Development and Evaluation of the Abdominal Pain Knowledge Questionnaire (A-PKQ) for Children and Their Parents

Overview

Journal Children (Basel)

Specialty Health Services

Date 2024 Jul 27

PMID 39062295

Authors

Verena Ness

Clarissa Humberg

Franka Lucius

Leandra Eidt

Thomas Berger

Martin Classen

Nils Christian Syring

Jens Berrang

Christine Vietor

Stephan Buderus

Lisa-Marie Rau

Julia Wager

Affiliations

Soon will be listed here.

Abstract

Background: Abdominal pain is a common and often debilitating issue for children and adolescents. In many cases, it is not caused by a specific somatic condition but rather emerges from a complex interplay of bio-psycho-social factors, leading to functional abdominal pain (FAP). Given the complex nature of FAP, understanding its origins and how to effectively manage this condition is crucial. Until now, however, no questionnaire exists that targets knowledge in this specific domain. To address this, the Abdominal Pain Knowledge Questionnaire (A-PKQ) was developed.

Methods: Two versions were created (one for children and one for parents) and tested in four gastroenterology clinics and one specialized pain clinic in Germany between November 2021 and February 2024. Children between 8 and 17 years of age ( = 128) and their accompanying parents ( = 131) participated in the study. Rasch analysis was used to test the performance of both versions of the questionnaire.

Results: The original questionnaires exhibited good model and item fit. Subsequently, both questionnaires were refined to improve usability, resulting in final versions containing 10 items each. These final versions also demonstrated good model and item fit, with items assessing a variety of relevant domains.

Conclusion: The A-PKQ is an important contribution to improving assessment in clinical trials focused on pediatric functional abdominal pain.

References

Brekke M, Brodwall A . Understanding parents' experiences of disease course and influencing factors: a 3-year follow-up qualitative study among parents of children with functional abdominal pain. BMJ Open. 2020; 10(8):e037288. PMC: 7462228. DOI: 10.1136/bmjopen-2020-037288. View

Ramchandani P, Murray L, Romano G, Vlachos H, Stein A . An investigation of health anxiety in families where children have recurrent abdominal pain. J Pediatr Psychol. 2010; 36(4):409-19. DOI: 10.1093/jpepsy/jsq095. View

Jaaniste T, Jia N, Lang T, Goodison-Farnsworth E, McCormick M, Anderson D . The relationship between parental attitudes and behaviours in the context of paediatric chronic pain. Child Care Health Dev. 2016; 42(3):433-8. DOI: 10.1111/cch.12312. View

Iovino P, Tremolaterra F, Boccia G, Miele E, Ruju F, Staiano A . Irritable bowel syndrome in childhood: visceral hypersensitivity and psychosocial aspects. Neurogastroenterol Motil. 2009; 21(9):940-e74. DOI: 10.1111/j.1365-2982.2009.01303.x. View

Hennell S, Brownsell C, Dawson J . Development, validation and use of a patient knowledge questionnaire (PKQ) for patients with early rheumatoid arthritis. Rheumatology (Oxford). 2004; 43(4):467-71. DOI: 10.1093/rheumatology/keh069. View

Schroeder S, Hechler T, Denecke H, Muller-Busch M, Martin A, Menke A . [German Pain Questionnaire for Children, Adolescents and Parents (DSF-KJ). A multimodal questionnaire for diagnosis and treatment of children and adolescents suffering from chronic pain]. Schmerz. 2010; 24(1):23-37. DOI: 10.1007/s00482-009-0864-8. View

Chitkara D, Rawat D, Talley N . The epidemiology of childhood recurrent abdominal pain in Western countries: a systematic review. Am J Gastroenterol. 2005; 100(8):1868-75. DOI: 10.1111/j.1572-0241.2005.41893.x. View

Korterink J, Devanarayana N, Rajindrajith S, Vlieger A, Benninga M . Childhood functional abdominal pain: mechanisms and management. Nat Rev Gastroenterol Hepatol. 2015; 12(3):159-71. DOI: 10.1038/nrgastro.2015.21. View

Di Lorenzo C, Colletti R, Lehmann H, Boyle J, Gerson W, Hyams J . Chronic Abdominal Pain In Children: a Technical Report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005; 40(3):249-61. DOI: 10.1097/01.mpg.0000154661.39488.ac. View

10.

Qiu S, Xia Y, Tian F, Yang Y, Song J, Chen L . Using a cartoon questionnaire to improve consent process in children: a randomized controlled survey. Pediatr Res. 2020; 90(2):411-418. DOI: 10.1038/s41390-020-01227-2. View

11.

Thabane M, Simunovic M, Akhtar-Danesh N, Garg A, Clark W, Collins S . An outbreak of acute bacterial gastroenteritis is associated with an increased incidence of irritable bowel syndrome in children. Am J Gastroenterol. 2010; 105(4):933-9. DOI: 10.1038/ajg.2010.74. View

12.

Thornton G, Goldacre M, Goldacre R, Howarth L . Diagnostic outcomes following childhood non-specific abdominal pain: a record-linkage study. Arch Dis Child. 2015; 101(4):305-9. DOI: 10.1136/archdischild-2015-308198. View

13.

Youssef N, Murphy T, Langseder A, Rosh J . Quality of life for children with functional abdominal pain: a comparison study of patients' and parents' perceptions. Pediatrics. 2006; 117(1):54-9. DOI: 10.1542/peds.2005-0114. View

14.

Ma X, Yu W, Lu Y, Yang H, Li X, Kang D . Pain knowledge of patients and family caregivers as predictors of pain management outcomes in cancer patients: a multicenter study in China. Support Care Cancer. 2021; 30(1):575-584. DOI: 10.1007/s00520-021-06457-6. View

15.

Ayonrinde O, Ayonrinde O, Adams L, Sanfilippo F, O Sullivan T, Robinson M . The relationship between abdominal pain and emotional wellbeing in children and adolescents in the Raine Study. Sci Rep. 2020; 10(1):1646. PMC: 6997389. DOI: 10.1038/s41598-020-58543-0. View

16.

Sjolund J, Uusijarvi A, Tornkvist N, Kull I, Bergstrom A, Alm J . Prevalence and Progression of Recurrent Abdominal Pain, From Early Childhood to Adolescence. Clin Gastroenterol Hepatol. 2020; 19(5):930-938.e8. DOI: 10.1016/j.cgh.2020.04.047. View

17.

Mayer E, Gupta A, Kilpatrick L, Hong J . Imaging brain mechanisms in chronic visceral pain. Pain. 2015; 156 Suppl 1:S50-S63. PMC: 4428597. DOI: 10.1097/j.pain.0000000000000106. View

18.

Eccleston C, McCracken L, Jordan A, Sleed M . Development and preliminary psychometric evaluation of the parent report version of the Bath Adolescent Pain Questionnaire (BAPQ-P): A multidimensional parent report instrument to assess the impact of chronic pain on adolescents. Pain. 2007; 131(1-2):48-56. DOI: 10.1016/j.pain.2006.12.010. View

19.

Crushell E, Rowland M, Doherty M, Gormally S, Harty S, Bourke B . Importance of parental conceptual model of illness in severe recurrent abdominal pain. Pediatrics. 2003; 112(6 Pt 1):1368-72. DOI: 10.1542/peds.112.6.1368. View

20.

Choi B, Pak A . A catalog of biases in questionnaires. Prev Chronic Dis. 2005; 2(1):A13. PMC: 1323316. View