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青少年慢性肌肉骨骼疼痛患者的疼痛、保护性父母反应和残疾之间的关系:疼痛灾难化的中介作用。

Relationships among pain, protective parental responses, and disability for adolescents with chronic musculoskeletal pain: the mediating role of pain catastrophizing.

机构信息

Department of Anesthesiology and CCM, The Children's Hospital of Philadelphia, PA 19104-4399, USA.

出版信息

Clin J Pain. 2011 Nov-Dec;27(9):775-81. doi: 10.1097/AJP.0b013e31821d8fb4.

Abstract

OBJECTIVES

Children learn to cope with pain within the context of the family and parental responses to pediatric pain can impact health outcomes. The aim of this study was to examine relationships among pain, protective parental responses to pain, functional disability, and pain catastrophizing for adolescents with chronic musculoskeletal pain syndromes.

METHODS

Initial evaluation records for 138 adolescents with chronic musculoskeletal pain who consulted a pediatric multidisciplinary pain management clinic were examined. Measures were collected at the time of the initial evaluation and included adolescent self-reports of their own usual pain intensity, perceived parental responses to their pain, adolescent functional disability, and pain catastrophizing.

RESULTS

Pain catastrophizing was significantly correlated with pain intensity, protective parental responses to pain, and functional disability. Multiple regression analyses further suggest that pain catastrophizing serves as a mediator of relationships between: (1) pain and disability and (2) protective parenting responses and disability. Evidence supporting a significant indirect effect for pain catastrophizing on disability was found within both models through bootstrap and Sobel analyses.

DISCUSSION

Pain catastrophizing seems to play an important role in understanding relationships between pain, protective parental responses, and disability for adolescents with musculoskeletal pain. Our findings suggest that strategies that help modify adolescent catastrophic pain beliefs and parental responses to pain, may help improve adolescent functioning.

摘要

目的

儿童在家庭环境中学会应对疼痛,父母对儿童疼痛的反应会影响健康结果。本研究旨在探讨青少年慢性肌肉骨骼疼痛综合征的疼痛、父母对疼痛的保护性反应、功能障碍和疼痛灾难化之间的关系。

方法

对在儿科多学科疼痛管理诊所就诊的 138 名患有慢性肌肉骨骼疼痛的青少年的初始评估记录进行了检查。在初始评估时收集了措施,包括青少年对自己通常疼痛强度的自我报告、感知到的父母对他们疼痛的反应、青少年的功能障碍和疼痛灾难化。

结果

疼痛灾难化与疼痛强度、对疼痛的保护性父母反应和功能障碍显著相关。多元回归分析进一步表明,疼痛灾难化是疼痛与残疾之间以及保护性父母反应与残疾之间关系的中介。通过自举和 Sobel 分析,在两个模型中都发现了疼痛灾难化对残疾有显著的间接影响的证据。

讨论

疼痛灾难化似乎在理解青少年肌肉骨骼疼痛的疼痛、保护性父母反应和残疾之间的关系方面起着重要作用。我们的研究结果表明,帮助改变青少年灾难性疼痛信念和父母对疼痛反应的策略可能有助于改善青少年的功能。

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