What are the needs of adolescents and young adults after a cancer treatment? A Delphi study.

Advances in the early detection of cancer and the development of more effective treatments have resulted in a larger number of adolescents and young adults (AYAs), becoming cancer survivors. However, knowledge regarding their needs and if those needs are adequately addressed remains limited. The aims of this study were to: (1) better understand the needs of AYAs after cancer treatment; (2) analyse the importance of those needs; (3) determine which needs are not adequately addressed; and (4) test the hypothesis that AYA cancer survivors have different needs than adult survivors. Twenty-nine health oncology professionals, 17 AYA survivors and 12 relatives of AYA survivors participated in the Delphi study. The needs identified could be classified into six categories, and all were rated as highly important by all participants. The category perceived as least adequately addressed across the three groups was 'Counselling and psychological support.' The findings provide important new information regarding the needs of AYA cancer survivors that can inform the development of interventions to improve the quality of life of these individuals.

Validity of three rating scales for measuring pain intensity in youths with physical disabilities.

BACKGROUND: There is growing evidence confirming that youths with physical disabilities are at risk for chronic pain. Although many scales for assessing pain intensity exist, it is unclear whether they are all equally suitable for youths. The aim of this study was to address this knowledge gap by comparing the validity of the Numerical Rating Scale (NRS-11), the Wong Baker FACES Pain Rating Scale (FACES), and a 6-point categorical Verbal Rating Scale (VRS-6) for assessing pain intensity among youths (aged 8-20) with physical disabilities. METHODS: One hundred and thirteen youths (mean age = 14.19 years; SD = 2.9) were interviewed and asked to rate their current pain intensity and recalled (in the past week) worst, least, and average pain with the NRS-11 and the FACES. Participants were also asked to rate their average pain intensity during the past 4 weeks using a VRS-6, and were administered measures assessing pain interference, disability and psychological functioning. RESULTS: Analyses showed that all of the pain intensity measures were associated positively with each other. Nevertheless, the NRS-11 appeared to out-perform both the VRS-6 and in particular the FACES scale with respect to: (1) the associations with the validity criterion (i.e. pain interference, disability and psychological functioning) and (2) a lack of any moderating effect of age on the association between the measure and the criterion variables. CONCLUSIONS: The findings support the validity of the NRS-11 for assessing pain intensity in youths with physical disabilities between the ages of 8 and 20 years.

Electrodermal responses and memory recall in migraineurs and headache-free controls.

BACKGROUND: Chronic pain patients show increased peripheral activity when exposed to stimuli relevant to their pain problem. It has been suggested that in migraine there is a highly specific conditioning or sensitization to pain stimuli. The aims of this study were to analyse whether migraineurs (1) are sensitive not only to pain-related but also to other negative emotional words; and (2) show a memory bias for pain words, when compared to headache-free controls. METHODS: Sixty-six adults participated in the study ( X ̅ = 27 years; SD = 7). They observed 30 words (pain or negative emotional or neutral) in a pseudo-randomized order. Subsequently, participants were asked to recall the words presented during the trial. RESULTS: Skin conductance responses (SCRs) induced by pain descriptors and emotional words were very similar to each other and significantly larger than those induced by neutral words; however, there were no differences between both groups in SCRs. Significant differences in immediate memory recall were found between the two groups: migraineurs recalled more emotional words than controls. CONCLUSIONS: The findings suggest that in migraine, not only pain-related but also negative emotional words may act as triggers. These outcomes may have therapeutic implications as interventions could target problematic pain-related memories that influence migraine pain perception and pain-related physiological responses.