An acceptance-based intervention for children and adolescents with cancer experiencing acute pain – a single-subject study

Abstract

Background

Children and adolescents with cancer report pain as one of their most recurrent and troublesome symptoms throughout the cancer trajectory. Pain evokes psychological distress, which in turn has an amplifying effect on the pain experience. Acceptance-based interventions for experimentally induced acute pain predict increased pain tolerance, decreased pain intensity and decreased discomfort of pain. The aim of this study was to preliminarily evaluate an acceptance-based intervention for children and adolescents with cancer experiencing acute pain, with regard to feasibility and effect on pain intensity and discomfort of pain.

Methods

This is a single-subject study with an AB design with a nonconcurrent multiple baseline. Children and adolescents aged four to 18 years undergoing cancer treatment at the Children’s University Hospital, Uppsala, Sweden, reporting sustained acute pain were offered participation. Pain intensity and discomfort of pain were measured during baseline and at post-intervention. The intervention consisted of a pain exposure exercise lasting approximately 15 minutes.

Results

Five children participated in the study. All participants completed the intervention and reported that it had helped them to cope with the pain in the moment. All participants reported decreased discomfort of pain at post-measurement, three of whom also reported decreased pain intensity.

Conclusion

The results suggest that an acceptance-based intervention may help children and adolescents with cancer to cope with the pain that is often associated with cancer treatment in spite of pharmacological pain management. The results are tentative but promising and warrant further investigation.

Keywords:

• acute pain
• acceptance
• pain intensity
• discomfort of pain

Acknowledgments

This study was supported by grants from the Swedish Childhood Cancer Foundation (FTJH11/002 and PR2013/0058) and the Swedish Cancer Society (CAN2013/749). The authors would like to thank the research nurses of the pediatric oncology center in Uppsala, Sweden, Maria Flink, Susanne Preinitz Lindberg and Katarina Wallin, for their assistance in information dissemination, recruitment and measurement assessment in the study.

Disclosure

The authors report no conflicts of interest in this work.