Lewandowski Amy S, Palermo Tonya M, Kirchner H Lester, Drotar Dennis
Department of Psychology, Case Western Reserve University, Cleveland, OH 44106-7123, USA.
Clin J Pain. 2009 May;25(4):299-306. doi: 10.1097/AJP.0b013e3181965578.
The current study investigated the daily relationship between pain, activity restriction, and depression in children and adolescents with chronic pain, and compared participants' responses on diary and retrospective assessment measures.
Data collection included the administration of diary and retrospective measures of pain, activity restriction, and depression to 93 children with recurrent headache, juvenile chronic arthritis, and sickle cell disease. The study used hierarchical linear modeling to examine the relationship between daily pain and activity restriction, and analyses compared participants' responses on diary and retrospective assessment measures.
Using diary measures, daily pain intensity was related to children's levels of activity restriction. Diary completion was predicted by age and diary-type, with younger children and children using electronic diaries demonstrating higher compliance. Pain intensity was significantly higher on retrospective compared with diary measures, demonstrating inflation in retrospective reports of pain. No significant differences between measures of activity restriction emerged.
These preliminary results suggest that although retrospective reports of activity restriction may be an acceptable alternative to daily diary assessment for children with chronic pain, retrospective measures of pain intensity may show inflated pain levels. To provide support for the findings, longitudinal research comparing responses to diary versus retrospective measures is recommended.
本研究调查了慢性疼痛儿童和青少年疼痛、活动受限与抑郁之间的日常关系，并比较了参与者在日记和回顾性评估测量中的反应。
数据收集包括对93名患有复发性头痛、青少年慢性关节炎和镰状细胞病的儿童进行疼痛、活动受限和抑郁的日记及回顾性测量。该研究使用分层线性模型来检验日常疼痛与活动受限之间的关系，并分析比较参与者在日记和回顾性评估测量中的反应。
使用日记测量方法，日常疼痛强度与儿童的活动受限水平相关。日记完成情况由年龄和日记类型预测，年龄较小的儿童以及使用电子日记的儿童表现出更高的依从性。与日记测量相比，回顾性测量中的疼痛强度显著更高，表明回顾性疼痛报告存在夸大。活动受限测量之间未出现显著差异。
这些初步结果表明，尽管对于慢性疼痛儿童，活动受限的回顾性报告可能是日常日记评估的可接受替代方法，但疼痛强度的回顾性测量可能显示出夸大的疼痛水平。为支持这些发现，建议进行纵向研究，比较日记测量与回顾性测量的反应。
