Clinical Journal of Pain最新文献

{"title":"Comparison of Dexmedetomidine and Midazolam in Sedoanalgesia for Lumbar Facet Radiofrequency Ablation.","authors":"Mustafa Kurçaloğlu, Pınar Uzun Uslu, Firdevs Yilmazlar, Aygun Jabbarli, Bora Uzuner, Fatih Özkan, Fuat Güldoğuş","doi":"10.1097/AJP.0000000000001298","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001298","url":null,"abstract":"<p><strong>Objectives: </strong>Lumbar facet radiofrequency ablation (LFRA) is a painful procedure. Sedation may be applied to improve patient comfort during the procedure however, deep sedation should be avoided to maintain the patient cooperation. The purpose of this study was to compare dexmedetomidine and midazolam in sedoanalgesia for LFRA.</p><p><strong>Methods: </strong>Patients planning to undergo LFRA were included in this cross-sectional, observational study. Following a bolus dose, intravenous infusion of dexmedetomidine was administered in Group D, while intravenous midazolam was given in Group M. Intraoperative vital signs, procedural pain severity (Numerical Rating Scale-NRS), Patient Satisfaction Score (PSS), Operator Satisfaction Score (OSS), and complications were recorded.</p><p><strong>Results: </strong>A total of 96 patients were included in the study. Group D consisted of 47 and Group M of 49 patients. Procedural NRS, PSS, and OSS were significantly in favor of Group D. Mean procedural NRS of Group D was 2.91±2.03, and 4.14±2.17 in Group M ( P =0.005). The rate of unsatisfactory PSS was one (2.1%) in Group D and seven (20%) in Group M ( P =0.03). The rate of unsatisfactory OSS results was two (4.2%) in Group D and sixteen (32.6%) in Group M ( P <0.001). While over-sedation and low oxygen saturation were significantly more frequent in Group M, hypotension was higher in Group D.</p><p><strong>Discussion: </strong>In sedoanalgesia for LFRA, dexmedetomidine is superior to midazolam with lower procedural pain, higher satisfaction scores and improved patient cooperation. The results of this study can be considered for sedoanalgesia in other interventional pain procedures.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Co-existing Motor Proficiency Delay and Chronic Pain in Children Presenting to a Tertiary Pain Service: A Cross-sectional Observational Study.","authors":"Rebecca Fechner, Kris Rogers, Linsay Rogers, Anna Gollan, Mark Alcock, Erin Turbitt, Arianne P Verhagen, Joshua W Pate","doi":"10.1097/AJP.0000000000001297","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001297","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic pain can profoundly impact children's physical, social and psychological functioning, with negative effects that can persist into adulthood. The prevalence of motor proficiency delay in children with chronic pain is unknown. We aimed to describe the prevalence of motor proficiency delay in a sample of children and estimate potential predictive factors of delayed motor proficiency from routinely collected self-report measures .</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 94 children and adolescents (6-18) with chronic pain who attended a tertiary pain clinic in Australia. We assessed their motor proficiency using the BOT-2 standardised assessment tool. Participants also completed a suite of routine clinical questionnaires and a self-perception questionnaire. We described the prevalence of motor proficiency delay using descriptive statistics and estimated the extent to which routine demographic and clinical data could explain variation in BOT-2 scores using a multivariable linear model to calculate adjusted R².</p><p><strong>Results: </strong>Overall, 83% of participants presented with challenges in at least one motor-proficiency subtest (e.g., coordination), and 41% had delayed total motor proficiency scores. We found that just 9% of the variance in BOT-2 scores could be explained by the covariates in the multivariable prediction model (Adjusted R2=0.09, 95% CI:0.01 to 0.25).</p><p><strong>Discussion: </strong>Most children presenting to a tertiary pain clinic presented with motor proficiency challenges unlikely to be identified through routinely collected self-report measures. Given the BOT-2 can identify norm-referenced developmental targets, the use of these assessments may enhance clinical formulations and guide developmentally sensitive rehabilitation programs.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Pain Self-Efficacy on Health Outcomes in High-Impact Chronic Pain: A Longitudinal Study.","authors":"Dokyoung Sophia You, Edward Lannon, Samsuk Kim, Troy C Dildine, Kenneth A Weber, Emma Raney, Sean C Mackey","doi":"10.1097/AJP.0000000000001295","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001295","url":null,"abstract":"<p><strong>Objectives: </strong>High-impact chronic pain (HICP), affecting 36.4% of individuals with chronic pain, significantly limits work, social, and self-care activities. Effective treatments for HICP remain elusive. In addition to pain catastrophizing, growing evidence suggests that pain self-efficacy may be a treatment target for HICP. Our study examines the relative contributions of pain self-efficacy and catastrophizing to health outcomes in patients with HICP.