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Children (Basel). 2017 Jan 30;4(2). pii: E11. doi: 10.3390/children4020011.

Parent and Child Report of Pain and Fatigue in JIA: Does Disagreement between Parent and Child Predict Functional Outcomes?

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Duke Children's Hospital and Health Center, 2301 Erwin Road, Durham, NC 27710, USA.
Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, M/S CW8-6, Seattle, WA 98145, USA.
Children's Mercy Hospital Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.
Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA.
Duke Children's Hospital and Health Center, 2301 Erwin Road, Durham, NC 27710, USA.


While previous research in juvenile idiopathic arthritis (JIA) has identified discrepancy between parent and child perception of disease-related symptoms such as pain, the significance and impact of this disagreement has not been characterized. We examined the extent to which parent-child discordance in JIA symptom ratings are associated with child functional outcomes. Linear regression and mixed effects models were used to test the effects of discrepancy in pain and fatigue ratings on functional outcomes in 65 dyads, consisting of youth with JIA and one parent. Results suggested that children reported increased activity limitations and negative mood when parent and child pain ratings were discrepant, with parent rated child pain much lower. Greater discrepancy in fatigue ratings was also associated with more negative mood, whereas children whose parent rated child fatigue as moderately lower than the child experienced decreased activity limitations relative to dyads who agreed closely on fatigue level. Implications of these results for the quality of life and treatment of children with JIA are discussed.


JIA; activity limitation; pain

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