Gender and age differences in pain, coping and health status among children with chronic arthritis

To investigate pain, coping and health status in children with chronic arthritis. Additional aims were to explore gender variations in pain, coping and health status, and the same factors in children under 16 years versus children 16 years or older.

For 125 children (43 boys) with a median age of 14.1 years (range 10.3-17.8) disability and discomfort were assessed (Childhood Health Assessment Questionnaire, CHAQ). Pain, coping, fatigue, sleeping and satisfaction with life were evaluated (Visual Analogue Scales). The Pain Intensity Scale was used to assess the variation in pain intensity during one week.

The CHAQ disability index (DI) was 0.63. In the total sample, girls had larger numbers of affected joints in upper extremities (p = 0.028) and more days with morning pain (p = 0.025) than boys. Boys reported greater perceived ability to reduce pain than girls (p = 0.020). Compliance with treatment was more frequent in girls than in boys (p = 0.029). In children 16 years of age and older, boys reported greater perceived ability to control pain (p = 0.032) and to reduce pain than girls (p = 0.001) and fewer days with worst pain in the mornings (p = 0.013), as well as less pain variations over the period of a day (p = 0.014) and over a period of a week (p = 0.035).

As a group, the children were clearly affected by their arthritis. Pain was related to the severity of disease. Some significant gender and age differences were highlighted, which should be considered in clinical pain management.