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Mothers' Responses to Children's Pain

Van Slyke, Deborah A. PhD; Walker, Lynn S. PhD

The Clinical Journal of Pain: May 2006 - Volume 22 - Issue 4 - p 387-391
doi: 10.1097/01.ajp.0000205257.80044.01
Original Articles

Objectives This study was aimed at identifying mothers' responses to children's pain, evaluating whether these could be organized into different types of responses, and developing a questionnaire to assess these responses.

Methods Common responses to children's pain were identified on the basis of a review of the literature and interviews with mothers of pediatric patients with pain. Categories reflecting these parenting behaviors were generated for a questionnaire on Adult Responses to Children's Symptoms, which was administered to 145 mothers of pediatric patients aged between 8–18 years referred for medical evaluation of abdominal pain.

Results Factor analysis using principal components extraction with oblique rotation yielded 3 factors. Factor 1, Protect, reflected caretaking behaviors that placed the child in a passive sick role. Factor 2, Minimize, reflected criticism of the child's pain behavior. Factor 3, Encourage and Monitor, reflected encouragement of the child's activity while monitoring the child's symptoms. Subscales based on these correlated factors had good internal consistency.

Discussion Results suggest that mothers' responses to children's pain behavior may be classified into 3 distinct categories. Additional research is needed to assess whether observational methodologies would yield a similar typology of parents' responses to children's pain. Psychometric properties of the Adult Responses to Children's Symptoms should be examined in larger samples and in studies of the relation of the subscales to related constructs (eg, measures of parenting beliefs and behavior) and to children's pain behavior.

Vanderbilt University Medical Center, USA

Reprints: Lynn S. Walker, PhD, Division of Adolescent Medicine and Behavioral Science, 11128 DOT, Vanderbilt Children's Hospital, Nashville, TN 37232-9060, USA (e-mail:

Received for publication February 3, 2005; revised August 28, 2005; accepted August 30, 2005

© 2006 Lippincott Williams & Wilkins, Inc.