How children cope with arthritis : the relationship of coping style to reported pain, and caregiver's influence

Abstract

Children with juvenile arthritis (JA) are subject to chronic pain. The literature suggests that style of coping may influence amount of pain experienced, and that parents' beliefs may influence their child's choice of coping skills. Fifteen youth with JA and their primary caregivers participated in a semi-structured interview. Pain experience was measured with the Varni/Thompson Pediatric Pain Questionnaire, and an instrument to measure youth arthritis coping skills adapted from the Vanderbilt Pain Management Inventory was titled The Children's Arthritis Coping Inventory, which consisted of two sub-scales representing inner-directed and outer-directed coping. No relationship was found between youth reports of frequency of uses of inner and outer directed coping skills. There was a nonsignificant negative relationship between a child's use of outer-directed coping and reported pain (r = -0.33₁₄), and a positive relationship between inner-directed coping and pain (r = 0.67₁₄, p < .01). The use of proportionately more inner than outer directed coping was also significantly related to reported pain (r = 0.66₁₄, p < .01), while primary use of outer coping was not (r = -0.13₁₄). Parents did accurately estimate the magnitude of their child's experienced pain, and type of coping skill used. Hypotheses of parental beliefs influencing their child's coping skill use were not fully supported, as there were non-significant positive relationships between (a) parents estimates of the child's coping and (b) their opinion of what skills are best to use, with those their child did report (r = 0.12₁₄, r = 0.30₁₄ respectively). Trends suggested in these results were encouraging given the small sample size. Use of information on both adaptive (negatively related to pain) and maladaptive (positively related to pain) types of coping is suggested for application in the design of child chronic pain management programs.