Pediatric Chronic Pain and Differences in Pediatric Chronic Pain and Differences in Parental Health-Related Quality of LifeParental Health-Related Quality of Life

Gustavo R. Medrano¹, Susan T. Heinze¹, Keri R. HainsworthGustavo R. Medrano¹, Susan T. Heinze¹, Keri R. Hainsworth2,32,3, Steven J. Weisman, Steven J. Weisman2,32,3 University of Wisconsin-Milwaukee¹, Children’s Hospital of Wisconsin² & Medical College of University of Wisconsin-Milwaukee¹, Children’s Hospital of Wisconsin² & Medical College of

WisconsinWisconsin33  

There is a paucity of research regarding fathers’ experiences parenting a child with chronic pain (Phares et al., 2005). Research on pediatric chronic illnesses suggests that fathers, like mothers, are significantly affected by their child’s chronic pain (e.g., Katz & Krulik, 1999), however their experiences are qualitatively different from mothers (Pelchat et al., 2007). For example, fathers have been shown to be less involved in their child’s healthcare and caretaking than mothers (Bailey, 1991; Quittner, 1992).

This study aims to elucidate fathers’ experiences by:

1) Examining differences in self-reported health-related quality of life (HRQOL) by mothers’ and fathers’ of children with chronic pain.

2) Explore the potential effects of child’s age and child’s self-reported HRQOL on dyadic differences in parental HRQOL.

BACKGROUND

STUDY AIMS

METHODOLOGY

Contact Gustavo Medrano at gmedrano@uwm.edu

FOR INFORMATION

Families in an outpatient interdisciplinary pain clinic at a large Midwestern pediatric hospital completed child and parent questionnaires prior to intake. Of the 590 families that completed the questionnaires, 268 adequately completed the child, mother and father reports. Among the questionnaires completed were:

PedsQLTM : Completed by children to assess self-reported

HRQOL.

Family Impact Module (FIM):Completed by parents to assess self-reported

HRQOL and family functioning.

METHODOLOGY (CONT.)Participants: The majority of children were Caucasian (85%), female (69%) and reported having chronic pain for longer than 6 months (62%). Children ranged from ages 8 to 18 (M=13.5, SD=2.7).

Statistical Analyses: First, independent samples t-tests were conducted to compare mothers’ and fathers’ scores on FIM scales and subscales. Second, parental differences on FIM scales were computed and used as outcome variables in regression models, with child age and child self-reported HRQOL scores as predictors.

RESULTS

Table 1. FIM Scale and Subscale Differences

Mothers

M (SD)

Fathers

M (SD)

Total* 64.32 (18.71) 67.84(18.77)

Parent HRQOL*** 66.72 (19.92) 73.01 (20.40)

Family Functioning 65.83 (22.66) 64.6(23.49

Physical Functioning*** 66.07(22.89) 74.95(25.01)

Emotional Functioning** 53.93 (21.90) 60.0 (22.9)

Social Functioning* 75.07(24.90) 80.0 (21.93)

Cognitive Functioning* 73.34(23.44) 77.96(24.62)

Communication 73.44(23.31) 74.53(23.79)

Worry 46.31(21.74) 47.43(21.42)

Daily Activities 64.09(27.72) 63.48(28.07)

Family Relationships 66.64(23.93) 65.19(24.31)

*p<.05 **p<.01 ***p<.001

RESULTS (CONT.)

Table 2. Regression Models Predicting Parental Differences

Differences Predictors B SE p R2 Overall p

Parent HRQOL

Age

PedsQL score

.156

.157

.471

.072

.741

.029

.021 .089

Physical Functioning

Age

PedsQL score

.599

.210

.60

.088

.301

.018

.029 .038

Cognitive Functioning

Age

PedsQL score

.268

.207

.638

.097

.675

.033

.021 .097

DISCUSSION Results of this study confirm and advance previous research on differences in the HRQOL reported by mothers and fathers of children with chronic pain. Specifically, mothers reported significantly poorer scores than fathers on the Total, Parent HRQOL, Physical Functioning, Emotional Functioning, Social Functioning and Cognitive Functioning scales and subscales.

In addition, through a series of regression models, large dyadic parental differences were predicted by poorer child-reported HRQOL. In other words, the lower the HRQOL of the child, the more discrepant the mother and father parent HRQOL. In contrast, child’s age was shown to be a poor predictor of parental differences, suggesting parental experiences do not differ more or less depending on the child’s age .

It should be noted that this pattern of parental differences may not generalize to other populations. Children in this sample reported poorer HRQOL (M= 60.6, SD= 17.70) than what has been reported for pediatric oncology patients (e.g., Varni et al., 2002).

Richer understanding of these parental differences in families dealing with pediatric chronic pain can lead to more effective family-oriented treatments. Results from this study suggest that parents in this population share less similar parenting experience when the child has poorer HRQOL.