Biomedical subjects

Joke A M Hunfeld

Publications and source records attributed to Joke A M Hunfeld.

10 recordsLinked to original sources

PubMed2005

Psychological consequences of termination of pregnancy for fetal anomaly: similarities and differences between partners.

OBJECTIVE: We examined the psychological responses to termination of pregnancy (TOP) for fetal anomaly from both men and women. The aim was to find risk factors for poor psychological outcome both for the individuals and for the couple. METHODS: A cross-sectional study was performed in 151 couples 2-7 years after TOP. We used standardized and validated questionnaires to investigate grief, symptoms of posttraumatic stress, somatic complaints, anxiety, and depression. RESULTS: Most couples adapted well to their loss, although several patients had pathological scores on posttraumatic stress symptoms and depression. Differences between men and women were slight. Higher education, good partner support, earlier gestational age, and life-incompatibility of the disorder positively influenced the outcomes, more for women than for men. Men and women with pathological scores rarely had such scores simultaneously. CONCLUSION: We emphasize the importance of equally involving both parents in the counselling because the outcomes of grief and posttraumatic stress symptoms between men and women only moderately differ and post-TOP psychopathology occurs in men as well. Good adjustment to TOP in women seems dependent on the level of support that they perceive from their partners. The intracouple results of the study suggest a mutual influence in the process of grieving between the partners.

Abortion, Induced↗

PubMed2005

A cognitive-behavioural program for adolescents with chronic pain-a pilot study.

The purpose of this pilot study is to evaluate the feasibility of a cognitive-behavioural training program for adolescents with chronic pain irrespective of pain localisation. A secondary aim was to give an impression of the effect of the program on pain and quality of life. Eight adolescents (14-18 years) with chronic non-organic pain recruited from the general population (and their parents) participated in this pilot study. The intervention included five group meetings alternated with four telephone contacts (during the self-management weeks) over a period of 9 weeks. The training aimed to change pain behaviour through pain education, relaxation strategies, problem-solving techniques, assertiveness training, cognitive restructuring and by stimulating the adolescent's physical activity level. The training further addresses the social context of pain by inviting parents to attend two meetings for the parents only, and by asking the adolescents to bring a peer to one of the meetings. Adolescents and their parents were positive about the program. Adolescents felt they were more in control of their pain and parents valued the support they experienced in helping their children to master the pain. The training was considered to be feasible in daily life. Further, the preliminary data showed an effect on pain and quality of life in the expected direction. The results underline the need for a definitive study with a larger sample size and a random controlled design.

Adaptation, Psychological↗

PubMed2003

Psychosocial factors associated with chronic pain in adolescents.

A number of psychosocial factors have been associated with the onset, exacerbation and/or maintenance of chronic pain in adolescents. The present study was conducted to evaluate the relative importance of vulnerability, reinforcement, and modeling. We compared 222 adolescents with chronic pain and no documented physiological etiology (headache, back, limb and abdominal pain) with 148 controls and their (respectively 183 vs. 127) parents. Analyses showed that adolescents with chronic pain are more vulnerable in terms of neuroticism, negative fear of failure, and (less) experienced social acceptance. Contrary to our expectations, the chronic pain group experienced less reinforcement for their pain behavior by both parents and peers than the control group. While the number of pain models was higher in the chronic pain group, no differences were found between their parents and those of the adolescents without chronic pain in pain experience, pain parameters, and pain coping. Regression analyses on the contribution of psychosocial factors to chronic pain and its parameters sustained the positive relation between vulnerability, (less) pain reinforcement, pain models and coping with pain. Furthermore, we also found evidence that gender differences have to be taken into account.

Adaptation, Psychological↗

PubMed2003

The natural course of chronic benign pain in childhood and adolescence: a two-year population-based follow-up study.

