Brattberg Gunilla
Department of Public Health and Caring Sciences, Health Service Research, Uppsala University, Sweden.
Eur J Pain. 2004 Jun;8(3):187-99. doi: 10.1016/j.ejpain.2003.08.001.
In a longitudinal study, 335 children ages 8, 11 and 14, first studied in 1989 were followed-up on two occasions in 1991 and 2002. The subjects filled in questionnaires on pain, the first two times in school, the last as a postal survey.
To determine if headache and back pain during the school years were transitory or if they grew into pain problems in adulthood; to determine predictors of pain.
In the 2002 study, 59% of the women and 39% of the men reported pain at 21, 24 and 27 years. A total of 68 (52 women, 16 men) or 20% of the subjects reported pain symptoms in all three studies. The cumulative incidence rate for the presence of pain in the cohort studied was 31% for 1989-2002 and 43% for 1991-2002. Four of the 10 individuals with pain also reported signs of stress. Three predictors were found: reported back pain in 8-14-year-olds (p < 0.0001); reported headaches once a week or more in the same age group (p < 0.0001); and a positive response in the ages 10-16 to the question: "Do you often feel nervous?" (OR=2.1, 95% CI 1.3-3.4). When adjusted for age, sex and all psychosocial risk determinants studied in multiple logistic regression, a positive answer to this question was a significant predictor of pain in young adulthood. A positive response by the 10-16-year-olds to "Do you find it difficult to describe your feelings?" was a predictor of pathological anxiety in early adulthood, but stress perceived in childhood/adolescence did not predict future pain or stress.
Since pain reports in childhood and early adolescence seem to be associated with the report of pain in early adulthood, more attention should be given to the way ill-health is managed in adolescence in this vulnerable group.
在一项纵向研究中,对1989年首次研究的335名8岁、11岁和14岁儿童于1991年和2002年进行了两次随访。受试者填写了关于疼痛的问卷,前两次在学校填写,最后一次通过邮寄调查。
确定学龄期的头痛和背痛是暂时的,还是会发展为成年后的疼痛问题;确定疼痛的预测因素。
在2002年的研究中,59%的女性和39%的男性报告在21岁、24岁和27岁时疼痛。共有68名(52名女性,16名男性)受试者,即20%,在所有三项研究中都报告了疼痛症状。在1989 - 2002年研究队列中疼痛出现的累积发病率为31%,在1991 - 2002年为43%。10名有疼痛的个体中有4人也报告了压力迹象。发现了三个预测因素:8 - 14岁儿童报告背痛(p < 0.0001);同一年龄组中每周头痛一次或更多(p < 0.0001);以及10 - 16岁对问题“你是否经常感到紧张?”的肯定回答(OR = 2.1,95%可信区间1.3 - 3.4)。在多元逻辑回归中对年龄、性别和所有研究的心理社会风险决定因素进行调整后,对该问题的肯定回答是成年早期疼痛的显著预测因素。10 - 16岁对“你是否觉得难以描述自己的感受?”的肯定回答是成年早期病理性焦虑的预测因素,但童年/青少年时期感知到的压力并不能预测未来的疼痛或压力。
由于儿童期和青春期早期的疼痛报告似乎与成年早期的疼痛报告相关,对于这个弱势群体在青春期的健康管理方式应给予更多关注。