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对预先选定的报告有幻肢的儿童和青少年截肢者样本中的无痛和疼痛性幻肢感觉进行前瞻性日记研究。

Prospective diary study of nonpainful and painful phantom sensations in a preselected sample of child and adolescent amputees reporting phantom limbs.

作者信息

Wilkins Krista L, McGrath Patrick J, Finley G Allen, Katz Joel

机构信息

Department of Nursing, University of Manitoba, Winnipeg, Canada.

出版信息

Clin J Pain. 2004 Sep-Oct;20(5):293-301. doi: 10.1097/00002508-200409000-00003.

Abstract

OBJECTIVE

To prospectively study factors associated with the occurrence of phantom sensations and pains in a pre-selected sample of child and adolescent amputees reporting phantom limbs.

DESIGN

Prospective diary study over 1 month.

PARTICIPANTS

Fourteen child and adolescent amputees from 10-18 years of age who were missing a limb due to trauma (n = 12) or congenital limb deficiency (n = 2), and who had previously reported having phantom sensations and pain.

MAIN OUTCOME MEASURE

Diary used to assess the occurrence of non-painful and painful phantom sensations. Items included age, sex, location and cause of amputation, past experience with stump pain and pre-amputation pain, and intensity, quality, duration, and triggers of the sensations and pains.

RESULTS

Thirteen amputees reported having 104 incidents of non-painful phantom sensations with an average intensity of 4.17 (SD = 2.14) on a 0-10 rating scale. Fifty-three incidents of phantom pain with an average intensity of 6.43 (SD = 1.76) were recorded by 8 amputees. Both amputees with a congenital limb deficiency reported phantom phenomena. Girls reported more psychosocial triggers than did boys whereas boys were more likely than girls to report that they could not identify a trigger (P = 0.0001). Boys also reported a higher proportion of physical triggers than psychosocial triggers while there were no differences for girls (P = 0.0001).

DISCUSSION

Child and adolescent amputees experience phantom sensations and pains on a regular basis over a 1-month period. Differences in triggers of phantom phenomena between boys and girls may be due to differences in activities, awareness, attribution, and willingness to report psychosocial triggers.

摘要

目的

前瞻性研究在预先选定的报告有幻肢的儿童和青少年截肢者样本中,与幻肢感觉和疼痛发生相关的因素。

设计

为期1个月的前瞻性日记研究。

参与者

14名10至18岁的儿童和青少年截肢者,其中因创伤截肢者12名,先天性肢体缺如者2名,且他们之前均报告有幻肢感觉和疼痛。

主要观察指标

用于评估无痛性和疼痛性幻肢感觉发生情况的日记。记录项目包括年龄、性别、截肢部位和原因、既往残端疼痛和截肢前疼痛经历,以及感觉和疼痛的强度、性质、持续时间和触发因素。

结果

13名截肢者报告发生了104次无痛性幻肢感觉事件,在0至10分的评分量表上平均强度为4.17(标准差=2.14)。8名截肢者记录了53次幻肢疼痛事件,平均强度为6.43(标准差=1.76)。两名先天性肢体缺如的截肢者均报告有幻肢现象。女孩报告的心理社会触发因素比男孩多,而男孩比女孩更有可能报告无法确定触发因素(P = 0.0001)。男孩报告的身体触发因素比例也高于心理社会触发因素,而女孩则无差异(P = 0.0001)。

讨论

儿童和青少年截肢者在1个月的时间内经常经历幻肢感觉和疼痛。男孩和女孩幻肢现象触发因素的差异可能是由于活动、意识、归因以及报告心理社会触发因素的意愿不同。

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