Thesis (M.A.)--York University, 2005. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 90-101). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss &rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR11852

Pain is a significant health issue in the paediatric oncology population. No study to date exists documenting the experience and characteristics of pain in Lebanese children with cancer. The primary aim of this research study is to identify the characteristics of the painful experience of paediatric cancer pain in Lebanese children and how pain is managed from the child’s own perspectives. A secondary aim is to assess the cross-cultural context of the Adolescent Paediatric Pain Tool (APPT) and the Functional Disability Inventory (FDI). The specific objectives that will be addressed are:1. To describe the demographic and clinical characteristics of Lebanese children experiencing cancer pain at the CCCL including: type of cancer, time since diagnosis, metastasis, and current treatment in outpatients and inpatients.2. To describe the characteristics of pain including: intensity, frequency, duration, location, and quality in Lebanese children with cancer at the CCCL. 3. To identify the major sources of pain (cancer-related, treatment-related, or procedure-related) in Lebanese children with cancer at the CCCL.4. To examine the impact of pain on activities of daily living in Lebanese children with cancer at the CCCL. 5. To determine the factors associated with the intensity of pain in Lebanese children with cancer at the CCCL. 6. To determine how pain is managed in Lebanese children with cancer at the CCCL from their own perspective. To meet the above aims and objectives a cross-sectional correlational design was used. A consecutive sample (n=62) was recruited from the Children Cancer Centre of Lebanon at the American University of Beirut Medical Centre (CCCL-AUBMC). Data was collected through face-to-face interviews using a structured questionnaire. The mean age of participants was 12.3 (SD 2.9). The mother was the primary caregiver in the majority of cases (69.4%). The overall mean intensity rating was 5.06 (SD 1.87) on a 10 cm Word Graphic Rating Scale. The majority (57.4%) of children reported a frequency of “sometimes”. The median duration of pain was two hours per pain episode. The most frequent locations were: the forehead, the abdomen, and lower back. Sensory words were most often used to qualify pain. The functional disability levels were moderate as measured by the FDI. Factors associated with overall pain intensity were: frequency, duration, location, affective words, and treatment-related pain. Time since diagnosis, treatment, surgery in the past, radiotherapy, pain duration and frequency of pain predicted pain intensity in the sample. Children reported receiving pharmacological help from nurses, and non-pharmacological measures from their mothers. The main self-initiated coping strategies used by children were behavioural avoidance and behavioural distraction. The most suggested coping strategy was stressor modification. The majority (56/62) did not expect to experience that much pain from cancer and treatment modalities.Pain assessment and management in Lebanese children with cancer are of concern. Health care professionals, policy makers, and institution stakeholders are urged to take action.

Pain in sport serves the adaptive functions of signalling impending or actual injury and signalling the achievement of optimum workload to produce a conditioning effect. It is important to be able to distinguish what pain is signalling in order to respond to it effectively. The different functions of pain present a challenge for athletes wanting to improve their skill and conditioning level in the most efficient manner without becoming injured. However, this challenge could prove dangerous to children who have only a partial understanding of the value of pain, or who believe that they must endure great amounts of pain in order to become successful in sport. Previous research with general populations has demonstrated that children have a naive understanding of pain causation and do not understand the value of pain. In addition, previous research demonstrated that social factors such as peer and parental pressure may lead to situations where child athletes suffer preventable injuries because they ignore the warning signals of pain. Because coaches and parents are often responsible for deciding what to do when children present with pain, it is important for these adults to be aware of the cognitive limitations of children regarding the causes and meaning of pain. To date, there is no research which examines what athletes know about sport-related pain. Participants for this research project were 68 gymnasts aged 6 to 13 years. Several questions were asked in this study: (a) can gymnasts of various ages distinguish different types of sport-related pain?; (b) do gymnasts respond differently to different types of sport-related pain?; (c) what reasons do gymnasts give for continuing or discontinuing gymnastics when they have pain?; (d) do gymnasts understand the concept of pain causality?; (e) do gymnasts understand the value of pain?; (0 do gymnasts use pain for secondary gain? These questions were investigated in the context of an interview designed for this study. Two subtests from the Stanford-Binet Intelligence Scale and tests of cognitive developmental level based on Piagetian theory were also administered. The effects of age, gender, level of cognitive development, experience with sport, and experience with pain and injury were examined for their influence on responses to the above questions. Results revealed age differences in the gymnasts' ability to distinguish types of pain such that older gymnasts identified more pain types. However, even the youngest participants were able to discuss more than one type of pain. There were age differences in gymnasts' understanding of pain causality. Contrary to previous research demonstrating children to be unable to identify a physiological cause of pain, 32% of the gymnasts aged 9 to 13 were able to describe the role of the brain and/or nerves in pain causality. Also contrary to previous research with general populations, the gymnasts were able to discuss the value of pain, especially as a signal of hard work and as a warning to stop what they are doing. Forty percent of participants reported using pain (sport-related and/or non sport-related) for secondary gain. Not a single gymnast reported using pain as an excuse for a poor performance. Six of them did, however, report pretending to be in pain to avoid something in the gym that caused them fear. Further demonstrating an appreciation of different types of pain, results showed the gymnasts to respond differently to various pain types. These young athletes demonstrated an awareness of the need to stop their sport in some cases and to continue gymnastics in other cases, depending upon the type of pain. When continuing gymnastics despite pain, participants usually justified their decision by saying that the pain was not harmful to them. When describing why they discontinued gymnastics because of pain, participants often stated that the pain or injury may worsen. Few participants stated a concern for their future functioning. No participant described pressure from coaches, parents or peers to continue gymnastics while experiencing pain. Results are discussed in a variety of contexts: (a) comparison of these results to those of similar research done with general populations of children; (b) implications for training practices, coach and athlete education. and sport policy in general; (c) support for a theory of cognition that encompasses both nativist and constructivist components; and (d) directions for future research.