STUDY OBJECTIVE: To assess the course of chronic benign pain in childhood and adolescence longitudinally.Setting. Cohort of children with chronic pain recruited from the open population. PATIENTS: A cohort of 987 children and adolescents aged 0-18 years with chronic pain (continuous or recurrent pain>3 months), who were identified in a previous population-based prevalence study, were approached for a two-year follow-up study. Subjects were asked to keep a 3-week diary on their pain and to fill out questionnaires about background factors, pain and pain-related consequences. This assessment was repeated annually for two years. RESULTS: At baseline, 254 subjects reported chronic benign pain; of these, 124 (48%) and 77 (30%) subjects still experienced chronic benign pain at one-year and two-year follow-up, respectively. Except for the estimated pain intensity, which decreased marginally, pain remained stable over the follow-up period. Minor changes occurred in the consequences of pain; the main changes were a decrease of the impact of pain on the child's behavior, social functioning and use of health care. Subjects with persistent pain (9.4%) differed from those with non-persistent pain in frequency, history and location of the pain, emotional problems and their mother's health. CONCLUSIONS: Chronic benign pain in childhood and adolescence is common, and seems to persist in a considerable proportion (30-45%), although pain generally does not deteriorate over time.

Adolescent↗

PubMed2002

Physically unexplained chronic pain and its impact on children and their families: the mother's perception.

Because children with physically unexplained chronic pain may become the adult chronic pain patients of the future and because little is known about this pain and its impact on children and their families, a sample of 77 children (aged 5-11 years) with this type of pain was investigated. The hypothesis was tested that a greater intensity and frequency of pain would diminish the child's functional status and increase the impact of pain on the family. All mothers completed questionnaires on their perception of the child's functional status and the impact of pain on the family, and kept a diary on the child's pain for three successive weeks, three times daily, by means of a visual analogue scale (VAS) and a behavioural list. The study was conducted in the general population in the Rotterdam area. Children with physically unexplained chronic pain were sampled from those participating in a prevalence study on chronic pain. The average pain was mild (30 mm on a 0-100 mm VAS), moderately frequent (34% of the diary registration time), increased during the day, and did not result in large school absence or problems with functional status. Pain showed a relatively negative impact on family life, especially restrictions in social life and personal strain were reported, based on behavioural changes. In particular, abdominal pain, headache and limb pain are already present in considerable numbers at a young age. Longitudinal research should determine whether shifts occur in pain experience and locations from childhood and adulthood and in different dimensions of functional status and, more broadly, in quality of life resulting from pain.

Abdominal Pain↗

PubMed2002

Comparison between children and adolescents with and without chronic benign pain: consultation rate and pain characteristics.

The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was drawn from the records of ten general practices. According to their responses to a pain questionnaire, subjects were assigned to the chronic benign pain group (n = 95) if they had pain of more than three months' duration, or to the control group (n = 105) if they had pain of less than three months' duration or no pain at all. All the subjects had an average GP consultation rate of 2.6 contacts per year. No significant age and sex differences were found. Chronic benign pain in childhood and adolescence is not related to increased use of healthcare services, suggesting that somatisation does not play a major role in children with chronic benign pain.

Adolescent↗

PubMed2001

Insights in the use of health care services in chronic benign pain in childhood and adolescence.

The utilization of health care services in children and adolescents with chronic benign pain was studied in a Dutch population sample of 254 chronic pain sufferers aged 0-18 years. Children and adolescents who had reported chronic pain (continuous or recurrent pain >3 months) in our previous prevalence study were asked to keep a 3-week diary on their pain and to fill out questionnaires on background factors, health care use and the impact of pain. Parent ratings were used for children aged 0-11 years, self-report was used in adolescents (12-18 years). In a 3-month period, in 53.4% of the cases medication was used for pain, and general practitioners and specialists were consulted for pain in 31.1% and 13.9% of subjects, respectively. Physiotherapists, psychologists and alternative health providers were visited by 11.5, 2.8, and 4.0%, respectively. In the preceding year, 6.4% had been hospitalized due to pain. The most important factors linked to utilizing medical services were gender, various pain characteristics, school absenteeism and disability. Although consulters reported to be less physically fit and less satisfied with health, their parents were better adapted to the pain, by talking and sharing, mutual support, normalization of the child and heightened self-esteem, than non-consulters. Prospective studies are needed to test causality of coping on care-seeking behavior.

Adolescent↗

PubMed2000

Pain in children and adolescents: a common experience.

