HOPE – Help Overcoming Pain Early
Short description
The aim of the project was to develop and evaluate a student health-based intervention called ‘Help Overcoming Pain Early’ (HOPE). The goal of the intervention was to promote young people’s ability to manage long-term pain. The school nurses received training on biopsychosocial perspectives, including the theory of neurophysiology, on the causes and connections between long-term pain, stress, sleep problems and functional ability in everyday life. They also received further training in stress and pain management. During the four-person sessions with the school nurses, the young persons discussed the specific problems they faced and tested strategies to deal with their problems. Furthermore, the young persons assessed whether they could integrate the strategies into their everyday lives. Outcome measures used were confidence in one’s own ability to carry out daily activities, pain intensity and pain impact, insomnia and self-rated health.
Short description of main results
The HOPE project was evaluated through a randomised controlled trial that showed that HOPE had no effect on the primary outcome measure, self-efficacy in daily activities, pain intensity or pain impact. However, self-efficacy in daily activities increased significantly in young people in junior high school. A non-randomised study showed that HOPE improved symptoms of insomnia at the six-month follow-up and self-rated health at the post-assessment and six-month follow-up.
The young people qualitatively described a trust-building relationship with school nurses, which is crucial to change. The school nurses shared that they actively listened to the young people’s stories about their everyday lives characterised by long-term pain, that they created health plans together and that they encouraged the young people to participate as partners in promoting their own health.
Scientific articles from the project
Nilsson S, Wallbing U, Alfvén G, Dalenius K, Fors A, Golsäter M, Rosvall P-Å, Wigert H, Lundberg M. Development of the Help Overcoming Pain Early (HOPE) Programme Built on a Person-Centred Approach to Support School Nurses in the Care of Adolescents with Chronic Pain—A Feasibility Study. Children (Basel). 2019;Aug 25;6(9). Development of the Help Overcoming Pain Early (HOPE) Programme Built on a Person-Centred Approach to Support School Nurses in the Care of Adolescents with Chronic Pain—A Feasibility Study
Golsäter M, Nilsson S, Wigert H. Dealing with adolescents' recurrent pain problems in school health care—Swedish school nurses' view. Nurs Open. 2019;Sep 11;6(4):1626-1633. Dealing with adolescents' recurrent pain problems in school health care—Swedish school nurses' view
Fors A, Wallbing U, Alfvén G, Kemani MK, Lundberg M, Wigert H, Nilsson S. Effects of a person-centred approach in a school setting for adolescents with chronic pain-The HOPE randomized controlled trial. Eur J Pain. 2020;Sep;24(8):1598-1608. Effects of a person-centred approach in a school setting for adolescents with chronic pain—The HOPE randomized controlled trial
Wallbing U. Help Overcoming Pain Early (HOPE) A person-centred intervention for adolescents with chronic pain in a school setting. Doctoral thesis 9 September 2022.
Rosvall P-Å. Perspectives of students with mental health problems on improving the school environment and practice. Education Inquiry. 2020. 11(3): 159-174.
Wigert H, Fors A, Nilsson S, Dalenius K, Golsäter M. A Person-Centred Approach When Encountering Students With Recurrent Pain: School Nurses' Experiences. J Sch Nurs. 2019;Jul 16:1059840519864158.
Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr. 2019;Dec;108(12):2148-2156.
Rosvall P-Å, Nilsson S. Gender-based generalisations in school nurses' appraisals of and interventions addressing students' mental health. BMC Health Serv Res. 2016;16:451.
Rosvall P-Å, Nilsson S. Challenges of engagement with health services in Sweden’s schools: listening to the views of school nurses and students with recurrent pain. Pastor Care Educ. 2016;34(1):3-12.
Nilsson S, Rosvall P-Å, Jonsson A. Adolescent-Centered Pain Management in School When Adolescents Have Chronic Pain - A Qualitative Study. Glob J Health Sci. 2016.
Alfvén G, Nilsson S. Validity and reliability of a short verbal rating test scale for clinical practice. Acta Paediatr. 2014;103(4):e173-175.
Researchers
Research group
Stefan Nilsson, RN, PhD, Professor, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Andreas Fors, RN, Associate Professor, Institute of Health and Care Sciences, and University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Gösta Alfvén, MD, PhD, Associate Professor, Department of Paediatrics, Karolinska University Hospital, Stockholm, Sweden
Kristina Dalenius, RN, Lerums kommun, Sektor lärande, Lerum, Sweden
Marie Golsäter, RN, PhD, Child Health Care and Futurum, Region Jönköping County, Barnhälsovården, Regionens hus, Jönköping, Sweden; CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
Mike Kemani, PhD, Department of Clinical Neuroscience (CNS), Karolinska Institutet, Stockholm, Sweden; Functional Area Medical Psychology, Functional Unit Behavior Medicine, Karolinska University Hospital, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden
Per-Åke Rosvall, PhD, Associate Professor, Department of Applied Educational Sciences, Umeå University, Umeå, Sweden
Ulrika Wallbing, PT, MSN, Department of Neurobiology, Care and Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
Helena Wigert, RN, PhD, Associate Professor, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Mari Lundberg, PT, PhD, Professor, Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden