Development of a tool to assess a child's concept of pain

This thesis builds upon the growing evidence base for pain science education in children, specifically in terms of developing and testing an assessment tool for a child's concept of pain. The overarching aim of this thesis is to develop and test an assessment tool for a child's concept of pain using rigorous methodology that includes input from both patients and experts. To provide background and depth to the development and potential applications of this assessment tool, this thesis will investigate pain science education, prognostic factors in paediatric pain, and a child's concept of pain. The need for an assessment tool for a child's concept of pain was demonstrated by: (1) observing the limitations of a knowledge-based tool for adults, (2) identifying an inability to include the construct of a child's concept of pain in a prognostic systematic review because of a lack of assessment tool, and (3) agreement from surveyed paediatric pain experts that it is highly important and useful to assess a child's concept of pain and that published resources designed for adult pain science education are seen as too complex for children. The importance of using child-friendly, age-appropriate language in such a tool was demonstrated qualitatively where it was found that the concept of pain of Australian children aged 8-12 years varied depending on their knowledge and experiences. Testing of the psychometric properties of the developed assessment tool demonstrated that the Concept of Pain Inventory (COPI) is a brief, psychometrically sound tool to assess a child's concept of pain. Clinically, this tool may facilitate individualized pain science education to target identified conceptual 'gaps' or misconceptions, as well as to evaluate the effectiveness of pain science education in children. These findings have immediate relevance to clinical practice and provide guidance for future research in the field.