The PhD defense will take place

Monday date, 5 December 2022
Time: 10.00 AM
Place: Room 6F, Fyrkildevej 7, 9220 Aalborg Øst and online: https://aaudk.zoom.us/j/68967187984

After the defense there will be held a reception. All are welcome

About the PhD thesis
Eight percent of all child and adolescent general practice consultations are due to musculoskeletal (MSK) conditions with pain as the most frequent symptom. Adolescents with MSK pain have an increased risk of health and social difficulties into adulthood. No studies have explored the prognosis of adolescents with MSK pain consulting general practice.

This PhD thesis was initiated with a systematic review on prospective cohort studies on prognostic factors or treatment effect modifiers on persistent MSK pain in 0-19 year old children and adolescents. Following this study based on international recruited data, we recruited a cohort of 8-19 year old children and adolescents consulting the general practitioner (GP) with self-reported MSK pain (ChiBPS cohort) from 17 general practice clinics across Denmark. The ChiBPS cohort lead to three studies. A cross sectional study describing characteristics of the ChiBPS cohort at time of consultation, a prospective cohort study investigating the 3, 6, and 12- months prognosis and prognostic factors of the ChiBPS cohort, and a qualitative study where we drew on a sample of 13 adolescents from the ChiBPS cohort, of which all had a poor prognosis at 6-months follow-up. We performed semi-structured interviews on this sample to gain insights into the adolescent’s experiences and beliefs on what influenced their prognosis.

Our first study yielded a total of 111 unique prognostic factors on persistent MSK pain. Female sex and psychological symptoms were the most frequent investigated prognostic factors. We included 100 children and adolescents in our ChiBPS cohort. The most common pain site was the knee and the median pain duration at time of consultation was 5 months. After 6-months, 36% reported activity limiting pain and 42% reported multi-site pain. Children and adolescents who felt nervous or tired during the day, with 1-7 days pain episodes, who used pain medication, had difficulties falling asleep or carrying a schoolbag had a higher risk of pain after 6-months. In our fourth study we derived four broad themes describing the experience of long-term MSK pain from: (a) the first pain, (b) other people’s reaction, (c) accepting the pain to (d) the long-term pain.

In conclusion this thesis have contributed with the identification of a number of components of the child and adolescent long-term MSK pain condition and experience. Our findings underline the commonality of long-term child and adolescent MSK pain and the demands for a multidisciplinary bio-psycho-social approach.