Pain Coping Strategies in Children With CP
Condition: Cerebral Palsy; Pain
MeSH terms: Cerebral Palsy
Study type: Observational

Summary: 
      The aim of the study is to describe pain coping strategies and their evolution in children
      and adolescent with cerebral palsy.
    

Detailed description: 
      Towards the end of the 20th century, Lazarus and Folkmann developed the concept that the
      individual provides "cognitive and behavioral efforts to control, reduce or tolerate the
      internal or external demands that threaten or exceed his or her resources". These cognitive
      and behavioral efforts are grouped under the term "coping", which describes a process rather
      than personality traits or abilities. Coping is not about controlling stress but about
      diminishing, avoiding, tolerating or accepting it.

      The pain, "unpleasant sensory and emotional experience related to a bodily injury", aims to
      warn the individual that the integrity of his body is threatened, and is thus a real
      "stressor". It will lead to the choice of coping strategies, which depends in part on the
      characteristics of the individual (his beliefs, stress endurance, anxiety propensity) and
      environmental variables (characteristics of the painful situation, social support and
      emotional connections, information about the threatening situation). Many studies have shown
      that the strategies used to cope with chronic pain in adults and children play a major role
      in the adjustment of patients to their pathology, in terms of emotional distress, disability,
      and quality of life. The different types of strategies have been widely studied in the
      literature in so-called "typical" children. Active strategies classically found in pediatrics
      are distraction, cognitive self-instruction, and problem solving. These active strategies are
      said to be positive because they have been proven to help children manage pain more
      effectively than passive strategies such as catastrophism, helplessness, or seeking social
      support, which are dysfunctional because they are not focused on the problem and increase the
      negative consequences associated with pain.

      This study is about children with cerebral palsy (CP) because the great variability and
      complexity of the manifestations of the pathology and the therapeutic treatment make it that
      there is a big risk for the child to experience pain, with a prevalence of pain ranging from
      60% to 73%, depending on the evaluation methods. Research has done a great deal in recent
      years to improve the assessment and management of inborn or induced pain in children with
      disabilities, with many validated recommendations, even though this still appears to be a
      neglected comorbidity in PC. However, coping strategies of PC children with pain have never
      been studied. The purpose of this work is to describe these strategies in PC children and
      adolescents, as well as their evolution.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The patients were recruited in the services of 2 French Red Cross Physical Medicine and
        Rehabilitation Centers in France. All parents and children were informed orally about the
        procedure, and parental consent as the child's consent was obtained in writing.