Piira Tiina, Champion G David, Bustos Theona, Donnelly Necia, Lui Kei
Pain Medicine Unit, Sydney Children's Hospital, Randwick, Sydney, Australia.
Early Hum Dev. 2007 May;83(5):319-26. doi: 10.1016/j.earlhumdev.2006.06.007. Epub 2006 Aug 22.
Specific potential determinants of infant pain response were assessed in the context of a 4- or 6-month immunization injection. The distal influences of gender, gestational and current age, temperament, and early nociceptive stimuli were considered, as well as the proximal influences of parental and nurse coping-promoting statements within the treatment room.
An observational study design was used. Pain responses in 93 infants receiving an immunization injection were videoed and coded using the Neonatal Facial Coding System (NFCS) and duration of crying was recorded. Parent and nurse vocalizations were coded using the Child-Adult Medical Procedure Interaction Scale-Revised.
A multiple regression analysis evaluated the influence of the 5 distal and 2 proximal factors on NFCS scores, and found parental coping-promoting statements in the 30 s period before the injection to have the strongest effect on facial pain response (p<0.01). Parents made significantly more coping-promoting statements (p<0.05), and generally talked more (p<0.05), to female infants than male infants.
The findings suggest that parental behavior in the treatment room has a key role in influencing how infants respond to painful procedures.
在4个月或6个月免疫接种注射的背景下，评估婴儿疼痛反应的特定潜在决定因素。考虑了性别、胎龄和当前年龄、气质以及早期伤害性刺激的远期影响，以及治疗室内父母和护士的应对促进性陈述的近期影响。
采用观察性研究设计。对93名接受免疫接种注射的婴儿的疼痛反应进行录像，并使用新生儿面部编码系统（NFCS）进行编码，记录哭泣持续时间。父母和护士的发声使用修订后的儿童-成人医疗程序互动量表进行编码。
多元回归分析评估了5个远期因素和2个近期因素对NFCS评分的影响，发现注射前30秒内父母的应对促进性陈述对面部疼痛反应的影响最大（p<0.01）。与男婴相比，父母对女婴做出的应对促进性陈述明显更多（p<0.05），并且总体上交谈更多（p<0.05）。
研究结果表明，治疗室内父母的行为在影响婴儿对疼痛程序的反应方式方面起着关键作用。
