Parents’ relationship to pain during children’s cancer treatment – a preliminary validation of the Pain Flexibility Scale for Parents

Abstract

Objectives

Pain is one of the most frequent and burdensome symptoms for children with cancer. Psychological acceptance has been shown to be beneficial in chronic pain. Acceptance-based interventions for experimentally induced pain have been shown to predict increased pain tolerance and decreased pain intensity. An acceptance-based pilot study for children with cancer experiencing pain has shown promising results. Further, parental acceptance has been shown to predict decreased child distress. To date, no instruments measuring acceptance in the context of acute pain in children are available. The aim of this study was to develop and evaluate an instrument to measure acceptance in parents of children experiencing pain during cancer treatment.

Methods

A test version of the Pain Flexibility Scale for Parents (PFS-P) was sent to parents of all children undergoing cancer treatment in Sweden at the time of the study. Exploratory factor analysis (n=243) examined numerous solutions. Internal consistency, test–retest reliability and convergent validity were calculated.

Results

A three-factor Promax solution best represented the data. The subscales were pain resistance, valued action and pain fusion. Internal consistency was good (α=0.81–0.93), and the total scale and the subscales demonstrated temporal stability (r=0.76–0.87) and good convergent validity (−0.40 to −0.84).

Discussion

The PFS-P measuring acceptance in parents of children experiencing pain during cancer treatment is now available, enabling evaluation of acceptance in the context of acute pain in children. The scale shows good psychometric properties but needs further validation.

Keywords:

• acute pain
• children
• parents
• acceptance
• psychological flexibility
• factor analysis

Acknowledgments

The Swedish Childhood Cancer Registry is greatly acknowledged for identifying eligible participants and supplying data. We would also like to thank the research nurses of the six pediatric oncology centers in Sweden for screening the data to avoid contact being made with parents of children who had recently gone into palliation or deceased. Professor Lance McCracken, Department of Psychology, King’s College London, Professor Kevin Vowles, Department of Psychology, University of New Mexico, and Professor Christopher Eccleston, Department for Health, University of Bath, are also greatly acknowledged for their work in developing the CPAQ, upon which the test version of the PFS-P was partly developed. This work was supported by grants from the Swedish Childhood Cancer Foundation (PR2013-0058) and the Swedish Cancer Society (CAN2013/749).

Disclosure

The authors report no conflicts of interest in this work.