Thesis (Ed. Spec.)--University of Wisconsin--Stout, 2009. / Includes bibliographical references.

Thesis (M. Sc.)--Memorial University of Newfoundland, 1997. / Bibliography: leaves 85-98.

Thesis (M.N.)--Memorial University of Newfoundland, 2002. / Bibliography: leaves 109-116.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Objetivos deste estudo realizar investigaÃÃo epidemiolÃgica da dor em crianÃas vÃtimas de queimaduras, identificar o perfil epidemiolÃgico das crianÃas vÃtimas de queimaduras no processo da dor, avaliar a dor da crianÃa queimada utilizando uma Escala Visual AnalÃgica â EVA (escala de faces) e fornecer subsÃdios ao serviÃo de queimados para avaliar o processo de dor. à um estudo de natureza epidemiolÃgica descritiva, que se desenvolveu no Centro de Tratamento de Queimados do Instituto Dr. Josà Frota no perÃodo de agosto de 2003 a setembro de 2004. A amostra foi de 100 crianÃas, no perÃodo de marÃo a setembro de 2004. Utilizamos um formulÃrio que contÃm a Escala Visual AnalÃgicaâ EVA (escala de faces). Para consolidaÃÃo dos dados, utilizamos a computaÃÃo eletrÃnica, com o programa Statistical Package of Social Service - SPSS. Os resultados obtidos sÃo que as crianÃas do sexo masculino (56%), na faixa etÃria de 0 a 24 meses (39%), provenientes da capital (55%), tendo a cozinha como principal cenÃrio (60%), e o agente causal mais comum os lÃquidos quentes (66%), demonstrando os diversos fatores de risco, que estas crianÃas estÃo expostas, levando-as ao fenÃmeno doloroso. A dor està presente nos acidentes com queimaduras em 91% das vÃtimas, principalmente nas queimaduras de 2 e 3 graus. Na EVA a avaliaÃÃo feita pela crianÃa teve um valor bem aproximado do acompanhante, com os nÃveis 0 (sem dor), 1, 2, 4 e 5 (pior dor) ficando aproximadamente 50% para cada avaliador, demonstrando que o adulto teve uma boa avaliaÃÃo da dor da crianÃa internada, denotando conhecer bem o seu ente. Nos nÃveis de dor 1 e 2, a avaliaÃÃo do acompanhante deteve um percentual um pouco maior, demonstrando que nÃo houve grandes discrepÃncias entre estas avaliaÃÃes. Entendemos que a avaliaÃÃo da dor deva ser incluÃda na rotina diÃria de cuidados afirmando se como o quinto sinal vital.

M.Cur. / An explanatory, descriptive method was undertaken to determine the effect of cognitive-sensory guidance on the pain experience of the child with bums during wound management procedures. The Nursing Theory of Wholeness was used as a premise for this study. The internal and external environments of the child were investigated. This was done by determining the pain perception (by using the Oucher!-scale) and the pain behaviour (by using the CHEOP-scale) respectively. The internal and external environments stand in interaction with each other and reflect within a specific physical, social and spiritual context the child's body, mind and spirit. These interactive patterns will be applied within the scientific and systematic framework of the nursing process. Prior to the study, attention was given to ethical issues such as acquiring permission and prevention of damage to the respondents. From the investigation of these three case studies the conclusion can be made that cognitive-sensory guidance could possibly be effective in reducing the pain experience of the child with bums during wound management procedures. Generalisation cannot be done due to the small sample size. This study only serves as background for future research and hypothesis formulation

