Quality of Life in Youth With Chronic Pain: An Examination of Youth and Parent Resilience and Risk Factors.

OBJECTIVES: Pediatric chronic pain has often been examined from a risk perspective, and relatively less is known about the individual and family-level resilience factors that help youth with chronic pain maintain their quality of life (QOL). This cross-sectional study: (1) examined the relations among purported youth and parent resilience (youth pain acceptance and pain self-efficacy, parent psychological flexibility) and risk (youth pain intensity and parent protectiveness) factors with youth QOL, and (2) tested exploratory statistical mechanisms that may explain relations between parent and youth variables. METHODS: Participants included 122 youth (10 to 17 y; M=14.26, SD=2.19) seen in an interdisciplinary pediatric chronic pain program and a parent. Youth completed measures of their average pain, QOL, pain acceptance, and pain self-efficacy. Parents completed measures of their pain-related psychological flexibility and behavioral responses to pain (ie, protectiveness, distraction, monitoring, minimizing). RESULTS: Youth pain acceptance, pain self-efficacy, and parent psychological flexibility were highly positively correlated with each other, and with overall youth QOL. Evidence for a buffering effect of pain acceptance and pain self-efficacy on the association between pain intensity and QOL was not found. Protectiveness was found to be a significant mediator of the relation between parental psychological flexibility and youth QOL. DISCUSSION: The results are discussed in the context of the resilience-risk framework and current understandings of the role of parental factors for pediatric chronic pain.

Web-Based Intervention for Teachers of Elementary Students With ADHD: Randomized Controlled Trial.

OBJECTIVE: To test the acceptability, satisfaction, and effectiveness of a web-based intervention for teachers of elementary school-aged children with ADHD. METHOD: Elementary classroom teachers (N = 58), along with their students with ADHD, participated in a randomized controlled trial. The program consisted of six sessions that included evidence-based intervention strategies for reducing ADHD symptoms and impairment in the classroom setting. Teachers also had access to a moderated Discussion Board and an online ADHD coach. Questionnaire data were electronically collected from teachers and parents pre-intervention, post-intervention (6 weeks), and after an additional 6-week follow-up. RESULTS: Intent-to-treat analyses found significant improvements based on teacher (but not parent) reports of core ADHD symptoms and impairment for the Teacher Help for ADHD treatment group. Teachers reported a high level of acceptability and satisfaction. CONCLUSION: Web-based ADHD interventions have the potential to reduce the barriers to treatment utilization and implementation that are common problems for school-based ADHD interventions.

A web-based intervention for elementary school teachers of students with attention-deficit/hyperactivity disorder (ADHD).

The goal of the present study was to determine whether a web-based medium is an effective tool for supporting knowledge, attitude, and behavior change in teachers of elementary school children with attention-deficit/hyperactivity disorder (ADHD). Nineteen teachers from Nova Scotia, Canada completed a 7-week intervention that consisted of presentations, web links, and discussion board activities related to different aspects of ADHD. Teachers' knowledge positively changed from pre- to post-intervention (p = .03), as did teachers' attitudes related to perceived control in their classrooms (p = .001) and competence in teaching (p < .0001). The study demonstrated that a web-based medium is a useful tool for knowledge creation and translation and has potential as a means of providing professional development to teachers about ADHD.