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Pediatric Pain &

Palliative Care

Research

Studies

Publications

Resources

PEDIATRIC PAIN & PALLIATIVE CARE

Palliative care helps improve the quality of life for children with chronic pain or complex illnesses as well as the lives of their families.

  • Pain Management and Palliative Care

    The UCLA Pediatric Pain & Palliative Care Program is dedicated to alleviating pain and other causes of distress for children with serious, chronic or life-threatening illnesses, with a focus on:

     

    • Providing support to children and families

    • Relieving pain and other symptoms

    • Facilitating communication among family members and healthcare providers

    • Enhancing the child’s quality of life

     

    Unlike hospice, palliative care can include curative treatments in early stages of illness and is not just focused on children with diseases for which a cure is unlikely. Its focus is on quality of life for all suffering or sick children.

     

  • Inpatient Consultations

    Our pain and palliative care team is dedicated to alleviating pain and other symptoms that children with complex illnesses may experience. Our goal is to provide the best quality of life possible for our pediatric patients and their families.

     

    Our team provides recommendations for many different types of treatments — both medical and non-medical — to help with pain, nausea, anxiety and other discomforts associated with illness. We are an interdisciplinary team that includes physicians; a nurse practitioner; a social worker who heads a special bereavement program for families of children who have passed away; and a research psychologist who helps identify, develop, and study new types of services for the children we serve, including home care and telemedicine.

     

    We also provide connections with the chaplain, child life program (which helps patients cope with their illness and hospitalization) and Heart Touch, a program that offers massage therapy for our patients. In addition, our nurse practitioner is trained to provide mind-body support for our patients, including aroma therapy, massage, yoga and Reiki energy therapy.

  • Enhanced Quality of Life

    Studies show that patients who receive the type of palliative care we offer not only may live longer but enjoy happier lives. They often report less suffering, reduced pain, enhanced feelings of well-being, lower rates of depression and may experience fewer days in the hospital.

     

    Family members may also benefit from the extra emotional and spiritual support they receive from our palliative care professionals.

  • Comfort Corner

    The Mattel Children's Hospital UCLA Comfort Corner is a space for pediatric patients, families and healthcare providers to relax and escape the hectic hospital environment. We provide a serene setting with tea, hot chocolate, aromatherapy and a listening ear.

     

    For parents, we provide resources on how you can actively help your child cope with his/her symptoms. For healthcare providers, we offer clinical consultation and informal debriefing opportunities, as well as team meetings for groups of clinicians involved in a child’s care.

  • Outpatient Clinics and Complementary Therapies

    Our interdisciplinary team of pain and palliative care physicians and other clinicians provide outpatient services for symptom management that take into account the child’s and family's needs. The program has a special focus on pain and symptoms associated with complex medical conditions or chronic pain problems.

     

    We also provide mind-body care that integrates all different aspects of a patient's needs: psychological, physical and social. Integrated into our outpatient program, we work together with music and art therapists, massage and craniosacral therapists, hypnotherapy and biofeedback clinicians, yoga and mindfulness instructors and physical therapists, psychologists and child psychiatrists.

  • Ask your child's doctor

    If you think your child could benefit from pediatric pain and palliative care services, please ask his/her doctor for a referral.

     

    Healthcare providers recognize the benefits of pain management and palliative care services for their patients and typically welcome our specialists to the healthcare team.

  • Contact Information

    For more information, please call the UCLA Pediatric Pain & Palliative Care Program at (310) 825-0731 or visit our website. For appointments, please call (310) 825-0867.

