Exploring Pain Adaptation in Youth With Juvenile Idiopathic Arthritis: Identifying Youth and Parent Resilience Resources and Mechanisms.

IF 3.7 2区 医学 Q1 RHEUMATOLOGY
Yvonne N Brandelli, Sean P Mackinnon, Christine T Chambers, Jennifer A Parker, Adam M Huber, Jennifer N Stinson, Shannon A Johnson, Jennifer P Wilson
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引用次数: 0

Abstract

Objective: Although juvenile idiopathic arthritis (JIA) is often associated with pain, this experience does not necessitate negative outcomes (eg, depression, functional impairment). Little research has explored youth and parent resilience resources (ie, stable traits) and mechanisms (ie, dynamic processes) in this context, and studies have focused on their contributions independently rather than collectively. This study, informed by the Ecological Resilience-Risk Model in Pediatric Chronic Pain, sought to (1) explore the relationships among youth and parent resilience resources and mechanisms and (2) identify the relative importance (RI; ie, independent contributions when entered simultaneously) of evidence-based youth and parent resources and mechanisms in contributing to youth-reported recovery, sustainability, and growth outcomes.

Methods: Youth (13-18 years) with JIA and their parents (156 dyads) completed a battery of online questionnaires assessing resilience resources (optimism, resilience), mechanisms (psychological flexibility, pain acceptance, self-efficacy), recovery and sustainability (pain intensity, functional disability, health-related quality of life), and growth (benefit finding) outcomes.

Results: Analyses demonstrated significant positive correlations across within-person resources and mechanisms and weaker correlations across within-dyad resources and mechanisms. Although the RI of predictors varied by outcome, youth pain acceptance was the most robust predictor across models (RI = 0.03-0.15). Some predictors (eg, parent psychological flexibility and pain acceptance) were generally categorized as "Not Important," whereas others (eg, youth resilience) had "Inconclusive" results, suggesting construct overlap.

Conclusion: Although additional research is needed to further understand resilience, results highlight the importance of fostering pain acceptance in youth and incorporating parents in psychosocial interventions to optimize living with JIA.

探索青少年特发性关节炎患者对疼痛的适应:确定青少年和家长的适应资源和机制。
目的:尽管幼年特发性关节炎(JIA)通常与疼痛有关,但这种经历并不必然带来负面结果(如抑郁、功能障碍)。在这种情况下,很少有研究探讨青少年和家长的抗逆力资源(即稳定特质)和机制(即动态过程),而且研究都集中在他们的独立贡献而非集体贡献上。本研究以 "小儿慢性疼痛生态复原力-风险模型 "为基础,旨在1)探索青少年和家长的抗逆力资源和机制之间的关系;2)确定以证据为基础的青少年和家长资源和机制在促进青少年报告的康复、可持续性和成长结果方面的相对重要性(RI;即同时输入时的独立贡献):方法:患有 JIA 的青少年(13-18 岁)及其父母(156 对)完成了一系列在线问卷,评估复原力资源(乐观、复原力)、机制(心理灵活性、疼痛接受度、自我效能)、康复/可持续性(疼痛强度、功能性残疾、与健康相关的生活质量)和成长(受益发现)结果:分析表明,个人内部资源和机制之间存在明显的正相关,而团队内部资源和机制之间的相关性较弱。虽然不同结果的预测因子的 RI 各不相同,但在各种模型中,青少年对疼痛的接受程度是最可靠的预测因子(RI=.03-.15)。一些预测因子(如父母的心理灵活性和疼痛接受度)通常被归类为 "不重要",而其他预测因子(如青少年的抗挫折能力)则有 "不确定 "的结果,这表明存在结构重叠:结论:虽然还需要更多的研究来进一步了解恢复能力,但研究结果强调了培养青少年对疼痛的接受能力和将父母纳入心理干预的重要性,以优化JIA患者的生活。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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