Oregon Health and Science University, Portland, Oregon 97239, USA.
J Pain. 2010 Nov;11(11):1027-38. doi: 10.1016/j.jpain.2010.04.005.
Disturbances in family functioning have been identified in youth with chronic pain and are associated with worse child physical and psychological functioning. Assessment measures of family functioning used in research and clinical settings vary. This systematic review summarizes studies investigating relationships among family functioning, pain, and pain-related disability in youth with chronic pain. Sixteen articles were reviewed. All studies were cross-sectional; 7 utilized between-group comparisons (chronic pain versus healthy/control) and 12 examined within-group associations among family functioning, pain, and/or pain-related disability. Studies represented youth with various pain conditions (eg, headache, abdominal pain, fibromyalgia) ages 6 to 20 years. Findings revealed group differences in family functioning between children with chronic pain and healthy control subjects in 5 of 7 studies. Significant associations emerged among family variables and pain-related disability in 6 of 9 studies with worse family functioning associated with greater child disability; relationships between family functioning and children's pain were less consistent. Different patterns of results emerged depending on family functioning measure used. Overall, findings showed that families of children with chronic pain generally have poorer family functioning than healthy populations and that pain-related disability is more consistently related to family functioning than pain intensity.
This review highlights the importance of family factors in pain-related disability in youth with chronic pain. Results suggest that family-level variables may be an important target for intervention. Family functioning measures showed significant variation, and researchers should take this into account when selecting instruments for use in research and clinical settings.
在患有慢性疼痛的青少年中发现了家庭功能障碍，并且与儿童身体和心理功能下降有关。在研究和临床环境中使用的家庭功能评估方法多种多样。本系统综述总结了研究家庭功能、疼痛和慢性疼痛青少年疼痛相关残疾之间关系的研究。共审查了 16 篇文章。所有研究均为横断面研究；7 项研究采用了组间比较（慢性疼痛与健康/对照组），12 项研究则考察了家庭功能、疼痛和/或疼痛相关残疾之间的组内关联。研究代表了患有各种疼痛疾病（如头痛、腹痛、纤维肌痛）的 6 至 20 岁青少年。有 7 项研究中的 5 项研究发现慢性疼痛儿童与健康对照组之间的家庭功能存在组间差异。在 9 项研究中有 6 项研究中出现了家庭变量与疼痛相关残疾之间的显著关联，结果表明家庭功能越差，儿童残疾程度越大；家庭功能与儿童疼痛之间的关系则不那么一致。研究结果因所使用的家庭功能测量方法不同而有所不同。总的来说，研究结果表明，患有慢性疼痛的儿童的家庭通常比健康人群的家庭功能更差，而且疼痛相关残疾与家庭功能的关系比疼痛强度更一致。
本综述强调了家庭因素在慢性疼痛青少年疼痛相关残疾中的重要性。结果表明，家庭层面的变量可能是干预的重要目标。家庭功能测量方法差异显著，研究人员在研究和临床环境中选择使用的工具时应考虑这一点。
