Versloot Judith, Veerkamp Jaap S J, Hoogstraten Johan
Department of Cariology, Edodontology and Pedodontology, University of Amsterdam, the Netherlands.
Pediatr Dent. 2004 Sep-Oct;26(5):445-9.
The objective of this study was to analyze the assessment of pain and distress by the child, dentist, and independent observers during a dental injection and study the relationship between the different assessments.
The amount of pain experienced by the child during local anesthesia was reported independently by the child to both the dentist and parent on a 4-point scale running from "no pain" to "a lot of pain." The dentist and observers also gave a score for the pain experienced on a 4-point scale. The amount of distress experienced by the child during local anesthesia was assessed by the dentist and observers using a 6-point scale (from "relaxed" to "out of contact").
The dentists' pain assessment was the lowest. A substantial correlation was found between the child's self-reported pain and the pain as assessed by independent observers. There was a moderate correlation between the amount of distress and pain intensity as reported by the child during the anesthesia phase.
Observation of a child in a videotaped procedure is apparently the most reliable method to accurately assess pain behavior and to discriminate pain from distress. A combination of the child's report and video observation is advised to assess pain in young children.
本研究的目的是分析在牙科注射过程中儿童、牙医和独立观察者对疼痛和痛苦的评估，并研究不同评估之间的关系。
儿童在局部麻醉过程中所经历的疼痛程度，由儿童分别向牙医和家长以从“无疼痛”到“非常疼痛”的4分制进行独立报告。牙医和观察者也以4分制对所经历的疼痛进行评分。牙医和观察者使用6分制（从“放松”到“失控”）评估儿童在局部麻醉过程中所经历的痛苦程度。
牙医对疼痛的评估最低。在儿童自我报告的疼痛与独立观察者评估的疼痛之间发现了显著相关性。在麻醉阶段，儿童报告的痛苦程度与疼痛强度之间存在中度相关性。
观察录像过程中的儿童显然是准确评估疼痛行为并区分疼痛与痛苦的最可靠方法。建议结合儿童的报告和视频观察来评估幼儿的疼痛。
