219: A Systematic Review of Interventions Improving Pain Communication Across Pediatric Clinical Contexts

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Psychology, Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: Chronic musculoskeletal pain affects 17 to 35% of children and young people (1). Pain communication enables healthcare professionals to capture information about patients’ pain experiences, provide opportunities to form therapeutic alliances and validate the individual’s experience, improving pain management and health outcomes (2). Despite this, research indicates that many healthcare professionals report feeling unconfident discussing pain with children and young people and receive little training on pain communication (3). Pain communication can be improved through behaviour change interventions, and this review aims to systematically identify and characterise the evidence of existing interventions to improve pain communication in paediatric contexts.

Methods: A mixed methods systematic review of online databases (PubMed, PsycInfo, Web of Science, Embase, Cinahl, and MEDLINE), following PRISMA guidelines. Inclusion criteria were peer-reviewed studies, not limited by study design, with full text available in English and investigating pain communication interventions across all paediatric clinical contexts. Two independent reviewers screened titles and abstracts and are conducting full text reviews, with a third reviewer resolving disagreements. Risk of bias will be assessed using including the GUIDED scale (4) and the Theoretical Framework of Acceptability (5).

Results: After removing duplicates (n=375), title and abstract screening (n = 1532) identified 39 studies eligible for progression to full text review. Studies included at full text review (n = 12) have indicated early findings in which the identified interventions primarily feature a mobile or online element. It is also apparent that pain communication features as a secondary target behaviour in identified interventions, with improvements in assessing and managing pain being a primary focus. No results have been found for specific pain communication interventions in paediatric rheumatology (n = 0), highlighting a significant gap in intervention research.

Conclusions: This systematic review is the first to synthesise literature on interventions to improve pain communication in paediatric clinical contexts. Early findings identify clinical settings that may benefit from pain communication interventions, demonstrating a gap in intervention-focused research. These findings will inform intervention co-design by identifying clinical settings lacking communication interventions despite the need for improvement for effective pain management, and by synthesising existing evidence to identify effective approaches for intervention development. This combined evidence will ultimately contribute to improvements in communication and patient outcomes, through greater efficiency in consultations, stronger therapeutic alliances through symptom validation, and increased healthcare engagement.

References: 1. Chambers, C. T., Dol, J., Tutelman, P. R., Langley, C. L., Parker, J. A., Cormier, B. T., Macfarlane, G. J., Jones, G. T., Chapman, D., Proudfoot, N., Grant, A., & Marianayagam, J. (2024). The prevalence of chronic pain in children and adolescents: a systematic review update and meta-analysis. PAIN, 165(10). https://doi.org/10.1097/j.pain.0000000000003267
2. Mistiaen P, van Osch M, van Vliet L, Howick J, Bishop FL, Di Blasi Z, et al. The effect of patient–practitioner communication on pain: a systematic review. European Journal of Pain [Internet]. 2015 Oct 22 [cited 2026 Feb 14];20(5):675–88. Available from: https://pubmed.ncbi.nlm.nih.gov/26492629/#:~:text=Results:%20Fifty%2Done%20studies%20covering,emotional%20care%20lowering%20patients'%20pain.
3. Lee, R. R., Rashid, A., Thomson, W., & Cordingley, L. (2019). “Reluctant to assess pain”: A qualitative study of health care professionals’ beliefs about the role of pain in juvenile idiopathic arthritis. Arthritis Care Research, 72(1), 69.
4. Duncan E, O’Cathain A, Rousseau N, Croot L, Sworn K, Turner KM, et al. Guidance for reporting intervention development studies in health research (GUIDED): an evidence-based consensus study. BMJ Open [Internet]. 2020 Apr [cited 2026 Feb 14];10(4):e033516. Available from: https://bmjopen.bmj.com/content/10/4/e033516
5. Sekhon M, Cartwright M, Francis JJ. Acceptability of health care interventions: A theoretical framework and proposed research agenda. British Journal of Health Psychology [Internet]. 2018 Feb 16 [cited 2026 Feb 14];23(3):519–31. Available from: https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/bjhp.12295

Presenting Author: Rebecca Lee
Submitting Author: Emily Hanley

Senior Author: Rebecca Lee

IASP 2026 Global Year theme of Neuropathic Pain: No

• Rebecca R Lee: PhD - University of Manchester
• Anisa Yaseen: MSc - University of Manchester
• Michelle Briggs: PhD - University of Liverpool
• Sarah Peters: PhD - University of Manchester
• Danielle C Mountain: PhD - Edge Hill University
• Emily Hanley - Faculty of Biology, Medicine & Health Division of Musculoskeletal & Dermatological Sciences University of Manchester