Department of Psychology, Georgia State University, USA.
Eur J Pain. 2010 Sep;14(8):882-6. doi: 10.1016/j.ejpain.2010.01.005. Epub 2010 Feb 26.
Accurate assessment of adolescent chronic pain is critical to guiding treatment decisions. Given the multifaceted role of the parents in their children's lives, parents, and patients often each provide reports of adolescents' pain-related functioning. In order to make sense of these data, clinicians should be aware of patterns of discordance in perspectives. In this study, we aimed to examine concordance and discordance in adolescents' self-report and mothers' proxy-report of adolescents' chronic pain-related functioning. Results suggested that although there were high correlations between the raters, there were also significant discordance with mothers rating their adolescents as having greater disability in social functioning, depression, and pain-specific anxiety. Analyses suggested that high pain and being older predicted greater concordance in ratings. Findings suggest that mothers and adolescents tended to have greater concordance for more observable and shared disability (e.g., physical disability, family functioning) and greater discordance for internal experiences (e.g., pain-specific anxiety, depression). Awareness of these patterns of concordance and discordance should help clinicians in interpreting mothers' proxy-reports and adolescents' self-reports of chronic pain-related functioning.
准确评估青少年慢性疼痛对于指导治疗决策至关重要。鉴于父母在孩子生活中扮演着多方面的角色，父母和患者通常都会提供有关青少年疼痛相关功能的报告。为了理解这些数据，临床医生应该注意观点的不一致模式。在这项研究中，我们旨在检查青少年自我报告和母亲代理报告青少年慢性疼痛相关功能之间的一致性和不一致性。结果表明，尽管评分者之间存在高度相关性，但母亲对青少年社会功能、抑郁和疼痛特异性焦虑方面的残疾程度的评分也存在显著差异。分析表明，较高的疼痛水平和年龄较大预示着评分的一致性更高。研究结果表明，母亲和青少年在更明显和共同的残疾（例如身体残疾、家庭功能）方面更倾向于一致性，而在内部体验（例如疼痛特异性焦虑、抑郁）方面则更不一致。了解这些一致性和不一致性模式有助于临床医生解释母亲的代理报告和青少年的慢性疼痛相关功能的自我报告。
