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Citation

Rheel E, Ickmans K, Caes L & Vervoort T (2021) The Impact of Parental Pain-attending and Non-pain-attending Responses on Child Pain Behavior in the Context of Cancer-related Painful Procedures: The Moderating Role of Parental Self-oriented Distress. Clinical Journal of Pain, 37 (3), pp. 177-185. https://doi.org/10.1097/ajp.0000000000000902

Abstract
Objectives: Literature has demonstrated inconsistent findings regarding the impact of parental responses upon child pain-related outcomes. Yet, research into factors that may underlie inconsistent findings regarding the variable impact of parental responses is lacking. The current study investigated the moderating role of parental distress in understanding the impact of parental pain-attending (e.g., reassuring the child) and non-pain-attending (e.g., distracting the child with humor) responses upon child pain behavior (e.g., crying). Methods: Children (≤18?y) suffering from leukemia, undergoing a lumbar puncture (LP) and/or bone marrow aspiration (BMA) procedure, and one of their parents, were recruited from the Pediatric Ghent University Hospital. Parent-child interactions were videotaped after the procedure allowing coding of parental responses and child pain behavior. Parents self-reported on experienced personal distress. Results: Participants consisted of 42 children (24 boys, 18 girls) with leukemia and one of their parents. Children were 0.6-15 (7.08±4.39) years old. Findings indicated a positive association between parental pain-attending and child pain behavior, but only when parents reported high levels of distress (β=0.56, P=0.001). No association was observed for parents reporting low levels of distress (β=-0.09, ns). Parental non-pain-attending responses contributed to lower child pain behavior (β=-0.24, P=0.045), independently from parental distress (β=-0.07, ns). Discussion: The current findings point to the moderating role of parental distress in understanding the impact of parental responses upon child pain behavior and highlight the importance of interventions targeting parental emotion regulation to promote more optimal child pain outcomes.

Keywords
invasive medical procedures; childhood leukemia; parental distress; parental responses; child pain behavior

Journal
Clinical Journal of Pain: Volume 37, Issue 3

• Accepted manuscript