10.0%); and (c) musculoskeletal symptoms such as stiffness in joints (15.8%). A significant negative correlation was found between pain and sleep (r = -.387, p = .024). Factors that predict pain included previous history of sickle cell disease (SCD) related events, symptoms, and negative thoughts. Pain and multiple symptoms entered on a web-based e-Diary were remotely monitored by an APRN and prompted communications, further evaluation, and recommendations. Remote monitoring using wireless technology may facilitate timely management of pain and symptoms and minimize negative consequences in SCD.
    Journal of the American Academy of Nurse Practitioners 01/2013; 25(1):42-54. DOI:10.1111/j.1745-7599.2012.00754.x · 1.02 Impact Factor
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