</p><p><strong>Methods: </strong>A total of 259 patients with chronic pain (154 with HICP; 105 without HICP) completed validated measures at baseline and three months later. These included the Chronic Pain Self-Efficacy Scale (CPSS), the Pain Catastrophizing Scale (PCS), and Patient-Reported Outcomes Measurement Information System (PROMIS) domains for physical health (i.e., pain interference, physical function, fatigue, and sleep disturbance) and psychosocial health (i.e., depression, anxiety, anger, and social isolation).</p><p><strong>Results: </strong>Repeated measures MANOVA showed a significant group effect (HICP vs. No-HICP), but no significant time or group by time interaction effect. The HICP group reported significantly lower CPSS scores and higher PCS scores than the No-HICP group, alongside worse physical and psychosocial health outcomes (η²=0.076~0.445). Pain self-efficacy explained a greater proportion of group differences in health outcomes (52.9-71.7%) compared to pain catastrophizing (10.1-43.3%). Especially, self-efficacy in activity engagement accounted for the largest health disparities between the groups.</p><p><strong>Discussion: </strong>Findings highlight pain self-efficacy as a critical treatment target for HICP, with greater predictive utility than pain catastrophizing. Enhancing self-efficacy through tailored interventions may reduce the burden of HICP. Future studies should prioritize self-efficacy-based interventions and explore their scalability and long-term impact.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Psychological Factors Explain the Persistence of Symptoms in Individuals With Rotator Cuff-related Shoulder Pain? A Prospective Cohort Study.","authors":"Dayana Patricia Rosa, Marc-Olivier Dubé, Simon Beaulieu-Bonneau, Alex Scott, Hugo Masse-Alarie, Jean-Sébastien Roy","doi":"10.1097/AJP.0000000000001280","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001280","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether psychosocial factors, such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with rotator cuff-related shoulder pain (RCRSP) following an education program.</p><p><strong>Methods: </strong>One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included 2 meetings with a physiotherapist. After 12 and 24 weeks, participants filled out pain and disability questionnaires and, based on their scores, were classified as having persistent shoulder pain or as recovered.</p><p><strong>Results: </strong>A univariable modified Poisson regression showed that higher perceived stress (RR adjusted : 1.02; 95% CI: 1.01-1.04), catastrophizing (RR adjusted : 1.01; 95% CI: 1.01-1.02), symptoms of depression (RR adjusted : 1.03; 95% CI: 1.01-1.06) and anxiety (RR adjusted : 1.03; 95% CI: 1.01-1.06), along with lower resilience (RR adjusted : 0.90; 95% CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. In addition, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RR adjusted : 0.98; 95% CI: 0.97-0.99) and 24 weeks (RR adjusted : 0.99; 95% CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RR adjusted : 0.98; 95% CI: 0.97-0.99).</p><p><strong>Discussion: </strong>This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":"41 5","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Noninvasive Brain Stimulation for the Treatment of Pain, Fatigue, and Sleep Quality in Fibromyalgia. A Systematic Review With Network Meta-Analysis.","authors":"Ishtiaq Ahmed, Rustem Mustafaoglu, Aamir R Memon, Rubab Zafeer, Huanyu Xiong, Sofia Straudi, Nils Runge","doi":"10.1097/AJP.0000000000001282","DOIUrl":"10.1097/AJP.0000000000001282","url":null,"abstract":"<p><strong>Objectives: </strong>There is tentative evidence to support the analgesic effects of noninvasive brain stimulation (NiBS) in fibromyalgia (FM), but a comprehensive synthesis is lacking. This systematic review with network meta-analysis (NMA) aimed to determine the relative effectiveness of different NiBS techniques, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in FM, and to identify the optimal stimulation location and intensity/frequency.</p><p><strong>Methods: </strong>Four databases were searched until July 9, 2023 for randomized trials (RCTs) comparing NiBS in FM. Pain was the primary outcome, while fatigue and sleep were secondary outcomes. A frequentist NMA calculated standardized-mean-differences (SMDs) for pain, with pairwise meta-analysis for fatigue and sleep. Bias was assessed with the Cochrane-risk-of-bias-tool (RoB-2.0), and evidence certainty through confidence-in-NMA.