Prevalence and impact of bumps, bruises, and other painful incidents among children while handling and riding horses

Horseback riding and related activities bring risks for serious injury. Extant literature focuses largely on moderate to severe horse-related injuries resulting in a need for medical care. Yet incidents deemed as less severe are also important, with potential to impact subsequent safety precautions and behaviors of parents and children. The study objectives were to gather preliminary information about: (1) the prevalence of a range of horse-related painful incidents experienced by children, (2) children\u27s helmet use and supervision, and (3) the subsequent impact of horse-related painful incidents. The methodological approach was based on a questionnaire. One hundred and twenty four child (120 Female; Mage: 11.82 years; rangeage: 8–18; SDage: 2.26) and parent (103 mothers; 16 fathers; 5 other legal guardians) dyads completed a brief 5 minute researcher-generated questionnaire. The results show, that painful incidents are common for children when handling and riding horses, with the majority of children having experienced these incidents more than once. Helmet use and supervision (typically by parents and coaches) were reported to occur consistently during riding, but less commonly during handling (e.g., grooming). Despite the high prevalence of painful incidents, these incidents largely do not impact children\u27s ability to participate in other activities, result in access to specialized medical attention, or alter children\u27s perceptions or behavior around horses. Findings may have implications for safety and education initiatives. Management implications: Findings from this work suggest several implications. First, in acknowledging the range and frequency of incidents that occur during horse-related activities, educational initiatives should target a broad range of incident types when teaching about horse safety and injury prevention. Second, in recognizing primary caregivers and riding coaches as the most common supervisors of horse-related activities, they should also be targeted in educational initiatives (e.g., horse and safety knowledge, first aid, supervision guidelines). Finally, in developing and implementing targeted safety and injury prevention initiatives, reported benefits of the sport (e.g., improved problem-solving skills) could be used and supported in safety programming

Teddy and I get a check-up: A pilot educational intervention teaching children coping strategies for managing procedure-related pain and fear

Would also benefit from an educational programregardingmore commonly experiencedmedical procedures (e.g., needles, general check-up). Objective. To determine whether an evidence-based educational program reduced children\u27s ratings of fear of and expected pain from medical stimuli and increased their knowledge of procedural coping strategies. Methods: An educational, interactive, developmentally appropriate Teddy BearClinic Tour was developed and delivered at a veterinary clinic.During this tour, 71 5-10-year-old children (Mage = 6.62 years, SD = 1.19) were taught about medical equipment, procedures, and coping strategies through modelling and rehearsal. In a single-group, pretest posttest design, participants reported their fear of and expected pain from medical and nonmedical stimuli. Children were also asked to report strategies they would use to cope with procedural fear. Results: Children\u27s ratings for expected pain during a needle procedure were reduced following the intervention. No significant change occurred in children\u27s fear of needles. Children reported more intervention-taught coping strategies at Time 2. Conclusions: The results of this study suggest that an evidence-based, interactive educational program can reduce young children\u27s expectations of needle pain and may help teach them procedural coping strategies

A cognitive-behavioral group intervention for parents of youth with chronic pain: Development, feasibility, and preliminary effectiveness.

Background: Caregiving for a youth with chronic pain is associated with unique stressors. Parents can play important roles for youth coping and functional outcomes, although parents often report uncertainty about how to support their youth and may benefit from learning evidence-based strategies. However, few parent-targeted interventions for pediatric chronic pain exist, particularly delivered within a group format. Objectives: The aims of this study were to describe the development of a parent-targeted group intervention within an outpatient interdisciplinary pediatric chronic pain clinic and to assess preliminary feasibility and effectiveness. Method: The development and content of the intervention are described in detail. Feasibility was assessed via enrollment, attendance, and attrition. Effectiveness was assessed via parent self-reported responses to pain and psychological flexibility (PF) before and after treatment. Results: Seventy parents consented and participated in the 5-week group intervention (2 hr/session). Preliminary results demonstrated adequate feasibility, with attendance rates at 61.4% and attrition rates at 24.3%. After treatment, there were significant moderate- to large-sized decreases in 3 of 4 parent behaviors assessed (protectiveness, monitoring, minimizing) and large-sized increases in PF. Conclusions: This group intervention for parents can produce positive changes in self-reported parent behavior and PF and may be a feasible way to intervene within an outpatient interdisciplinary setting. (PsycInfo Database Record (c) 2021 APA, all rights reserved

