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Rheumatology Advance Access originally published online on October 17, 2003
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Rheumatology 2004; 43: 325-330
Rheumatology Vol. 43 No. 3 (c) British Society for Rheumatology 2003; all rights reserved

Clinical

The relationship between health-related quality of life, pain and coping strategies in juvenile idiopathic arthritis

M. G. Sawyer, J. N. Whitham, D. M. Roberton1, J. E. Taplin2, J. W. Varni3 and P. A. Baghurst4

Research and Evaluation Unit and 1Rheumatology Clinic, Women's and Children's Hospital and Department of Paediatrics, University of Adelaide, South Australia, 2Department of Psychology, University of Adelaide, South Australia, 3Colleges of Architecture and Medicine, Texas A&M University, College Station, Texas, USA and 4Public Health Research Unit, Women's and Children's Hospital, South Australia.

Correspondence to: M. Sawyer, Research and Evaluation Unit, Women's and Children's Hospital, 72 King William Rd, North Adelaide, South Australia 5006, Australia. E-mail: michael.sawyer{at}adelaide.edu.au

Objectives. To investigate the relationship between health-related quality of life (HRQL), experience of pain and pain coping strategies in children with juvenile idiopathic arthritis (JIA). To compare reports describing these variables obtained from children and their parents.

Methods. Participants were 59 children aged 8 to 18 yr with JIA and their parents. Parents and children completed the PedsQLTM generic core scales and arthritis module, the visual analogue scale of the Varni–Thompson Pediatric Pain Questionnaire, and the Waldron/Varni Pediatric Pain Coping Inventory. Parents rated children's functional disability using the Childhood Health Assessment Questionnaire.

Results. Parents reported significantly lower scores (indicating worse HRQL) than children on five of the eight PedsQLTM scales rating children's HRQL. Parents and children reported a significant negative relationship between pain levels and the PedsQLTM scores assessing children's physical, emotional and social functioning. They also reported a significant negative relationship between scores on several pain coping scales and scores on the PedsQLTM scales. However, the pattern of these relationships varied for reports from parents and children.

Conclusions. Pain intensity and pain coping strategies have a significant and independent relationship with several domains that comprise the HRQL of children with JIA. However, parents and children have differing perceptions of the nature of these relationships. The differences emphasize the importance of clinicians obtaining information about children's HRQL, pain levels and pain coping strategies from both parents and children.

KEY WORDS: Juvenile idiopathic arthritis, Health-related quality of life, Functional disability, Paediatric pain, Coping strategies.


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