Pillai Riddell R, Racine Nicole
Opportunities to Understand Childhood Hurt Laboratory, Department of Psychology, Faculty of Health, York University, and Department of Psychiatry Research, Hospital for Sick Children, Toronto, Ontario.
Pain Res Manag. 2009 Jan-Feb;14(1):27-32. doi: 10.1155/2009/410725.
Pain is largely accepted as being influenced by social context. Unlike most other developmental stages throughout the lifespan, infancy is marked by complete dependence on the caregiver. The present paper discusses the primary importance of understanding the caregiver context when assessing infant pain expression.
Based on a review of research from both the infant pain and infant mental health fields, three lines of evidence are presented. First, pain assessment is as subjective as the pain experience itself. Second, assessors must be cognizant of the relationship between infant pain expression, and caregiver sensitivity and emotional displays. Finally, larger systemic factors of the infant (such as caregiver relationship styles, caregiver psychological distress or caregiver acculturative stress) directly impact on infant expression.
As a result of infants' inability to give a self-report of their pain experience, caregivers play a crucial role in assessing the pain and taking appropriate action to manage it. Caregiver behaviours and predispositions have been shown to have a significant impact on infant pain reactivity and, accordingly, should not be ignored when assessing the infant in pain.
疼痛很大程度上被认为受社会环境影响。与一生中的大多数其他发育阶段不同，婴儿期的特点是完全依赖照顾者。本文讨论了在评估婴儿疼痛表现时了解照顾者环境的首要重要性。
基于对婴儿疼痛和婴儿心理健康领域研究的综述，提出了三条证据。第一，疼痛评估与疼痛体验本身一样主观。第二，评估者必须认识到婴儿疼痛表现、照顾者敏感性和情感表露之间的关系。最后，婴儿的更大系统因素（如照顾者关系模式、照顾者心理困扰或照顾者文化适应压力）直接影响婴儿的表现。
由于婴儿无法自我报告其疼痛体验，照顾者在评估疼痛并采取适当措施进行处理方面起着关键作用。照顾者的行为和倾向已被证明对婴儿疼痛反应有重大影响，因此在评估疼痛婴儿时不应被忽视。