RESEARCH

STUDIES

  • Central Pain Mechanisms in Primary Dysmenorrhea

     

    (March 2016)

    PI: Laura A. Payne, PhD

     

    The primary goal of this research project is to characterize mechanisms underling primary dysmenorrhea (PD; menstrual pain without an identified organic cause) in older adolescent girls and young adult women (ages 16-25). This innovative study uses recently developed techniques to better understand how and why adolescents and women with PD experience pain. In addition, this study is the first of its kind to explore pain responses in PD in younger populations. We hope this study can help identify girls at risk for the development of future chronic pain problems and potentially inform new interventions and prevention strategies. We are recruiting girls ages 16-25 both with and without menstrual pain. Study participation involves attending one intake session at our research offices at UCLA, and then 3 separate laboratory sessions during each of 3 phases of the menstrual cycle. Laboratory sessions will involve a undergoing a series of heat and cold tasks, as well as collecting saliva samples. The intake visit lasts about 1 hour; each laboratory session lasts about 1 ½ hours. Participants are paid $25 for the intake session, $50 for the first laboratory visit, $75 for the second laboratory visit, and $100 for the final laboratory visit. For more information, please contact Laura Seidman at (310) 825-6907.

  • A Behavioral Intervention for Pain Catastrophizing in Primary Dysmenorrhea

     

    (MARCH 2016)

    PI: Laura A. Payne, PhD

     

    Primary dysmenorrhea (PD; menstrual pain without an identified organic cause) is a very common problem, with 20-25% of girls and women experiencing severe symptoms that interfere with functioning. Yet, no non-drug treatments for PD have been rigorously evaluated. The current study aims to test the feasibility and preliminary efficacy of a brief group therapy focused on reducing pain catastrophizing in adolescents and young adults (ages 16-21) with menstrual pain. Study participants will undergo a laboratory session involving testing responses to heat and cold pain both before and after treatment. Treatment involves 5 sessions held over a 6-week period. Participants are paid $25 for the first laboratory session, $75 for the laboratory session after treatment, and $10 for each of 3 monthly questionnaire assessments following the completion of the second laboratory session. For more information, please contact Laura Seidman at (310) 825-6907.

  • Mobile Application for Managing Headaches in Adolescents

     

    (March 2016)

    PI: Jennie C. I. Tsao, PhD

     

    Headache pain is a common and significant problem for adolescents that can negatively impact quality of life. The aim of the current study is to develop and test a mobile application (app) ThinkMe, to assist teens with self-management of recurring headaches. Teens aged 13-17 years with recurring headaches not due to organic causes and with an Iphone are invited to participate in a user testing trial of the ThinkMe app. Eligible teens will be randomly assigned to receive either the ThinkMe intervention or to a care as usual control group.  Teens assigned to the ThinkMe app will complete questionnaires online and use the ThinkMe app each day for 30 days to track their headaches and to receive daily suggestions for how to cope with their headache pain. At the end of the trial, teens will complete another set of questionnaires, and will complete follow-up questionnaires at 3- and 6-month follow-ups. Teen assigned to the control group will also complete the same questionnaires at the same time points and will continue with their usual care. Parents of all teens will also complete questionnaires at these same time points. Teens and parents may each earn up to $100 for completing the study questionnaires, for a total of up to $200 per family.  Payment per participant will be distributed as follows: $10 for completing baseline questionnaires; $20 for completing the post-intervention questionnaires; $30 for completing 3-month follow-up; $40 for completing 6-month follow-up. This study is being conducted in conjunction with a technology company, Inflexxion, Inc. based in Boston, MA. For more information, please contact Ravi Bhatt at (217) 414-1825.

  • Mobile Application for Managing Abdominal Pain in Adolescents

     

    (March 2016)

    PI: Jennie C. I. Tsao, PhD

     

    Functional abdominal pain is one of the most frequent sources of chronic pain in adolescents. This study will lay the groundwork for the development of a fully-functioning mobile application (app) to support and motivate teens to adopt and maintain self-management skills for recurrent abdominal pain as well as video-tutorials for parents to reinforce self-care skills at home. Teens aged 13-17 with recurrent abdominal pain not due to organic causes and with an Iphone are invited to participate in a user testing trial of a prototype of the planned app.  Eligible teens will complete questionnaires online and then use the app for 30 days. They will be asked to use the app daily to receive messages on how to cope with their abdominal pain. After the 30 day trial, teens will complete another set of questionnaires. Parents of enrolled teens will also complete questionnaires before and after their child uses the app. Adolescents will receive $25 and parents will receive $50 for their participation. This study is being conducted in conjunction with a technology company, Bodimojo, Inc. based in Boston, MA. For more information, please contact Laura Seidman at (310) 825-6907.

