A94: Examination of Resiliency, Pain, Coping and Quality of Life in Children with Rheumatologic Disease

Background/Purpose: Emotional and behavioral difficulties may be present in children and adolescents with juvenile rheumatic diseases such as Juvenile Idiopathic Arthritis, Dermatomyositis, and Systemic Lupus (Iobst, Nabors, Brunner, & Precht, 2007). Studies have found increased negative daily mood was related to increased pain, increased fatigue and stiffness, and a decrease in participation in social activities and school attendance (Schanberg et al., 2000). The purpose of this study is to examine the psychosocial variables that are associated with pain, resiliency and quality of life. Identifying coping skills and protective factors for resiliency will aid providers. Methods: Participants were 150 children, 8–17 years of age, identified at a routine follow-up appointment. Parent-child pairs completed a series of measures documenting demographics, symptoms, HRQOL, coping mechanisms family environment and psychosocial variables. The primary rheumatologist documented a global assessment of disease severity as well as disease activity. Children were labelled as “resilient”, if they reported being in severe pain while reporting a high quality of life, or “not resilient”, if they reported low pain with a low quality of life. The individuals who reported high pain and low quality of life were grouped together as the “expected low” group (N = 50, 34%) while individuals who reported low pain and high quality of life were grouped into the “expected high” group (N = 49, 33.3%). Results: MANOVA analyses were conducted in order to determine if significant differences existed in coping skill usage between resilient and not-resilient groups. When grouped by age, results indicated younger children in the resilient group (ages 8–12) (M = 1.89, SD = 0.33) used screaming as a coping skill significantly more often than their non-resilient peers (M = 1.36, SD = 0.54), p = 0.01, η2 = 0.26. In addition, individuals in the not-resilient group (M = 1.19, SD = 0.98) reported withdrawing socially as a coping skill significantly more often than their resilient peers (M = 0.46, SD = 0.78), p = 0.04, η2 = 0.16 (Table 1). Lastly, the resilient group (M = 2.75, SD = 1.14) reported finding using resignation as a coping skill to be significantly more effective than their non-resilient peers (M = 1.14, SD = 0.86), p = 0.001, η2 = 0.14. No other significant differences between these groups were found. Conclusion: Although a surprising result, it may indicate that screaming is an outlet for children to express their anger in a beneficial manner. In addition, withdrawing from others may place individuals at an increased risk for having trouble coping with the stressors, as participants experiencing low pain and low quality of life reported withdrawing from others significantly more often than their resilient peers. Lastly, the resilient group reported finding that resigning themselves to their disease is more effective as a coping skill than their non-resilient peers, indicating that accepting the limitations of the disease may be beneficial to a certain extent, however, future research should be pursued.