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儿童慢性疼痛的 CAM 治疗偏好。

Treatment Preferences for CAM in children with chronic pain.

机构信息

Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, USA.

出版信息

Evid Based Complement Alternat Med. 2007 Sep;4(3):367-74. doi: 10.1093/ecam/nel084.

Abstract

CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years +/- 2.4; range = 8-18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80%) were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

摘要

CAM 疗法在儿科人群中越来越受欢迎。然而,对于儿童对 CAM 的偏好知之甚少。本研究考察了在提供 CAM 疗法选择治疗慢性儿科疼痛患者时,儿童的治疗偏好。参与者为 129 名儿童(94 名女孩)(平均年龄= 14.5 岁 +/- 2.4;范围= 8-18 岁),他们在一家专门治疗儿科慢性疼痛的多学科三级诊所就诊。使用双变量和多变量分析来检查 CAM 治疗偏好与患者社会人口学和临床特征以及他们自我报告的功能水平之间的关系。超过 60%的患者选择尝试至少一种 CAM 方法来治疗疼痛。最受欢迎的 CAM 疗法是生物反馈、瑜伽和催眠;最不受欢迎的是艺术疗法和能量疗法,颅骶疗法、针灸和按摩处于中间位置。与其他疼痛诊断的患者相比,被诊断为纤维肌痛的患者(80%)最有可能尝试 CAM。在多变量分析中,疼痛持续时间是 CAM 偏好的一个重要预测因素。对于基于思维的方法(即催眠、生物反馈和艺术疗法),疼痛持续时间和家庭活动受限都是显著的预测因素。当给予 CAM 疗法的选择时,这群患有慢性疼痛的儿童,无论疼痛诊断如何,都更喜欢非侵入性的方法,这些方法可以增强放松和增加躯体控制。疼痛持续时间更长和功能障碍更大,尤其是在家庭活动中,会增加这些患者同意接受 CAM 治疗的可能性,特别是那些被归类为基于思维的模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb8c/1978240/90180e7d6c1f/nel084f1.jpg

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