Hadden Kellie L, von Baeyer Carl L
Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
Clin J Pain. 2005 Mar-Apr;21(2):140-6. doi: 10.1097/00002508-200503000-00005.
The aim of this research was to validate global and behavioral observation methods for measuring pain in children with cerebral palsy (CP).
Nineteen children diagnosed with CP (2-21 years of age) and their primary caregivers participated in this study. Children and their caregivers were videotaped in their home before, during, and after a stretching exercise, and tests of cognitive and social development were administered. Children who were able to pass a training task were also asked to rate their experience of pain using a numerical rating scale (self-report NRS), but only 5 children (24%) passed so their self-report scores were not included. Healthcare professionals rated videotaped segments for each of the 3 time periods in a randomized order using an observer NRS and the Non-Communicating Children's Pain Checklist-Postoperative Version (NCCPC-PV). Raters trained in the Child Facial Coding System (CFCS) examined the same videotaped segments.
Results showed significantly greater pain behavior (observer NRS, NCCP- PV) during the stretching procedure than during the baseline and recovery segments. There were no significant differences in CFCS scores, across time segments.
These findings support the hypothesis that children with CP express discernible pain behaviors regardless of cognitive or language ability. These results contribute to multidimensional assessment of pain in children with neurologic impairment.
本研究的目的是验证用于测量脑瘫（CP）患儿疼痛的整体观察法和行为观察法。
19名被诊断为CP的儿童（年龄在2至21岁之间）及其主要照料者参与了本研究。在拉伸运动前、运动期间和运动后，对儿童及其照料者在其家中进行录像，并进行认知和社会发展测试。能够通过训练任务的儿童还被要求使用数字评定量表（自我报告NRS）对其疼痛体验进行评分，但只有5名儿童（24%）通过了测试，因此他们的自我报告分数未被纳入。医疗保健专业人员使用观察者NRS和《非语言儿童疼痛检查表 - 术后版》（NCCPC - PV）以随机顺序对三个时间段的录像片段进行评分。接受儿童面部编码系统（CFCS）培训的评分者检查相同的录像片段。
结果显示，与基线和恢复阶段相比，拉伸过程中的疼痛行为（观察者NRS，NCCP - PV）明显更强烈。在不同时间段内，CFCS评分没有显著差异。
这些发现支持以下假设，即CP患儿无论认知或语言能力如何，都会表现出可识别的疼痛行为。这些结果有助于对神经功能受损儿童的疼痛进行多维度评估。