Adult judgments of children’s pain and fear during venipuncture: The impact of adult and child sex

Background: Low levels of agreement between caregiver and child reports of acute pain are well documented. Aims: This study builds on prior research through exploring factors that may contribute to low caregiver–child concordance. Specifically, the study examined the influence of adult and child sex on adult judgments of children’s pain and fear during venipuncture and examined whether trait parental pain catastrophizing, empathy, and anxiety predicted judgment accuracy. Methods: Using a judgment study paradigm, 160 participants (82 women) viewed 20 10-s video clips of children (10 boys, 10 girls) undergoing venipuncture and rated each child’s pain and fear. Adults’ ratings were compared to the children’s own ratings. Adults completed measures of trait parental pain catastrophizing, dispositional empathy, and trait anxiety. Results: Adults accurately judged boys’ pain and fear significantly more often than that of girls. Further, adults underestimated and overestimated girls’ pain and overestimated girls’ fear significantly more frequently than that of boys. No effects of adult sex or adult by child sex interactions emerged. Parental pain catastrophizing significantly predicted underestimation of girls’ pain, with adults who engaged in more catastrophizing being less likely to underestimate girls’ pain. The variables did not predict adult judgment of child pain for women and men separately and did not predict adult judgment of child fear when examined by adult sex, child sex, or both combined. Conclusions: Child sex influences adult pain and fear judgments, with girls being more vulnerable to inaccurate assessment than boys. Higher levels of parental pain catastrophizing may buffer against adults’ propensities to underestimate girls’ pain

Children’s perspectives on outpatient physician visits: Capturing a missing voice in patient-centered care

Actively involving children in their healthcare is a core value of patient-centered care. This is the first study to directly obtain children’s detailed perspectives on positive and negative aspects of outpatient physician visits in a primary care setting (e.g., checkups) and their preferred level of participation. Individual interviews were conducted with 167 children (female n = 82, male n = 85; ages 7–10, Mage = 8.07 years, SD = 0.82). Open-ended questions were used so that children’s responses were not confined to researchers’ assumptions, followed by close-ended questions to meet specific objectives. Quantitative content analysis, correlations, logistic regression, and Cochran’s Q were used to explore the data. Children were highly fearful of needle procedures (61%), blood draws (73%), pain (45%), and the unknown (21%). Children indicated that they liked receiving rewards (32%) and improving their health (16%). Children who were more fearful during physician visits wanted more preparatory information (ExpB = 1.05, Waldx2 (1) = 9.11, p = 0.003, McFadden’s R22 = 0.07) and more participation during the visit (ExpB = 1.04, Waldx2 (1) = 5.88, p = 0.015, McFadden’s R22 = 0.03). Our results can inform efforts to promote positive physician visit experiences for children, reduce procedural distress, and foster children’s ability to take an active role in managing their health

Caring for children with intellectual disabilities part 2: Detailed analyses of factors involved in respite workers’ reported assessment and care decisions