  • Brain connectivity and structure, pain inhibition, and gut microbiota in pediatric irritable bowel syndrome (IBS)

     

    (March 2016)

    PI’s: Jennie C. I. Tsao, PhD & Kirsten Tillisch, MD

     

    Irritable bowel syndrome (IBS) is a disorder of the brain-gut axis characterized by recurrent abdominal pain and altered bowel habits, affecting 10-20% of children. This study sought to examine the pathways linking the gut, the brain and behavior in children with IBS. The project aimed to: 1) Determine the feasibility and acceptability of an fMRI protocol to assess brain structure and resting state networks in children (aged 7-17 years) with IBS and healthy, age- and sex- matched controls (HC); 2) Compare IBS and HC subjects’ structural and functional brain parameters to determine whether they are supportive of the alterations in cortical thickness, white matter properties and resting state brain activity found in adult patients with IBS and to provide data to determine effect size for future power analyses; 3) Assess for structural and resting state functional brain correlates with a behavioral index of endogenous pain inhibition, Conditioned Pain Modulation (CPM), within and across IBS and HC groups. 4) Identify stool microbial composition patterns that may be associated with altered pain inhibition and/or brain parameters within and across IBS and HC groups. Since IBS is more common in girls than boys and to avoid the confounding effects of sex, only girls were enrolled in this pilot study. 11 girls with IBS and 14 control girls completed the CPM protocol which involved standardized administrations of cold and heat pain stimuli. Structural, diffusion tensor and functional MRI scans were completed for these 25 subjects; food diaries were completed by 24 subjects and stool samples were collected from 25 subjects. Thus, the fMRI protocol is feasible and acceptable; all eligible participants completed the scans without adverse events. The data quality from the acquired scans was excellent for a pediatric population where movement is often a concern.  Four resting state functional MRI scans (1 IBS, 3 healthy control) and 1 DTI scan (healthy control) failed quality assessment due to excessive motion; all structural scans were of good quality. The processed scans are parcellated into 156 brain regions. Region of interest comparisons will be made between groups for gray matter volumes, white matter fractional anisotropy and mean diffusivity, and correlation analyses performed with pain metrics. Resting state functional connectivity will be compared between groups. Microbiota data will be stored at -80 ºC until analysis can be completed.

  • Symptom Communication Intervention Study

     

    (March 2016)

    PI: Elana E. Evan, PhD

     

    When children confront serious illnesses, reliance on their parents and/or primary caregivers for communication with the healthcare team and other support networks becomes the norm. Differences between children’s and parents’ reports of children’s symptoms have been documented. Parents may need help in learning to understand and reflect their child’s symptoms, while children can learn how to better express their symptoms to their parents so their symptom management needs are met via proxy reporting by their parents. This study tests feasibility of a manualized communication intervention for children with serious illnesses and their parents. The primary goal is to help the child/parent dyad to maximize the parent’s understanding of their child’s symptoms and to enhance the child’s abilities to report their symptoms to their parents. With improved communication, parents would be expected to become more accurate proxy reporters for their children, a critical factor for good symptom management and improved quality of life in pediatric palliative care. Dr. Evan, will recruit, with the discretion of the treating team, families to participate in the intervention. Pediatric patients with serious GI, cardiomyopathy, Cystic fibrosis and oncologic disease between the ages of 10-21 are eligible. The intervention will consist of three sessions, scheduled in the place most comfortable for the participating family members (e.g. home, hospital or outpatient facility). Participants will complete symptom and demographic questionnaires, learn symptom communication strategies. Both pediatric patient and primary caregiver will each receive $10 gift cards at the completion of each of the 3 sessions. This information along with analyzed assessment data will be applied to future changes in the intervention.

