Examining Hope in Adolescents with Chronic Musculoskeletal Pain

This cross-sectional study aimed to quantify hope levels in adolescents with chronic musculoskeletal pain (CMP) and examine patient-reported outcomes associated with hope.

This was an exploratory, cross-sectional, secondary analysis of baseline data from a prospective, single-center longitudinal study of 60 youth presenting for an initial evaluation at a pediatric subspecialty pain clinic. Subjects were English-speaking 12-17-year-olds with a diagnosis of CMP, primarily female and non-Hispanic White, with diffuse pain, median pain duration of 2 years, and moderate to severe physical dysfunction. Subjects completed surveys measuring hope (Children's Hope Scale [CHS]) and patient-reported mental, physical, and overall health. Associations between hope scores (total and each subscale) and patient-reported outcomes were evaluated using Spearman rank correlations.

The median CHS score was 20.0 (IQR: 16.5-25.0), indicating slight hope. Patient hope was negatively correlated with depression (r = -0.61), anxiety (r = -0.49), psychological distress (r = -0.52), functional disability (r = -0.43), and pain interference (r = -0.37), but not pain intensity. Adolescents' hope was positively correlated with resilience (r = 0.74) and overall health (r = 0.55; all p < 0.01).

Hope is correlated with various patient-reported health measures in youth with CMP. Although causal inferences are not possible due to the cross-sectional nature of this study, the results suggest that hope may be an important coping mechanism in pediatric chronic pain. Future efforts to incorporate existing resilience coaching programs into usual care may improve hope and health-related quality of life in youth with CMP.