Abbie Jordan

Objectivity and reliability in qualitative analysis: realist, contextualist and radical constructionist epistemologies.

The effect of the individual analyst on research findings can create a credibility problem for qualitative approaches from the perspective of evaluative criteria utilized in quantitative psychology. This paper explicates the ways in which objectivity and reliability are understood in qualitative analysis conducted from within three distinct epistemological frameworks: realism, contextual constructionism, and radical constructionism. It is argued that quality criteria utilized in quantitative psychology are appropriate to the evaluation of qualitative analysis only to the extent that it is conducted within a naive or scientific realist framework. The discussion is illustrated with reference to the comparison of two independent grounded theory analyses of identical material. An implication of this illustration is to identify the potential to develop a radical constructionist strand of grounded theory.

The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study.

&NA; Chronic pain in adulthood is one of the most costly conditions in modern western society. However, very little is known about the costs of chronic pain in adolescence. This preliminary study explored methods for collecting economic‐related data for this population and estimated the cost‐of‐illness of adolescent chronic pain in the United Kingdom. The client service receipt inventory was specifically adapted for use with parents of adolescent chronic pain patients to collect economic‐related data (CSRI‐Pain). This method was compared and discussed in relation to other widely used methods. The CSRI‐Pain was sent to 52 families of adolescents with chronic pain to complete as a self‐report retrospective questionnaire. These data were linked with unit costs to estimate the total care cost package for each family. The economic impact of adolescent chronic pain was found to be high. The mean cost per adolescent experiencing chronic pain was approximately £8000 per year, including direct and indirect costs. The adolescents attending a specialised pain management unit, who had predominantly non‐inflammatory pain, accrued significantly higher costs, than those attending rheumatology outpatient clinics, who had mostly inflammatory diagnoses. Extrapolating the mean total cost to estimated UK prevalence data of adolescent chronic pain demonstrates a cost‐of‐illness to UK society of approximately £3840 million in one year. The implications of the study are discussed.

Parental catastrophizing about their child's pain. The parent version of the Pain Catastrophizing Scale (pcs-p) : A preliminary validation

Abstract Numerous studies have found evidence for the role of catastrophizing about pain in adjustment to pain in both adults and children. However, the social context influencing pain and pain behaviour has been largely ignored. Especially in understanding the complexities of childhood pain, family processes may be of major importance. In line with the crucial role of pain catastrophizing in explaining adjustment and disability in adults and children, this study investigates the role of parental catastrophic thinking about their child’s pain in explaining child disability and parental distress. To study parental catastrophizing, a parent version of the Pain Catastrophizing Scale (PCS‐P) was developed. An oblique three‐factor structure emerged to best fit the data in both a sample of parents of schoolchildren (N = 205) and in a sample of parents of children with chronic pain (N = 107). Moreover, this three‐factor structure was found to be invariant across both parent samples. Further, in the clinical sample, parents’ catastrophic thinking about their child’s pain had a significant contribution in explaining (a) childhood illness‐related parenting stress, parental depression and anxiety, and (b) the child’s disability and school attendance, beyond the child’s pain intensity.

Being a parent of the adolescent with complex chronic pain: An interpretative phenomenological analysis

Background Previous quantitative research has shown that parents of adolescents with chronic pain report elevated levels of emotional distress in addition to limitations in social and family functioning.

The Bath Adolescent Pain Questionnaire (BAPQ): development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents

&NA; Chronic pain causes significant problems in the lives of many adolescents, considerably affecting their physical, psychological and social functioning. The assessment of the multidimensional impact of chronic pain is an essential clinical task. This study reports on the development and psychometric evaluation of the Bath Adolescent Pain Questionnaire (BAPQ); an assessment tool designed specifically for use with adolescents who experience chronic pain. A sample of 222 adolescents (11–18 years) experiencing chronic pain completed the 109‐item draft inventory. Participants were recruited from two different UK clinics. All participants responded to items using a 5‐point frequency scale. Psychometric evaluation of the data resulted in a reduced inventory length of 61 items. Internal consistency of all seven questionnaire subscales was established using Cronbachs alpha. Comparative validity was undertaken by comparison of all individual subscales with existing validated measures (SCAS, CDI‐S, FDI, Brief FAM. PCS and CASAFS). The temporal reliability of each inventory subscale was established using a sub‐sample of 30 adolescent participants over a 17‐day period. Psychometric evaluation of the data suggests the inventory yields both a reliable and valid assessment of the impact of chronic pain on the lives of adolescents. The BAPQ may offer a comprehensive way to assess the widespread deleterious impact of adolescent chronic pain in both a research and clinical setting. Further investigation is needed on the predictive validity of the subscales. Additional data from samples of patients with diagnoses that are not musculoskeletal in origin would be of great assistance.

Adolescent social development and chronic pain

Adolescents with chronic pain report disability, distress and reduced social functioning. A clinical sample of 110 adolescents, with a mean four year history of pain, was investigated for the psychosocial impact of pain on social development. All participants completed a range of self‐report measures of pain intensity, disability, distress, social and family functioning. Also completed was the Bath Adolescent Pain Questionnaire, including its development subscale. The development subscale measures the extent to which adolescents perceive themselves to be ahead or behind their peers on 11 aspects of social development. Three related analyses were undertaken. First, over 50% of adolescents reported themselves to be less developed than their peers on four or more aspects. The item with the highest endorsement of being ahead compared with peers was “dealing with problems”. Second, factor analyses revealed three factors of adolescent social development labelled ‘independence’, ‘emotional adjustment’ and ‘identity formation’. Third, regression analyses revealed that peer support had a positive effect on all three factors, disability and anxiety had a negative effect on perceptions of independence, greater family dysfunction had a negative effect on emotional adjustment, and depressive mood had a negative effect on identity formation. Pain intensity had a negative effect on all three factors. Findings suggest that adolescents with chronic pain judge themselves to be less developed than their peers. Pain intensity has a negative effect on this perception, but peer relations may play a protective role: strong peer relationships are associated with positive social comparisons of the level of social development.