Little is known about the epidemiology of pain in children. We studied the prevalence of pain in Dutch children aged from 0 to 18 years in the open population, and the relationship with age, gender and pain parameters. A random sample of 1300 children aged 0-3 years was taken from the register of population in Rotterdam, The Netherlands. In the Rotterdam area, 27 primary schools and 14 secondary schools were selected to obtain a representative sample of 5336 children aged 4-18 years. Depending on the age of the child, a questionnaire was either mailed to the parents (0-3 years) or distributed at school (4-18 years). Of 6636 children surveyed, 5424 (82%) responded; response rates ranged from 64 to 92%, depending on the subject age and who completed the questionnaire. Of the respondents, 54% had experienced pain within the previous 3 months. Overall, a quarter of the respondents reported chronic pain (recurrent or continuous pain for more than 3 months). The prevalence of chronic pain increased with age, and was significantly higher for girls (P<0.001). In girls, a marked increase occurred in reporting chronic pain between 12 and 14 years of age. The most common types of pain in children were limb pain, headache and abdominal pain. Half of the respondents who had experienced pain reported to have multiple pain, and one-third of the chronic pain sufferers experienced frequent and intense pain. These multiple pains and severe pains were more often reported by girls (P<0.001). The intensity of pain was higher in the case of chronic pain (P<0. 001) and multiple pains (P<0.001), and for chronic pain the intensity was higher for girls (P<0.001). These findings indicate that chronic pain is a common complaint in childhood and adolescence. In particular, the high prevalence of severe chronic pain and multiple pain in girls aged 12 years and over calls for follow-up investigations documenting the various bio-psycho-social factors related to this pain.

Adolescent↗

PubMedDate not supplied

Stability of pain parameters and pain-related quality of life in adolescents with persistent pain: a three-year follow-up.

OBJECTIVE: Many juveniles with chronic pain of no known organic cause recover. Because adolescents whose pain persists may have chronic pain as adults, a subsample of 42 adolescents from a prevalence study in which continuation of their pain was observed throughout the study period was investigated quantitatively and qualitatively. All mothers (n = 42) completed a questionnaire on the impact of the adolescent's pain on the family. The authors tested the hypothesis that pain parameters, pain-related quality of life, and impact of pain on the family would deteriorate over time. DESIGN: Three-year follow-up questionnaires, diaries, and interviews were used. SETTING: The study was conducted in the general population in the Rotterdam area. PARTICIPANTS: Adolescents (aged 12-18 years) who indicated chronic pain in our previous prevalence study and in a diary and questionnaire each year of the 3-year follow-up were included in the study. RESULTS: The most prevalent pains were limb pain and headache. The pain intensity was mild (33 mm on a visual analog scale), very frequent (72% of all diary entries), and associated with relatively poor functional status and poor psychological and somatic functioning. The pain parameters, pain-related quality of life, and impact of pain on the family (i.e., restrictions in social life and problems in dealing with the stress of the adolescent's pain) remained surprisingly stable across the assessments. The interviews showed that pain had become part of the daily life of several adolescents, who structured their activities and sleeping hours to prevent aggravation of pain. In particular, adolescents with headache reported problems with cognitive activities, whereas those with limb pain and back pain reported problems with physical activities. CONCLUSIONS: For adolescents with persistent pain with no known organic cause, intensity and frequency of pain, quality of life, and impact of pain on the family did not change. Generally, they seemed to cope quite well with their pain. In view of these results, further studies should involve follow-up of adolescents with persistent pain into adulthood to establish the determinants of their pain and to find out whether they maintain their adaptive ways of living with their pain.

Adolescent↗

PubMedDate not supplied

Factors related to the quality of life in adolescents with chronic pain.

OBJECTIVE: This study examined the relationships between pain characteristics, psychosocial factors, and quality of life among adolescents with chronic pain that existed for at least 3 months, either recurrently (ie, pain with pain-free intervals) or continuously. METHODS: The authors conducted a cross-sectional study in 194 adolescents aged 12 to 18 years who completed questionnaires on pain, psychosocial factors (ie, vulnerability, reinforcement, modeling, and coping), and quality of life, and also kept a diary about their pain complaints for 3 weeks. RESULTS: Multiple hierarchical regression analysis revealed that psychosocial variables accounted for a significant variance in the adolescents' quality of life, even when controlling for pain characteristics. Analysis of the independent variables showed that pain intensity and vulnerability contributed significantly and uniquely to the variance of most quality-of-life domains. In addition, the authors found that emotion-focused avoidance coping strategies (ie, catastrophizing) strengthened the negative relation between pain intensity and psychological functioning. CONCLUSIONS: In addition to pain, psychosocial factors (vulnerability, reinforcement, modeling, and coping) are strongly associated with quality of life in adolescents with chronic pain. These results may contribute to psychological interventions focused on psychological adaptation in young pain patients to improve their quality of life.

Adolescent↗