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Validity of reported pain as a measure of clinical state in juvenile rheumatoid arthritis
C K Ross1, J V Lavigne, J R Hayford
1Department of Pediatrics, Northwestern University Medical School, Chicago, Illinois 60614.
Insights
Parents
Area of Science:
- Pediatric Rheumatology
- Pain Management
- Child Health
Background:
- Juvenile rheumatoid arthritis (JRA) requires comprehensive assessment.
- Pain is a critical indicator of a child's clinical state in JRA.
- Understanding factors influencing reported pain is essential for effective management.
Purpose of the Study:
- To investigate the relationship between clinical indicators and parent-reported pain in children with JRA.
- To determine if different JRA classifications impact pain reporting.
- To explore the influence of child's age on pain perception.
Main Methods:
- Utilized multiple regression analysis on data from 101 children with JRA.
- Analyzed parent-reported pain in relation to JRA type (pauciarticular and polyarticular).
- Assessed clinical state using joint activity, morning stiffness, and physician-rated disease activity.
Main Results:
- Parent-reported pain in JRA varied significantly based on disease classification.
- Clinical measures (joint activity, stiffness, physician rating) independently predicted parent-reported pain.
- Child's age did not significantly correlate with parent-reported pain levels.
Conclusions:
- Clinical assessment of joint activity and disease severity is crucial for understanding pain in JRA.
- Parental reports of pain in JRA are influenced by objective clinical findings, not child's age.
- Tailoring pain management strategies based on JRA type and clinical status is recommended.
Abstract:
Reported pain is one valid indicator of clinical state which should be used in the assessment and management of children with juvenile rheumatoid arthritis. Parents' reports of children's pain for 101 children with juvenile rheumatoid arthritis differed significantly by type of juvenile rheumatoid arthritis. When multiple regression was used separately for pauciarticular and polyarticular classifications of juvenile rheumatoid arthritis a measure of clinical state, which reflected joint activity, morning stiffness, and overall disease activity as rated by the doctor, had a significant and independent effect upon pain reported by parents. The child's age was not significantly related to the pain reported by parents. Children's pain reports did not differ significantly between older and younger children.