Encouraging Effective Coping Behavior of School Children with Chronic Pain and Evaluation

Monday, July 11, 2011

Sumiko Tsuhako, PhD, RN
Nursing, Seibo College, Tokyo, Japan

Learning Objective 1: How do children with chronic pain view their pain emotionally; and how do they cope with pain stimuli?

Learning Objective 2: How do children with chronic pain express emotional feelings with supportive intervention program of the dialogue story?

Purpose: The purpose of this research is to develop and to implement an  Interventional Dialogue  Program with a perspective of quality care to control children’s pain in pediatric nursing situations of outpatient. The specific aims of this study are: 1) to describe feelings of children with arthritis( ages 8 to 12 years old) by implementing an intervention program of "dailogue story".

Methods: Through dialogue of the story of five emotional expressions (anxiety, depression, assertion, concentration/withdrawal, anger) which plays a cognitive intervention with children of chronic pain, the subjects focused on their feelings. After the dialog story of five emotional expressions, ask child to pick up an expression of the character.

 Results: 1) Self Concept: of Current-self which was picked up through the five expressions of the story, 57% has chosen <anxiety>.  In case of Ideal Self, 57% were <concentration/withdrawal>.  In the dialogue of anger expressed story, the subjects expressed “why me” has to go through this pain disease.  Children who expressed <depression> were mostly related with body changes from side effect of medication.  What was particularly striking was that the anger and depression were expressed and swing back and forth.   2) Coping Behavior having pain: like <ignore having the pain><keep watching TV>, it was suggested that children tend to show the endurance with pain.

Conclusion: The study suggests that the interventional dialogue story of five emotional expressions (anxiety, depression, assertive, concentration/withdrawal, anger) is effective for expression of children's feelings for chronic pain with arthritis. It may be useful for quality care to control children's pain in pedatric nursing.