Promoting Self-Management of Spinal Pain in Adolescents

University Of Connecticut Storrs, Storrs-Mansfield CT

Investigators

Linked publications & trials

Abstract

Renee Manworren: Promoting Self-Management of Spinal Pain in Adolescents Pilot Study Abstract/Summary The overarching goal of this program of study is improve pain SM in adolescents with spinal pain, and develop theory-based empirical data for expanding precision pain SM interventions for adolescents and families who are affected by pain. The phenomenon of pain SM among adolescents undergoing spinal surgery will provide the opportunity to examine the influence of the pain context on SM processes, behaviors, and outcomes. Our research team has a unique opportunity to intensively evaluate a cognitive-behavioral pain SM intervention in adolescents with chronic spinal pain due to the standardized protocols used for pharmacological pain management in the inpatient and outpatient settings. Therefore, we have designed the intervention of the pilot project to address SM of spinal pain ? including postoperative pain through prevention of chronic pain in recovery. Using a randomized controlled design among 60 adolescents with AIS who are undergoing spinal fusion we will examine the feasibility of the cognitive-behavioral pain SM intervention that is based on the IFSMT framework compared to adolescents receiving usual care (UC) with the following specific aims: SA1. Determine the feasibility of a personalized pain SM intervention for adolescents with idiopathic scoliosis receiving posterior spinal fusion. The primary outcome of this aim will be recruitment, enrollment, number completing the intervention and retention rates. SA2. Examine potential effects of a personalized pain SM intervention in comparison to the control group in adolescents with AIS receiving posterior spinal fusion at baseline (preoperatively) and 1, 2, and 6-weeks postoperatively on: a. context factors of spinal pain (pain catastrophizing, perceived stress, reactivity, family dynamics, pain sensitivity, mRNA expression of pain-sensitivity genes) b. pain SM process (pain self-efficacy, problem-solving, self-regulation, activation, SM ability). c. proximal (engagement in pain SM, utilization of prescribed pharmacological therapies and healthcare utilization, pain coping) and distal outcomes (pain severity & interference, quality of life). The proposed SM intervention will specifically target the interpretation of pain, pain self-efficacy and problem-solving as central components of the pain context and SM process. We will examine the influence of pain sensitivity and mRNA expression of pain sensitivity genes on SM process and outcome variables over time to gain knowledge about the precise influence of the molecular context of pain on pain SM. The empirical data from this pilot study will leverage the experience and skills of the PPI and her team and guide development of precision approaches for improving pain SM in this population.