</p><p><strong>Results: </strong>Forty-three RCTs with 2120 participants were included. NMA showed that low frequency (LF)-rTMS (SMD: -1.20, 95% CI: -1.82 to -0.58), dual tDCS (SMD: -0.91, 95% CI: -1.82 to -0.58), and high frequency (HF)-rTMS (SMD: -0.58, 95% CI: -1.00 to -0.17) likely results in a reduction in pain intensity at the end of intervention compared with sham stimulation. For stimulation location, right dorsolateral prefrontal cortex (DLPFC)(SMD: -1.42, 95% CI: -2.69 to -0.15), bilateral DLPFC (SMD: -0.94, 95% CI: -1.82 to -0.05), and left primary motor cortex (M1)(SMD: -0.49, 95% CI: -0.85 to -0.14) likely results in reduction in pain intensity at the end of intervention, with DLPFC maintaining effects in short-term. LF-rTMS over DLPFC (SMD: -1.42, 95% CI: -2.69 to -0.15) and HF-rTMS over M1 (SMD: -0.78, 95% CI: -1.39 to -0.18) likely results in the reduction in pain intensity at the end of intervention, with LF-rTMS over right DLPFC maintaining effects in the short term. NiBS appears to be safe and may reduce fatigue and improve sleep quality.</p><p><strong>Discussion: </strong>Excitatory stimulation like HF-rTMS over M1 and inhibitory like LF-rTMS over DLPFC may yield better results.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Analgesic Efficacy of Different Regional Blocks After Single-incision Video-assisted Thoracoscopic Surgery.","authors":"Gu-Yue Liu, Fu-Shan Xue, Mu Jin","doi":"10.1097/AJP.0000000000001287","DOIUrl":"10.1097/AJP.0000000000001287","url":null,"abstract":"","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Validation of Clinical Measures to Discriminate Between Nociceptive, Neuropathic, and Nociplastic Pain: Cluster Analysis of a Cohort With Chronic Musculoskeletal Pain.","authors":"Paul W Hodges, Raimundo Sanchez, Shane Pritchard, Adam Turnbull, Andrew Hahne, Jon Ford","doi":"10.1097/AJP.0000000000001281","DOIUrl":"10.1097/AJP.0000000000001281","url":null,"abstract":"<p><strong>Objectives: </strong>The International Association for the Study of Pain defines 3 pain types presumed to involve different mechanisms-nociceptive, neuropathic, and nociplastic. Based on the hypothesis that pain types should guide the matching of patients with treatments, work has been undertaken to identify features to discriminate between them for clinical use. This study aimed to evaluate the validity of features to discriminate between pain types.</p><p><strong>Materials and methods: </strong>Subjective and physical features were evaluated in a cohort of 350 individuals with chronic musculoskeletal pain attending a chronic pain management program. The analysis tested the hypothesis that, if features nominated for each pain type represent 3 different groups, then (1) cluster analysis should identify 3 main clusters of patients, (2) these clusters should align with the pain type allocated by an experienced clinician, (3) patients within a cluster should have high expression of the candidate features proposed to assist identification of that pain type. Supervised machine learning interrogated features with the greatest and least importance for discrimination, and probabilistic analysis probed the potential for the coexistence of multiple pain types.</p><p><strong>Results: </strong>Results confirmed that data could be best explained by 3 clusters. Clusters were characterized by a priori specified features and agreed with the designation of the experienced clinician with 82% accuracy. Supervised analysis highlighted features that contributed most and least to the classification of pain type, and probabilistic analysis reinforced the presence of mixed pain types.</p><p><strong>Discussion: </strong>These findings support the foundation for further refinement of a clinical tool to discriminate between pain types.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Trajectories in Pediatric Inflammatory Bowel Disease: Disease Severity, Optimism, and Pain Self-efficacy.","authors":"A Natisha Nabbijohn, Ian R Newby-Clark, David Mack, Alain Stintzi, C Meghan McMurtry","doi":"10.1097/AJP.0000000000001279","DOIUrl":"10.1097/AJP.0000000000001279","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to characterize pain intensity (average, worst) and disease severity in youth with inflammatory bowel disease in the 12-month postdiagnosis, and to examine the relation between pain and risk (disease severity) and resilience (optimism, pain self-efficacy) factors over time.</p><p><strong>Methods: </strong>Data collection ran from February 2019 to March 2022. Newly diagnosed youth aged 8 to 17 with IBD completed numerical rating scales for average and worst pain intensity, Youth Life Orientation Test for optimism, and Pain Self-Efficacy Scale for pain self-efficacy through REDCap; weighted Pediatric Crohn's Disease Activity Index and the Pediatric Ulcerative Colitis Activity Index were used as indicators of disease severity. Descriptive statistics characterized pain and disease severity. Multilevel modeling explored relations between variables over time, including moderation effects of optimism and pain self-efficacy.</p><p><strong>Results: </strong>At baseline, 83 youth ( Mage =13.9, SD=2.6; 60.2% Crohn's disease; 39.8% female) were included. Attrition rates at 4 and 12 months were 6.0% and 9.6%, respectively. Across time, at least 52% of participants reported pain. Participants in disease remission increased from 4% to 70% over 12 months. Higher disease severity predicted higher worst pain, regardless of the time since diagnosis. Higher pain self-efficacy (1) predicted lower average and worst pain, especially at later time points and (2) attenuated the association between disease severity and worst pain when included as a moderator. Higher optimism predicted lower worst pain.