Effects of a person-centred approach in a school setting for adolescents with chronic pain-The HOPE randomized controlled trial

Andreas Fors; Ulrika Wallbing; Gösta Alfvén; Mike K Kemani; Mari Lundberg; Helena Wigert; Stefan Nilsson

doi:10.1002/ejp.1614

Effects of a person-centred approach in a school setting for adolescents with chronic pain-The HOPE randomized controlled trial

Eur J Pain. 2020 Sep;24(8):1598-1608. doi: 10.1002/ejp.1614. Epub 2020 Jun 26.

Authors

Andreas Fors^{1

2

3}, Ulrika Wallbing^{1

4}, Gösta Alfvén⁵, Mike K Kemani^{6

7

8}, Mari Lundberg^{2

4

9}, Helena Wigert^{1

2

10}, Stefan Nilsson^{1

2}

Affiliations

¹ Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
² Centre for Person-Centred Care (GPCC), University of Gothenburg, Sahlgrenska Academy, University of Gothenburg, Sweden.
³ Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Sweden.
⁴ Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Huddinge, Sweden.
⁵ Clintec, Karolinska Institute, Stockholm, Sweden.
⁶ Department of Clinical Neuroscience (CNS), Stockholm, Sweden.
⁷ Medical Unit Medical Psychology, Section Behavioral Medicine, Karolinska University Hospital, Stockholm, Sweden.
⁸ Stress Research Institute, Stockholm University, Stockholm, Sweden.
⁹ Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁰ Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden.

PMID: 32501596
DOI: 10.1002/ejp.1614

Abstract

Background: Chronic pain among adolescents is common but effective interventions applicable in a school setting are rare. Person-centred care (PCC) is a key factor in improving health by engaging persons as partners in their own care.

Methods: In this randomized controlled trial, a total of 98 adolescents in secondary school or upper secondary school (aged 14 - 21 years) with chronic pain were randomly assigned to a PCC intervention or standard school healthcare. In the intervention group a pain management programme, based on a PCC approach, comprising four face-to-face sessions with a school nurse over a period of 5 weeks was added to standard school healthcare. The main outcome measure was self-efficacy in daily activities (SEDA scale) and rating scales for pain intensity and pain impact were used as secondary outcome measures.

Results: At the follow-up, no significant differences were found between the groups in the SEDA scale (p = .608) or in the rating scales for pain intensity (p = .261) and pain impact (p = .836). In the sub-group analysis, a significant improvement in the SEDA scale was detected at the secondary school in favour of the PCC intervention group (p = .021).

Conclusion: In this pain management programme based on a PCC approach, we found no effect in the total sample, but the programme showed promising results to improve self-efficacy in daily activities among adolescents at secondary school.

Significance: This study evaluates the effects of a pain management programme based on a PCC approach in a school setting addressing adolescents at upper secondary and secondary schools with chronic pain. No overall effects were shown, but results illustrate that the intervention improved self-efficacy in adolescents at secondary school. Implementation of a PCC approach in a school setting may have the potential to improve self-efficacy in daily activities for adolescents with chronic pain at secondary school.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Chronic Pain* / therapy
Humans
Outcome Assessment, Health Care
Schools
Self Care
Self Efficacy
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding