Papers by Patrick McGrath
The Journal of Pain, Apr 1, 2004
Pain Research & Management, 2013
P rimary headache disorders (eg, migraine, tension-type headaches) are frequent in the general po... more P rimary headache disorders (eg, migraine, tension-type headaches) are frequent in the general population. Headache prevalence varies considerably through the lifespan, typically increasing in childhood and youth, and remaining relatively stable and high over the third to fifth decades of life before markedly declining in both sexes. Headaches can negatively impact all aspects of quality of life (psychological [1-3], work/school [4-8] and social functioning [9,10]), resulting in costly disability. Paper pain diaries have been used for several decades in diverse patient populations for many purposes. In the headache patient population, they have primarily been used to assess the impact of headaches and to evaluate the efficacy of headache treatments. However, paper headache diaries exhibit several important limitations, including participant noncompliance and inaccuracies in data entry (11). Noncompliance in participants has been found to be due to the fact that paper diaries are bulky and cannot be used easily or discreetly in the workplace or school. Inaccuracies result from false entries or multiple entries being made at a more convenient time to compensate for noncompliance (11). When pain diaries (paper or electronic) are used to assess the efficacy of treatments for recurrent and chronic pain conditions, ideally, they should conform to the recent recommendations regarding the core outcome domains suggested for use in clinical trials in children (Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials [Ped-IMMPACT]) and adults (IMMPACT) with recurrent and chronic pain (12,13). The eight core outcomes include pain, physical functioning, emotional functioning, role functioning, revieW
Pain Research & Management, 2010
BACKGROUND: Peer relationships during childhood and adolescence are acknowledged to be negatively... more BACKGROUND: Peer relationships during childhood and adolescence are acknowledged to be negatively impacted by chronic pain; however, to date there has been no synthesis of this literature. OBJECTIVE: To systematically review existing literature describing the social functioning and peer relationships in children and adolescents with recurrent or continuous chronic pain. METHODS: Articles on peer relationship factors studied in samples of children and adolescents with chronic pain published in English or French were identified using EMBASE, Medline, CINAHL and PsycINFO. Two independent reviewers performed initial screenings using study titles and abstracts, and reviewed each eligible article in full. RESULTS: Of 1740 published papers yielded by the search, 42 articles met the inclusion criteria and were included in the present review. Nine studies had peer relationship investigation as the primary purpose of the study; the remaining 33 examined peer relationships as part of a broader study. A range of specific and more general measures was used to examine peer relationships. Across studies, children and adolescents with chronic pain were reported to have fewer friends, be subjected to more peer victimization, and were viewed as more isolated and less likeable than healthy peers. CONCLUSIONS: Children and adolescents with chronic pain have peer relationship deficiencies. However, the majority of studies to date measure peer relationships as part of a broader study and, thus, little attention has been paid specifically to peer relationships in this group. Additional research examining the quality of peer relationships of children and adolescents with chronic pain, as well as development of measures specifically designed to assess these relationships, is needed.
The Clinical Journal of Pain, Apr 1, 2014
Objectives: A variety of psychological treatments exist for headaches (HAs). Their efficacy has b... more Objectives: A variety of psychological treatments exist for headaches (HAs). Their efficacy has been evaluated through systematic reviews with meta-analysis. Our goal was to evaluate the scope of these reviews and reevaluate the efficacy of treatments considering potential sources of variation systematically. These findings should help guide clinical practice and will provide guidance to researchers planning to address the efficacy of psychological treatments for HAs. Materials and Methods: Two systematic reviews were conducted: one searched for systematic reviews with meta-analysis exploring the efficacy of psychological treatments for HA in Cochrane Database, DARE, EMBASE, ISI Web of Knowledge, Medline, and PsychINFO from inception to December 2011. Two independent reviewers screened, evaluated quality, and extracted data. The second review searched for primary studies from the included reviews estimating the efficacy of psychological treatments for a clinically significant change. Results: Eighteen reviews met a priori criteria for inclusion. The broad scope of research on efficacy of psychological treatments for HA is reflected by variation in clinical and methodological characteristics of the reviews. These variations were explored through meta-analysis and subgroup analysis of 41 primary studies and showed that some of these variations, including time of assessment, treatment type, age, HA diagnosis, and study quality, can impact the magnitude of treatment effect. Discussion: There is substantial evidence in favor of psychological treatments for HA management. Further investigation, especially in specific treatments (cognitive-behavioral or autogenic treatment) for HA disorders, is needed. The assessment of these systematic reviews highlighted key areas where improvement should be made to increase the quality of evidence.
Health Informatics Journal, 2018
The main objective of this study was to preliminary explore the effects of DARWeb on different ou... more The main objective of this study was to preliminary explore the effects of DARWeb on different outcomes. A Quasi-experimental, one-group, pretest–posttest design was used. Parents and children were asked to complete questionnaires and questions (separately) about quality of life, abdominal pain severity, and satisfaction. Semi-structured interviews with families were also performed. This study focuses on 17 families. Results showed that parent’s ratings of children’s abdominal pain severity were significantly lower after finishing the intervention and at the 3-month follow-up, and quality of life scores had increased significantly after 3 months. From children’s ratings, mean abdominal pain severity scores were significantly lower after the intervention compared to the preintervention assessment. Both parents and children were quite satisfied with the intervention. In qualitative interviews, families suggested that DARWeb helped them to give less importance to pain and to learn copi...
Pain Research and Management, 2010
BACKGROUND: Although children experience pain during their daily life, research has generally foc... more BACKGROUND: Although children experience pain during their daily life, research has generally focused on medical pain. Sport-related pain has not been widely studied in children and research has not examined the occurrence of painful incidents in gymnastics. The prevalence of painful incidents among children in recreational gymnastics classes and accompanying coach responses were recorded.METHODS: Sixty-one children between five and 10 years of age were observed at a gymnastics club. A checklist was used to record painful incidents as well as coach and child responses.RESULTS: The rate of painful incidents was 0.17 per child per hour observed. The floor apparatus was the most common site of incidents, while bumping into equipment was the most common incident. Based on observer ratings, most incidents were mild to moderate in severity and, on average, the child’s reaction to these mild to moderate incidents lasted for 8.5 s. Forty per cent of the children had a mild to moderate painf...
Pain Research and Management, 2008
BACKGROUND: Hospitalized infants undergo multiple, repeated painful procedures. Despite continued... more BACKGROUND: Hospitalized infants undergo multiple, repeated painful procedures. Despite continued efforts to prevent procedural pain and improve pain management, clinical guidelines and standards frequently do not reflect the highest quality evidence from systematic reviews.OBJECTIVE: To critically appraise all systematic reviews on the effectiveness of procedural pain interventions in hospitalized infants.METHODS: A structured review was conducted on published systematic reviews and meta-analyses of pharmacological and nonpharmacological interventions of acute procedural pain in hospitalized infants. Searches were completed in the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL and PsycINFO. Two reviewers independently selected articles for review and rated the methodological quality of the included reviews using a validated seven-point quality assessment measure. Any discrepancies were resolved by a third reviewer.RESULTS: Of 1469 potential systematic reviews on i...
Pain Research and Management, 2008
Research in the field of pediatric pain has largely ignored the role of fathers in their children... more Research in the field of pediatric pain has largely ignored the role of fathers in their children’s pain experiences. The first objective of the present study was to examine the effect of the presence of mothers versus fathers on children’s subjective ratings, facial expressions and physiological responses to acute pain. The second objective was to examine whether child and parent sex influence parents’ proxy ratings of their children’s pain. The final objective was to compare levels of agreement between mothers’ and fathers’ assessments of their children’s pain. Participants included 73 children (37 boys, 36 girls), four to 12 years of age, along with 32 fathers and 41 mothers. Children undertook the cold pressor pain task while observed by one of their parents. During the task, the children’s heart rates and facial expressions were recorded. Children provided self-reports and parents provided proxy reports of child pain intensity using the seven-point Faces Pain Scale. Neither chi...
Pain Research and Management, 2014
BACKGROUND: Published reports of substantial rates of moderate to severe pediatric inpatient pain... more BACKGROUND: Published reports of substantial rates of moderate to severe pediatric inpatient pain tend to overlook lower-intensity pain that may be clinically significant.OBJECTIVE: To document the prevalence of clinically significant pain in pediatric inpatients by considering the pain threshold at which each child desires intervention, and to assess sources of pain, pain assessment and intervention, and relationships among demographic and medical variables to reported pain.METHODS: Inpatients or their parents on four hospital units during four nonconsecutive days were eligible for inclusion. Interviews (76 parents; 31 patients) captured experiences of 107 inpatients (three weeks to 18 years of age) including current, worst and usual pain, pain treatment thresholds, sources of pain and help received during the previous 24 h. A chart review provided data regarding demographic and medical variables, and pain assessment and management.RESULTS: In total, 94% of patients experienced pai...
JMIR research protocols, Jan 13, 2015
Fetal alcohol spectrum disorder (FASD) is a term used to encompass the full range of neurobehavio... more Fetal alcohol spectrum disorder (FASD) is a term used to encompass the full range of neurobehavioral and cognitive dysfunction that may occur as a consequence of prenatal alcohol exposure. There is relatively little research on intervention strategies that specifically target the behavioral problems of children with FASD. Availability and access to services are barriers to timely and effective care for families. The Strongest Families FASD intervention was recently adapted from the Strongest Families "Parenting the Active Child" program to include FASD-specific content delivered via an Internet-based application in conjunction with 11 telephone coaching sessions. Our objectives are to (1) evaluate the effectiveness of Strongest Families FASD in reducing externalizing problems (primary outcome), internalizing problems, and parent distress (secondary outcomes) in children aged between 4 and 12 years diagnosed with FASD when compared to a control group with access to a static...
Journal of pediatric psychology, 2012
OBJECTIVE: To investigate the impact of experimentally manipulated state anxiety and the influenc... more OBJECTIVE: To investigate the impact of experimentally manipulated state anxiety and the influence of anxiety-related variables on children's memories for pain. METHODS: A total of 110 children (60 boys) between the ages of 8 and 12 years were randomly assigned to complete a state anxiety induction task or a control task. Following experimental manipulation, children completed a laboratory pain task, pain ratings, and questionnaire measures of anxiety-related variables. 2 weeks later, children provided pain ratings based on their memories of the pain task. RESULTS: The experimental manipulation effectively induced state anxiety; however, pain memories did not differ between groups. Irrespective of group assignment, children with higher state anxiety had more negative pain memories. State anxiety uniquely predicted children's pain memories over and above other well established factors. Anxiety sensitivity and trait anxiety were significant predictors of recalled pain-relate...
Evidence-Based Child Health: A Cochrane Review Journal, 2008
The objectives are as follows: To assess the efficacy of cognitive-behavioral psychological inter... more The objectives are as follows: To assess the efficacy of cognitive-behavioral psychological interventions for needle-related procedural pain and distress in children and adolescents. Psychological interventions for needle-related procedural pain and distress in children and adolescents (Protocol)
The Clinical Journal of Pain, 2014
Objective: The current study investigated the construct validity of a multidimensional pain diary... more Objective: The current study investigated the construct validity of a multidimensional pain diary for youth with juvenile idiopathic arthritis and also compared participants" responses on electronic and retrospective diary measures. The purpose of the latter part of this study was to compare absolute agreement, between and within-person consistency and judged change in weekly pain between these two methods of assessing pain. Methods: 70 adolescents with Juvenile Idiopathic Arthritis (JIA) completed both weekly recalled and momentary reports of pain over a 2-week period and assessed their change in pain over the 2-week period using 5-point global change in pain scale. Pearson correlations and intra-class correlation coefficients were computed to demonstrate three different ways of comparing the measures on both a between-persons and within-person basis. Results: Momentary ratings of pain episodes were consistently greater than weekly ratings of recalled pain. Moderate to strong consistency and agreement correlations were computed for between-person momentary and recalled pain intensity. However, these correlations were much weaker when the within-person data were analyzed. The judged change in pain across weeks was significantly associated with computed change in both average momentary and recalled pain. Discussion: This is one of the few studies to explore the relationship between the measurement methods of pain recall and momentary assessment in adolescents. The poor within-person correlations observed have important implications for research design and practice in pediatric pain.
Canadian Journal of Pain, 2019
Background: The 2018 Global Year for Excellence in Pain Education, an initiative of the Internati... more Background: The 2018 Global Year for Excellence in Pain Education, an initiative of the International Association for the Study of Pain, brought worldwide attention to the need for education that crosses narrow disciplinary boundaries, addresses up-to-date research methods and findings, and encourages teamwork among trainees and mentors at different levels of training and with different perspectives. Aims: This commentary describes the development of Pain in Child Health (PICH), an interdisciplinary training program for researchers in pediatric pain at the undergraduate, graduate, and postdoctoral levels of training. Methods: Based on documentation of the structure, training processes, leadership, and membership of PICH, we outline its organization and its challenges and accomplishments over the first 12 years of its growth into a well-known international program. Results and Conclusions: Pain in Child Health began as a Strategic Training Initiative of the Canadian Institutes of Health Research in 2002 and developed into an international research training consortium featuring cross-site and cross-discipline mentorship and collaboration. PICH trainees and alumni have contributed extensively to the current scientific literature on children's pain. PICH could serve as a possible model for training and mentorship in other specialized health research domains within and outside thestudy of pain.
Advances in Neonatal Care, Apr 1, 2017
BACKGROUND AND SIGNIFICANCE The admission of an infant to the neonatal intensive care unit (NICU)... more BACKGROUND AND SIGNIFICANCE The admission of an infant to the neonatal intensive care unit (NICU) is a very stressful experience for families. Feeling unprepared is a large contributor to this distress, with many parents feeling emotionally and educationally ill-equipped to fully participate in their infant's care. 1 , 2 Despite a growing movement toward family-centered care in many NICUs 3-5 and an abundance of research that identifies the benefits for both parent and child when parents are actively involved in their infant's care, 6-9 studies show that parents still desire to be provided with more information 1 , 10 and to be more involved. 10 , 11 Information Seeking in the NICU New parents of an infant in the NICU can spend up to 20 hours a week participating in informationseeking behavior, 12 and today's parents routinely consult the Internet to satisfy their information needs. 13-15 The Internet provides free, convenient, and private access to health information. 14 It also provides an opportunity to share and exchange information via social media sites, which is becoming an increasingly popular means for parents to acquire health information 16 and social support. 13 , 15
The Journal of Pain, Apr 1, 2016
sociocultural factors related to the doctor-patient relationship, such as feelings of trust, simi... more sociocultural factors related to the doctor-patient relationship, such as feelings of trust, similarity, and liking, may mediate previously reported racial discordance effects. In the present study, we tested the effects of doctor-patient shared group membership and patient ratings of doctor similarity, trust and liking on patient reported pain during simulated clinical interactions. A mixed-ethnicity sample of 80 participants (40 male), age 19-54 years old, was divided into two groups ostensibly based on the similarity of their self-reported beliefs (actually random), and then randomly assigned the role of doctor or patient. Participants took part in two simulated clinical interactions in which patients rated pain from 16 thermal heat stimulations delivered by an ingroup or outgroup doctor. Patients reported greater trust, similarity, and liking of ingroup than outgroup doctors, and patients' average ratings of their feelings towards their doctors predicted both continuous pain intensity rating during each heat stimulation and overall pain intensity rating completed after each heat stimulation. These results suggest that interventions aimed at increasing patient feelings of trust, similarity, and liking to their doctors may decrease patient reported pain during medical care regardless of racial and ethnic discordance. Such interventions may help mitigate the negative impact of doctor-patient racial and ethnic discordance in pain treatment.
Jmir mhealth and uhealth, Aug 19, 2014
Background: Headache diaries are often used by headache sufferers to self-monitor headaches. With... more Background: Headache diaries are often used by headache sufferers to self-monitor headaches. With advances in mobile technology, mobile electronic diary apps are becoming increasingly common. Objective: This review aims to identify and evaluate all commercially available mobile headache diary apps for the two most popular mobile phone platforms, iOS and Android. Methods: The authors developed a priori a set of 7 criteria that define an ideal headache diary app intended to help headache sufferers better understand and manage their headaches, while providing relevant data to health professionals. The app criteria were intended as minimum requirements for an acceptable headache diary app that could be prescribed by health care professionals. Each app was evaluated and scored against each criterion. Results: Of the 38 apps identified, none of the apps met all 7 app criteria. The 3 highest scoring apps, meeting 5 of the app criteria, were iHeadache (developed by Better QOL), ecoHeadache (developed by ecoTouchMedia), and Headache Diary Pro (developed by Froggyware). Only 18% of the apps were created with scientific or clinical headache expertise and none of the apps reported on psychometric properties. Conclusions: Despite the growing market and demand, there is a concerning lack of scientific expertise and evidence base associated with headache diary apps.
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Papers by Patrick McGrath