  • Genes, Stress, and Pain Study

    The main goal of this study is to investigate the relationship between genes, stress, and pain.  The findings of this study will contribute to our understanding of the connection between genes, stress, and pain in adult and child research participants and their parents and may help identify people at risk for developing pain.  We are recruiting healthy children and children with chronic pain (ages 8 through 21) and their biological parent(s) to complete one lab session at UCLA or at home which lasts less than 50 minutes.  Brothers and sisters may also participate.  During the lab session each participant will answer questions about health, personal attitudes, depression, anxiety, and trauma, and a sample of saliva (spit) will be collected.  Participants can also complete the questionnaires and provide the sample of saliva (spit) at home and mail the questionnaires and sample back to us.  For more information, please contact Loran Hayes for the Genes, Stress, and Pain Study at the UCLA Pediatric Pain Program at (310) 475-3191 ext. 225.

  • Stress/Pain Responses in Parents and Children Study

    The UCLA Mattel Children’s Hospital is seeking healthy children ages 8 through 17 years old for a study examining how children who are not being treated for pain and children with chronic pain (headaches) as well as their parents respond to stress/pain in a controlled, safe, laboratory setting.  The study involves the child and his/her parents attending one session at UCLA.  The child and parents will answer questions about their health, including experiences with pain and other bodily symptoms, mood, and views about how different people respond to pain. These questions will take about 1 hour to complete. Participants will also perform four brief lab stress/pain tasks and a sample of saliva (spit) will be taken to analyze for stress hormones.  Each visit to UCLA will last about 3 ½ to 5 hours depending on how many family members participate. Each participating family member will receive $50 in cash and free parking. For more information please call the Stress/Pain Responses in Parents and Children Study or Mona Moieni at the UCLA Pediatric Pain Program at (310) 475-3191 ext. 223.

  • Iyengar Yoga for Young People with Irritable Bowel Syndrome

    The Pediatric Pain Program at UCLA is conducting a study on Iyengar Yoga for young people aged 16-22 years with Irritable Bowel Syndrome (IBS). The study involves young people completing an 8-week course of yoga. Participants will also be asked to attend two laboratory sessions at UCLA which will involve completing questionnaires, interviews, lab stress tasks, and saliva samples and will last approximately 3 hours. All yoga classes will be free, and we will cover UCLA parking. For more information, please call (310) 475-3191 ext. 221 and leave a message for Laura Cousins/IBS Yoga Study.

  • History and Narratives of Pain

    The History and Narratives of Pain Study (PI's:  Lonnie Zeltzer, MD and Jennie Tsao, PhD) is recruiting children and adolescents ages 8-17 with chronic pain.  The study requires that the child/adolescent and a parent (mother or father) complete one set of questionnaires.  These are the same questionnaires that are completed for the initial clinic visit (either at Whole Child or UCLA).  In order to reduce the burden of time on patients/participants, we ask permission from all new eligible patients who have completed the questionnaires to release these for research so that completing another set is not necessary.  If you have any questions, please call Loran Hayes at (310) 475-3191 ext. 225 or email at loranhayes@mednet.ucla.edu.

PUBLICATIONS

RESOURCES

  • teen pain help

    Teen Pain Help Foundation is designed to help children and teenagers with chronic pain by raising funds for treatment, research, education, and increased public awareness. Together we can help children and families going through chronic pain conquer it, and live the happy, healthy lives they deserve. Visit the website here.

  • American pain society

    The American Pain Society is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering. APS envisions a world where pain prevention and relief are available to all people. Visit the website here.

  • children's music fund

    CMF is a 501(c)(3) non-profit organization whose mission is to provide musical instruments and music therapy to children, adolescents, and young adults with chronic conditions and life-altering illnesses, and to support research on the effects of music therapy. Visit the website here.

  • ted talk on chronic pain

    Dr. Elliot Krane talks about chronic pain. He gives insight into why chronic pain occurs in some people and not others and draws apt metaphors for what the children/teens are experiencing.

     

    See the video here.

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