The Bath Adolescent Pain – Parental Impact Questionnaire (BAP-PIQ): development and preliminary psychometric evaluation of an instrument to assess the impact of parenting an adolescent with chronic pain

&NA; When an adolescent has chronic pain many aspects of a parent’s life can be affected, including their emotional and social functioning. The assessment of this multidimensional parental impact is an essential, yet often neglected, clinical task. This study reports on the development and psychometric evaluation of the Bath Adolescent Pain – Parental Impact Questionnaire (BAP‐PIQ), an assessment tool comprising multiple scales thought to be relevant for better understanding changes in functioning and behavior associated with parenting an adolescent with chronic pain. A sample of 194 parents of adolescents with chronic pain, recruited from three UK clinics, completed the 94 item draft inventory. Frequency and item correlation analyses resulted in a final inventory of 62 items. Internal consistency of all eight scales was established based on Cronbach’s alpha. Convergent validity was undertaken by comparison of individual scales with existing validated measures of parental stress, mood, parenting behavior, marital adjustment, and general functioning. The temporal reliability of each scale was established using a sub‐sample of 46 participants over a 14‐day period. Psychometric evaluation suggests that the inventory yields a reliable and valid assessment of the multiple impacts of parenting an adolescent with chronic pain. The BAP‐PIQ may offer a comprehensive assessment of these impacts in both a research and a clinical setting. Further study of the validity of BAP‐PIQ scales and their ability to detect clinically meaningful change would be of use. Additional data from samples comprising fathers of adolescents with chronic pain and parents of adolescents with non‐musculoskeletal pain would be of benefit.

Development and preliminary psychometric evaluation of the parent report version of the Bath Adolescent Pain Questionnaire (BAPQ-P): A multidimensional parent report instrument to assess the impact of chronic pain on adolescents.

Abstract Assessing the experience and impact of pain in adolescents with chronic pain is necessary to guide both individual treatment and to inform treatment development. Ideally, to obtain a comprehensive understanding of the impact of pain, assessment should be multidimensional, should be sensitive to contextual variables, and should allow for multiple informants (in particular, parents). The purpose of this study was to develop a standardized parent‐report measure of chronic pain in adolescents, the Bath Adolescent Pain Questionnaire – Parent report (BAPQ‐P). Participants included 222 adolescents with chronic pain and their parents recruited from two specialty clinics in the UK. The adolescents completed a battery of self‐report inventories related to their pain and daily functioning whilst parents completed the BAPQ‐P and additional measures of adolescent functioning. Scales of the BAPQ‐P emerged to be internally consistent and temporally stable over a 17‐day period. Validity was examined in relation to existing validated child report measures of anxiety, depression, catastrophizing, disability, family, and social functioning and parent report measures of disability and family functioning. Psychometric evaluation suggests that the BAPQ‐P is a reliable and valid parental report tool for assessing the multidimensional impact of adolescent chronic pain. It can be used in conjunction with the previously established adolescent self‐report measure, the BAPQ, alone where adolescent self report is not possible, in studies where parent report is the focus, or in studies where concordance between parent and adolescent reports is of interest.

Parental Functioning in the Context of Adolescent Chronic Pain: A Review of Previously used Measures

OBJECTIVE To examine the use of instruments which assess the functioning of individuals who parent an adolescent with chronic pain. The study will focus on examining the population in which measures were developed, content, length, psychometric evaluation, and published use with this specific chronic pain population. METHODS A systematic search of the literature identified 4,225 articles, generating a total of 73 eligible studies. Examination of these studies revealed the existence of 68 instruments. All measures underwent comprehensive content analysis. RESULTS The majority of instruments were in the psychological (N = 32) or social domain (N = 25). Median frequency of usage was 1. While 27 instruments demonstrated evidence of psychometric evaluation in a sample of parents of adolescents with chronic pain, in 20 instances, this evaluation involved only assessment of internal consistency. CONCLUSIONS Clinically relevant psychometric data were missing for many instruments. Results identified a diversity of instrumentation with little consistency in instrument usage.

A comprehensive categorical and bibliometric analysis of published research articles on pediatric pain from 1975 to 2010.

Abstract The field of pediatric pain research began in the mid-1970s and has undergone significant growth and development in recent years as evidenced by the variety of books, conferences, and journals on the topic and also the number of disciplines engaged in work in this area. Using categorical and bibliometric meta-trend analysis, this study offers a synthesis of research on pediatric pain published between 1975 and 2010 in peer-reviewed journals. Abstracts from 4256 articles, retrieved from Web of Science, were coded across 4 categories: article type, article topic, type and age of participants, and pain stimulus. The affiliation of the first author and number of citations were also gathered. The results suggest a significant increase in the number of publications over the time period investigated, with 96% of the included articles published since 1990 and most research being multiauthored publications in pain-focused journals. First authors were most often from the United States and affiliated with a medical department. Most studies were original research articles; the most frequent topics were pain characterization (39.86%), pain intervention (37.49%), and pain assessment (25.00%). Clinical samples were most frequent, with participants most often characterized as children (6-12 years) or adolescents (13-18 years) experiencing chronic or acute pain. The findings provide a comprehensive overview of contributions in the field of pediatric pain research over 35 years and offers recommendations for future research in the area.