Quantitative and Qualitative Assessments of Pain in Children with Juvenile Chronic Arthritis Based on the Norwegian Version of the Pediatric Pain Questionnaire

Abstract

Quantitative and qualitative aspects of pain were studied using a standardized questionnaire (the Varni/Thompson Pediatric Pain Questionnaire - PPQ). Fifty-seven of 64 consecutive in- and out-patients (6–18 yrs) with juvenile chronic arthritis (pauciart. n = 27, polyart. n = 30) and 52 parents participated. The patients were examined by the same rheumatologist and randomly interviewed by either a disabled or a non-disabled person. Present pain, worst pain intensity and disease severity were scored (on visual analogue scales [10 cm. VAS]) by patients, parents and rheumatologist. Eighty-two percent of the children reported pain lasting from 30 min up to 24 h daily (mean 4.3 h). No significant differences were found between median pain scores of children, parents and the physician, but the correlations found between children's and parent's assessment of pain and assessment of disease severity were low, indicating that the two sets of raters did not agree to an acceptable level. Two-thirds of the adolescents reported that they would become more physically active if pain disappeared. Should the pain suddenly vanish, a positive change in family relationships was anticipated by one out of four patients. Forty-two percent of the patients thought it valuable to be interviewed by a disabled physician. The Norwegian Varni/Thompson PPQ is easy to administer to children down to six years and makes it possible to compare results internationally. Lack of agreement on the assessment of pain by a child and his/her parent indicates the need to interview both parties.

Key Words:

• pain
• disease severity
• psychosocial function
• disabled interviewer
• juvenile chronic arthritis
• the NorwegianVarni/Thompson Pediatric Pain Questionnaire