</p><p><strong>Discussion: </strong>Pain is prevalent in pediatric inflammatory bowel disease and impacted by disease severity, pain self-efficacy, and optimism. Findings highlight modifiable intervention targets.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperbaric Oxygen Therapy for Management of Complex Regional Pain Syndrome.","authors":"Joon Cha, Gerardo Bosco, Richard E Moon, Giorgio Melloni, Enrico M Camporesi","doi":"10.1097/AJP.0000000000001276","DOIUrl":"10.1097/AJP.0000000000001276","url":null,"abstract":"<p><strong>Objectives: </strong>Complex regional pain syndrome remains a challenging condition characterized by severe, persistent pain and a variety of inflammatory and trophic symptoms. This study aimed to analyze the current literature to evaluate hyperbaric oxygen therapy (HBOT)'s efficacy in treating complex regional pain syndrome (CRPS), focusing on both sympathetically maintained pain (SMP) and sympathetically independent pain (SIP) subtypes.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed Clinical Queries using the MeSH term \"Complex Regional Pain Syndromes\" OR the keyword \"CRPS\" AND \"Hyperbaric Oxygen Therapy\" OR the keyword \"HBOT.\" The selected publication types included a randomized controlled trial, a retrospective observational study, a comparative study, a retrospective case series, and case reports. The search was restricted to articles published in English between January 1994 and October 2024. The results from the search were used to compile this review. Patients were categorized into SMP, SIP, or indeterminate groups based on the presence of prior sympathetic nerve block history or disease duration.</p><p><strong>Results: </strong>Thirteen studies involving 280 participants were reviewed. Of the patients, 42.5% were categorized as SMP, 48.2% as SIP, and 9.3% as indeterminate. HBOT treatment ranged from 3 to 63 sessions, typically using 2.4 atmospheres absolute for 90 minutes. The results indicated significant symptom relief and functional improvement across both SMP and SIP subtypes, suggesting the broad efficacy of HBOT for CRPS management.</p><p><strong>Discussion: </strong>This review of the current literature suggests that HBOT may offer significant symptom relief, regardless of CRPS subtype or disease duration. HBOT's anti-inflammatory and neuroplasticity promoting properties make it a valuable noninvasive option for CRPS patients, potentially improving outcomes when combined with other therapeutic modalities. Further research is necessary to refine patient selection and optimize treatment protocols.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring and Contextualizing School Refusal in Pediatric Chronic Pain: Establishing the Psychometric Properties of the SChool REfusal EvaluatioN Measure for Youth With Chronic Pain.","authors":"Catherine E Stewart, Rupa Gambhir, Sana Aladin, Deirdre E Logan","doi":"10.1097/AJP.0000000000001278","DOIUrl":"10.1097/AJP.0000000000001278","url":null,"abstract":"<p><strong>Objective: </strong>School refusal is a longstanding difficulty for youth with chronic pain. Yet, research is hindered by a lack of adequate measurement tools to assess and describe the complex interpersonal and system-level factors contributing to school refusal. This study investigates the utility of the SChool REfusal EvaluatioN (SCREEN) measure and its psychometric properties in a sample of youth with chronic pain.</p><p><strong>Materials and methods: </strong>Youth undergoing multidisciplinary evaluation at outpatient pain clinics completed self and parent-report questionnaires. Descriptive data examined school refusal. Internal consistency and construct validity were tested. Multiple regressions examined the parent and child factors related to school refusal.</p><p><strong>Results: </strong>In all, 698 youth with chronic pain participated. Two-thirds reported symptoms suggesting at-risk or clinically significant symptoms of school refusal. Cronbach alpha scores were in the acceptable to good range on the SCREEN. Convergent validity for the interpersonal discomfort subscale of the SCREEN was established. The child's fear of pain, stress, peer relationships, and parent protective behaviors significantly correlated with SCREEN total scores. Participants enrolled in fully in-person school during the study period reported significantly higher scores on the interpersonal discomfort scale than those enrolled in remote learning.</p><p><strong>Discussion: </strong>Our results provide evidence that youth with chronic pain experience significant challenges with school functioning and offer some support for the reliability and validity of the SCREEN in a sample of youth with chronic pain, a population for which few appropriate measures of school functioning have been established. The SCREEN measure may aid in assessing school refusal, with good clinical potential to quantify risk and identify modifiable factors.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}