M.Tech. (Chiropractic) / Introduction The aim of this study is to determine whether standard leg rubs and reassurance combined with lumbosacral manipulations have an effect on growing pain symptoms by comparing it to standard leg rubs and reassurance only. The study can possibly serve as a platform for further research. Furthermore, this will be one of the first chiropractic studies done in this field and may provide the chiropractic profession with a proven treatment for growing pains. Methodology Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of fifteen participants each on a first come first serve basis. The two groups received different treatment protocols according to their group allocation. Group One received chiropractic manipulative therapy to the lumbar spine and sacroiliac joint restrictions combined with legs rubs and reassurance administered by the parent(s)/guardian(s). Group Two received only legs rubs and reassurance administered by the parent(s)/guardian(s). The participants completed the study over a period of three weeks. Subjective and objective readings were taken. Subjective readings from each participant were taken using the Oucher self-rating pain scale (OSRPS) and a pain diary completed by the parent(s)/guardian(s). Objective readings were taken using a pressure algometer over the anterior tibial muscles bilaterally. A six-week post study follow up was done via email. Results The statistical data was analyzed using the Friedman test, Mann-Whitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, Group One proved to show a quicker response to treatment over time; and the post study follow up of Group One proved to be significantly more positive than Group Two. These results highlight the positive effects of the chiropractic manipulation. Discussion The fact that the participants of Group One have improved in subjective and objective measurements and the parent(s)/guardian(s) of the participants have responded very positively to the post study follow up, one has to consider that the anatomical theory proposed by Evans and Scutter (2007), the pain referral theory supported by Cookson (2003) and the activation of pain inhibitory systems supported by Wright (1995) and Sterling et al. (2001) might all be a likely aetiologies for growing pains. However, one has to consider that the participants from Group Two, who received no spinal manipulation, have also improved in subjective and objective readings. Therefore it is possible, and cannot be excluded, that the leg rubs administered to both groups could also have played a role in relieving the growing pains. Conclusion The results of the data collected from this study, the pressure algometer and OSRPS readings, showed that spinal manipulation did not have much of a benefit. However, the pain diaries and feedback from the parent(s)/guardian(s), which are probably more reliable for growing pains, indicates that spinal manipulation does show to be beneficial.

Very few good empirical investigations of pain and coping in children and adolescents currently appear in the published literature. In contrast to the adult literature, for ethical reasons, a foundation of basic research using experimentally-induced pain does not exist in the pediatric literature (McGrath, in press). This remaining deficiency in knowledge about children's spontaneous abilities to cope with pain is particularly harmful because it means that clinicians must base their assessment and treatment of pain in children on their knowledge of adults (Jeans, 1983). The need to consider cognitive-developmental issues has been emphasized in several recent papers (Lavigne, Schulein, & Hahn, 1986; Maddux, Roberts, Sledden, & Wright, 1986; Thompson & Varni, 1986). The present investigation evaluated the pain experienced and spontaneous coping strategies used by 39 children and adolescents with various forms of arthritis, during a painful joint-measuring task which is typically part of physiotherapy treatments for this illness. The two purposes of the study were: 1) to assess age/cognitive-developmental differences and 2) to compare "effective copers" versus children who were having some difficulties coping with pain (i.e. pain was interfering with their activities of daily living). Three age groups (5-7 years, 8-10 years, and 11-18 years), corresponding to the Piagetian stages of preoperational, concrete operational and formal operational thought, were compared. Subjects were videotaped while the range of motion in their joints was measured by the physiotherapist. Videotapes were subsequently coded for behavioral coping strategy use. Immediately following the joint measurement task, subjects were interviewed regarding thoughts they recalled experiencing. Transcribed interviews were subsequently coded for cognitive coping strategies reportedly used and catastrophizing cognitions reportedly experienced. In addition, parents completed two questionnaires rating the degree to which pain interferes with their child's activities of daily living, and the physiotherapist made a global rating of each child's functional capacity. The overall MANOVA using age group as a between groups factor, with self-reported pain variables entered as dependent measures was nonsignificant. A significant multivariate effect did emerge, however, when the coping variables were entered as dependent measures in a second overall MANOVA. Follow up univariate analyses revealed an age/cognitive-developmental trend in behavioral and cognitive coping strategy use. Children in the youngest group (preoperational) used primarily behavioral strategies to cope with pain elicited by the physiotherapy joint-measuring task, whereas slightly older children (concrete operational) began to supplement their repertoire of behavioral coping strategies with some cognitive coping strategies. A significant rise in reported cognitive coping strategy use was observed in the oldest group (formal operational). In addition, a discriminant function revealed that the two most important discriminators between "effective copers" versus children having some difficulties coping with pain were the amount of pain expression (vocal or nonvocal) coded and the amount of catastrophizing thoughts reportedly experienced during the physiotherapy task. Implications of these results for the treatment of children having difficulties coping with arthritic pain are discussed. / Arts, Faculty of / Psychology, Department of / Graduate