Abstract
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.
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.
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.
Findings suggest that the effectiveness of specific coping strategies may vary depending on a child's level of pain.
These findings suggest that clinicians (e.g., nurses, psychologists) use a more tailored approach when recommending interventions for managing chronic pain.
•Primary control engagement coping strategies (e.g., problem solving) predict higher quality of life for all patients.•Secondary control engagement coping strategies (e.g., acceptance) may be more effective when the patient reports less pain.•Future research should examine whether disengagement coping strategies (e.g., avoidance) are helpful when pain is high.•Nurses can tailor recommendations for coping strategies based on pain complaints.