Respite workers (RW) commonly care for children with intellectual disabilities (ID), and pain is common for these children. Little is known about factors which inform RW pain assessment and management-related decisions. Objectives To describe/determine the following in response to a series of pain-related scenarios (e.g., headache, falling): (1) factors considered important by RW when assessing children with ID\u27s pain; (2) whether children\u27s verbal ability impacts pain assessment factors considered; (3) RW assessment and management approach. Participants Fifty-six RW (18–67 years, Mage = 33.37, 46 female). Procedure/measures In an online survey, participants read and responded to six vignettes manipulating child verbal ability (verbal, nonverbal) and pain source. Results The factors most frequently considered when assessing pain were child behavior (range: 20–57.4%), and history (e.g., pain, general; 3.7–38.9%). Factors did not vary by child\u27s verbal ability. RW indicated varied assessment and management-related actions (range: 1–11) for each scenario. Discussion Findings suggest: a) factors informing pain assessment did not depend on whether or not the child was verbal and b) a degree of flexibility in RW response to pain across situations. While these findings are encouraging, ensuring RW have adequate pain assessment and management knowledge specific to children with ID is critical

Facilitating respite, communication, and care for children with intellectual and developmental disabilities: Preliminary evaluation of the Caregiver Pain Information Guide.

Background: Pain is common in children with intellectual and developmental disabilities (I/DD) and yet is an understudied issue. Respite workers commonly care for children with I/DD but are lacking in resources to assist in pain assessment and management for this population. Without adequate knowledge in this domain, children with I/DD are at risk of their pain being underrecognized and undermanaged. A resource for caregivers was developed to address this issue, facilitating communication between parents and respite workers and better addressing the complex pain-related needs of children with I/DD. The objective of this study was to solicit initial feedback on the content, feasibility, and usability of the resource. Method/Procedure: Semistructured individual interviews and questionnaires were completed with 7 parents of children with I/DD and 6 respite workers. Results: All participants viewed the resource as important and potentially useful. Content analyses indicated that participants appreciated the comprehensiveness and format of the resource, whereas the modifiability was identified as an area for improvement. Participants believed that the resource would be useful across settings with a variety of caregivers. Three categories of considerations were identified as potential facilitators and barriers for implementation: consideration of how the resource is being completed, who is completing it, and organization-based procedures. Discussion/Conclusions: Results from this study suggest that the Caregiver Pain Information Guide is a promising resource for helping respite workers better understand pain in children with I/DD. Future work is needed on implementation and impact of this resource in community settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved)Implications for Impact Statement—Children with intellectual and developmental disabilities experience pain frequently and are at risk of having their pain missed by caregivers. Parents would like to share pain-related knowledge and skills specific to their children with intellectual and developmental disabilities with those who support their child in other settings. The Caregiver Pain Information Guide was created to facilitate communication between parents and caregivers of these children. The current article discusses initial feedback from parents and respite workers regarding this new tool. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Observer perceptions of pain in children with cognitive impairments: vignette development and validation

AIM: Develop vignettes depicting different pain types in verbal and nonverbal children with cognitive impairments that could help examine pain assessment and management decisions of secondary caregivers, and conduct initial convergent and divergent validity analyses

Caring for children with intellectual disabilities part 1: Experience with the population, pain-related beliefs, and care decisions

Some children with intellectual disabilities (ID): experience pain more frequently than children without ID, express their pain differently, and are incapable of providing self-reports. No research has examined disability and pain-related beliefs of respite workers (RW) and their relations to pain assessment and management decisions for children with ID. Objectives (1) compare disability and pain-related beliefs between RW and a sample with little experience in ID; (2) determine whether individuals’ beliefs and personal characteristics are related to pain assessment and management decisions. Participants Fifty-six RW (aged: 18–67 years, Mage = 33.37, 46 female) and 141 emerging adults (aged: 18–31 years, Mage = 19.67, 137 female). Procedure/measures In an online survey, participants responded to six vignettes depicting pain in children with ID, and completed measures of pain and disability-related beliefs. Results/discussion Compared to those without experience, RW held more positive disability-related beliefs, t(192) = 4.23, p \u3c 0.001. Participants’ pain-related beliefs (e.g., sensitivity to pain) differed depending on severity of the child\u27s ID and participant group. Participants’ pain-related beliefs predicted care decisions. Results provide initial insight into RW pain-related beliefs about children with ID, and a basic understanding of the relations among pain beliefs, personal characteristics and pain-related decisions