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An investigation of psychological and clinical factors associated with the development of chronic or persistent pain in children and young people with inflammatory and non-inflammatory musculoskeletal conditions.


Project Description

Background
Juvenile Idiopathic Arthritis (JIA) is an inflammatory arthritis presenting in children and young people. Pain is one of the main features of JIA and it is often described as one of the most burdensome yet invisible symptoms of this long-term condition. Children and young people with JIA have varying degrees of pain, with some not experiencing pain and others being severely disabled from recurrent pain symptoms. Pain is strongly associated with significant reductions in physical, educational and social activity in a large proportion of these children but it is difficult to capture because children find it difficult to remember and discuss pain. We have developed a new mHealth pain assessment tool called My Pain Tracker (MPT) which children and young people can use at home to collect complex multi-dimensional pain information in between clinic visits.

Objectives
The objective of this PhD will be to continue our work on developing better methods of assessing pain and pain associated outcomes in children and young people with JIA and other musculoskeletal conditions. The candidate will use MPT to collect in-depth pain data which will allow us and the candidate to explore complicated pain patterns which could in turn enable us to phenotype particular types of pain and pain profiles within JIA. The candidate will collect additional information about pain associated variables such as beliefs about pain, pain coping and pain interference to explore whether there are clusters of symptoms which relate to the amount of pain perceived in these children and young people.

Methods
This will be a mixed method PhD project. The successful candidate will design their own studies, apply for ethical approval, collect and analyse data as part of their research. There is potential for both quantitative and qualitative research designs to be employed.

Training/techniques to be provided:
The candidate will be based within the Centre of Epidemiology Versus Arthritis which is a UK center of excellence in rheumatology research. The Centre has an outstanding international reputation in the study of the epidemiology of rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis and treatment response. More recently, we have become well known for our pain research, within which we are developing more novel and advantageous methods of assessing and managing pain in paediatrics. The candidate will be taught how to use our mHealth pain assessment tool, My Pain Tracker to collect comprehensive pain data from patients with chronic pain from Dr Rebecca Lee. Extensive wider training will be provided in health psychology principles, epidemiology, genetics, biostatistics, qualitative interviewing and psychophysical aspects of pain, pain management and assessment from Professor Wendy Thomson, Dr Janet E McDonagh and Dr Lis Cordingley.

Entry Requirements:
Candidates are expected to hold (or be about to obtain) a minimum upper second class honours degree (or equivalent) in a related area / subject and a Masters level qualification in a relevant area which included a substantial research component. Candidates with experience in Psychology, Applied Psychology or Biomedical based degrees with an interest in pain, rheumatology, chronic conditions, outcome measures and illness management are encouraged to apply.

For international students we also offer a unique 4 year PhD programme that gives you the opportunity to undertake an accredited Teaching Certificate whilst carrying out an independent research project across a range of biological, medical and health sciences. For more information please visit http://www.internationalphd.manchester.ac.uk

Funding Notes

Applications are invited from self-funded students. This project has a Band 1 fee. Details of our different fee bands can be found on our website (View Website). For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website (View Website).

As an equal opportunities institution we welcome applicants from all sections of the community regardless of gender, ethnicity, disability, sexual orientation and transgender status. All appointments are made on merit.

References

Lee, R.R., Shoop-Worrall, S., Rashid,A., Thomson,W & Cordingley, L., (Under review). “Asking too much?”: A randomised N-of-1 trial exploring patient preferences and measurement reactivity to frequent use of remote multi-dimensional pain assessments in children and young people with Juvenile Idiopathic Arthritis. Journal of Medical Internet Research
Lee, R.R. Rashid,A., Ghio.D., Thomson,W & Cordingley, L., (In Press). “Seeing pain differently”: A qualitative investigation into the differences and similarities of pain and rheumatology specialists interpretation of multi-dimensional mHealth pain data from children and young people with Juvenile Idiopathic Arthritis. Journal of mHealth and uHealth
Lee, R.R., Rashid,A., Thomson,W & Cordingley, L., (2019). “Reluctant to assess pain”: A qualitative study of healthcare professionals’ beliefs about the role of pain in Juvenile Idiopathic Arthritis. Arthritis Care & Research, https://doi.org/10.1002/acr.23827
Ghio, D. , Thomson, W. , Calam, R. , Ulph, F. , Baildam, E. M., Hyrich, K. and Cordingley, L. (2018), The prioritization of symptom beliefs over illness beliefs: The development and validation of the Pain Perception Questionnaire for Young People. Br J Health Psychol, 23: 68-87. doi:10.1111/bjhp.12275
Lee, R.R., Rashid,A., Ghio,D., Thomson,W & Cordingley, L., (2017). Chronic pain assessments in children and adolescents: A systematic literature review of the selection, administration, interpretation and reporting of uni-dimensional pain intensity scales. Pain Research and Management. https://doi.org/10.1155/2017/7603758

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