Pain-specific Beliefs and Pain Experience in Children with Juvenile Idiopathic Arthritis: A Longitudinal Study

Abstract

Objective.To assess longitudinal associations between pain-specific health beliefs and pain in children with juvenile idiopathic arthritis (JIA), and to compare a selected group of patients with high pain and low disease activity (high-pain patients) with the remaining group.Methods.Forty-seven children with JIA, aged 7–15 years, completed the children’s version of the Survey of Pain Attitudes (SOPA-C) and a 3-week pain diary at study entry (T1) and in a followup study 2 years later (T2). Parents also rated the Childhood Health Assessment Questionnaire (CHAQ), and an arthritis activity score was calculated each time. Second-order principal component analysis was conducted to reduce the number of independent variables. Regression analysis of the dependent measure was performed. The use of health beliefs was compared using t test for independent samples.Results.T1 health beliefs predicted 7% of the variance in T2 pain scores after controlling for T1 pain, CHAQ, and disease activity. At T2, statistical differences were found between the scores of the high-pain group and the rest of the group for the health belief subscales of disability (mean ± SD 2.7 ± 0.5 and 2.2 ± 0.7, respectively) and harm (mean ± SD 3.8 ± 0.8 and 3.3 ± 0.6).Conclusion.Our findings suggest that pain beliefs are influential on the longitudinal course of pain in children with JIA. Dysfunctional health beliefs in patients with high pain seem to be stable over time.