Browsing by Author "Stinson, Jennifer N."

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    Development and Acceptability of an Adolescent Self-Management Program for Juvenile Idiopathic Arthritis
    (2020-09-04) Chomistek, Kelsey; Schmeling, Heinrike; Barnabé, Cheryl Carmelle Marie; Santana, Maria Jose; Stinson, Jennifer N.
    Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease in children diagnosed under the age of 16 years. The overarching aim of this thesis was to develop and evaluate the acceptability of a self-management program (SMP) for adolescents with JIA. A systematized review of literature was conducted to understand the effectiveness of pre-existing self-management interventions for adolescents with JIA. The findings of this review provided insight into the key elements of our SMP, including the creation of a multicomponent and multisession intervention. In the development phase, the content, format, and structure of our program was determined using a previously completed needs assessment for adolescents with JIA and additional input from adolescents with JIA and interdisciplinary pediatric rheumatology health professionals at the Alberta Children’s Hospital. The program incorporated knowledge from the Public Health Ontario Program Planner framework and Lorig’s self-management theory. Semi-structured focus groups were conducted with adolescents with JIA and healthcare providers to examine the acceptability of the SMP. Finally, thematic analysis of the focus groups was performed to evaluate the acceptability of the program. Findings from the qualitative phase revealed that adolescents and healthcare providers appreciated the program. Participants provided valuable recommendations to improve its structure, design aesthetics, and content prior to conducting future feasibility and effectiveness trials. The findings from this thesis contribute to existing research on the development and acceptability of group-based, in-person, and videoconference SMP for adolescents with JIA and could inform future feasibility and effectiveness trials.
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    Remembering the pain of surgery 1 year later: a longitudinal examination of anxiety in children's pain memory development
    (International Association for the Study of Pain, 2019-01) Noel, Melanie; Rosenbloom, Brittany N.; Pavlova, Maria; Campbell, Fiona; Isaac, Lisa A.; Pagé, M. Gabrielle; Stinson, Jennifer N.; Katz, Joel D.
    Children who develop greater negatively-biased recall of pain (ie, recalled pain is higher than the initial pain report) following surgery are at risk for developing chronic pain; therefore, identifying risk factors for the development of biased pain memories is important. Higher anxiety has been implicated in the development of greater negatively-biased recall of pain; however, studies have not examined anxiety at multiple time points before and after a surgery and its relationship to children's post-surgical pain memories after 1 year. This prospective study examined a cohort of 237 children and adolescents undergoing major surgery. Anxiety sensitivity, pain catastrophizing, and pain anxiety were assessed at baseline, 48 to 72 hours after surgery, and at 6- and 12-month follow-ups. Pain intensity at rest, movement-evoked pain intensity, and pain unpleasantness were assessed daily in hospital. Memories for pain were elicited via telephone 1-year post-surgery. Findings revealed that children who had higher levels of anxiety at baseline and 48 to 72 hours after surgery developed greater negatively-biased recall of pain intensity 12 months after surgery. Specifically, higher anxiety sensitivity at baseline and greater tendencies to catastrophize about pain at baseline and in the immediate acute recovery phase were most strongly linked to greater negatively-biased recall of pain. Greater negatively-biased recall of pain was related to higher pain intensity at 6 and 12 months post-surgery. Findings support conceptual models of anxiety and pain memory biases and can inform intervention efforts to reduce anxiety in the pre- and post-op periods to minimize negative biases in pain memories.