父母对儿童急性疼痛整体印象的准确性。

Accuracy of parental-global-impression of children's acute pain.

作者信息

Zisk Rachel Yaffa, Grey Margaret, Medoff-Cooper Barbara, Kain Zeev N

机构信息

Yale University School of Nursing, New Haven, CT, USA.

出版信息

Pain Manag Nurs. 2007 Jun;8(2):72-6. doi: 10.1016/j.pmn.2007.03.002.

DOI:10.1016/j.pmn.2007.03.002

PMID:17544126

Abstract

The primary purpose of this study is to compare parental-global-impression of children's level of acute pain at home with parental assessment of children's pain using a structured instrument and with children's self-reports of pain. We recruited 32 parents of children aged 5 to 10 years who were diagnosed with a fractured limb and treated in a tertiary emergency department. After discharge, parents were asked to complete three home-based assessments relating to their child's acute pain: the parental-global-impression of pain, child's reported pain, and structured Parental Postoperative Pain Measure. Data analysis included odds ratios, sensitivity, specificity, positive and negative predictive values, and repeated-measures analysis of variance. When compared with child report of pain, the sensitivity of parental-global-impression was 76% on day 1 and 93% on day 2, whereas specificity was 91% on day 1 and 83% on day 2. When compared with child report of pain, the sensitivity of Parental Postoperative Pain Measure was 71% on day 1 and 66% on day 2, whereas specificity was 82% on day 1 and 83% on day 2. On the basis of acceptable statistical criteria, parental-global-impression has good sensitivity and specificity compared with the child self-report measure. We do not suggest, however, that parental-global-impression can or should replace child report, but rather suggest that it can be used as an adjunct assessment measure as needed.

摘要

本研究的主要目的是比较家长对孩子在家中急性疼痛程度的整体印象、家长使用结构化工具对孩子疼痛的评估以及孩子对疼痛的自我报告。我们招募了32名5至10岁被诊断为肢体骨折并在三级急诊科接受治疗的孩子的家长。出院后，要求家长完成三项与孩子急性疼痛相关的家庭评估：家长对疼痛的整体印象、孩子报告的疼痛以及结构化的家长术后疼痛测量。数据分析包括比值比、敏感性、特异性、阳性和阴性预测值以及重复测量方差分析。与孩子报告的疼痛相比，家长整体印象的敏感性在第1天为76%，在第2天为93%，而特异性在第1天为91%，在第2天为83%。与孩子报告的疼痛相比，家长术后疼痛测量的敏感性在第1天为71%，在第2天为66%，而特异性在第1天为82%，在第2天为83%。基于可接受的统计标准，与孩子自我报告测量相比，家长整体印象具有良好的敏感性和特异性。然而，我们并不建议家长整体印象能够或应该取代孩子的报告，而是建议它可以根据需要用作辅助评估措施。