Swiggum Mary, Hamilton Merry Lynne, Gleeson Peggy, Roddey Toni, Mitchell Katy
School of Physical Therapy, Texas Woman's University, Houston, Texas, USA.
Pediatr Phys Ther. 2010 Fall;22(3):330-5. doi: 10.1097/PEP.0b013e3181ea8d7d.
This study explored pain assessment measures and interventions used by physical therapists in the treatment of children with neurologic impairment.
Following extensive literature review on pain assessment and intervention, a survey was developed, pilot tested, and posted on the listserv of the Pediatric Section of the American Physical Therapy Association.
Eighty percent of the respondents used subjective measures to assess pain, 70% used self-report scales, and 41% used behavioral and physiological measures. Behaviors frequently used included vocalizations, facial expression, and irritability. Rarely used cues included decreased attention, withdrawal, and changes in sleeping and eating behaviors. Therapists used research-supported pain interventions such as distraction and praise as well as potentially harmful distress producing measures such as procedural talk and reassurance.
Further research is needed to determine the feasibility of using behavioral pain assessment measures during physical therapy sessions. Physical therapist continuing education regarding nonpharmaceutical pain interventions is indicated.
本研究探讨了物理治疗师在治疗神经功能障碍儿童时使用的疼痛评估措施和干预方法。
在对疼痛评估和干预进行广泛文献综述之后，制定了一项调查问卷，进行了预测试，并发布在美国物理治疗协会儿科分会的邮件列表上。
80%的受访者使用主观测量方法评估疼痛，70%使用自我报告量表，41%使用行为和生理测量方法。经常使用的行为包括发声、面部表情和易怒。很少使用的线索包括注意力下降、退缩以及睡眠和饮食行为的改变。治疗师使用了如分散注意力和表扬等有研究支持的疼痛干预措施，以及如程序性谈话和安慰等可能产生有害痛苦的措施。
需要进一步研究以确定在物理治疗过程中使用行为疼痛评估措施的可行性。建议对物理治疗师进行关于非药物疼痛干预的继续教育。
