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在初次疼痛门诊评估前,慢性肌肉骨骼疼痛青少年及其父母的疼痛信念和改变意愿。

Pain beliefs and readiness to change among adolescents with chronic musculoskeletal pain and their parents before an initial pain clinic evaluation.

作者信息

Guite Jessica W, Kim Sohee, Chen Chia-Pei, Sherker Jennifer L, Sherry David D, Rose John B, Hwang Wei-Ting

机构信息

Departments of *Anesthesiology and Critical Care Medicine §Pediatrics, Division of Rheumatology, The Children's Hospital of Philadelphia Departments of ∥Biostatistics and Epidemiology ‡Biotechnology, School of Engineering and Applied Science †Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA.

出版信息

Clin J Pain. 2014 Jan;30(1):27-35. doi: 10.1097/AJP.0b013e31828518e9.

Abstract

OBJECTIVES

To understand relationships between pain-related beliefs and readiness to change among treatment-seeking adolescents with chronic musculoskeletal pain and their parents.

METHODS

A total of 102 adolescent-parent dyads were recruited at the time of initial evaluation at a multidisciplinary pain management clinic. Dyads completed self-report measures to assess pain, catastrophizing, endorsement of a biopsychosocial perspective of pain, and readiness to change/motivation to adopt a self-management approach to pain coping.

RESULTS

Agreement between adolescent-parent dyad reports of pain catastrophizing and readiness to change was found; however, adolescents were less likely to view pain as "affected by feelings and emotions" than parents. The hypothesis that greater pain catastrophizing would be correlated with less readiness to change was partially supported. Adolescent and parents who reported lower levels of endorsement of a biopsychosocial perspective were less willing to adopt a self-management approach to pain coping. Endorsement of a biopsychosocial perspective of pain aligned with readiness to change stages more consistently for parents.

DISCUSSION

This study documents initial relationships among pain catastrophizing, biopsychosocial perspectives of pain, and readiness to engage in a self-management approach to pain coping for adolescents with chronic pain and their parents. Although agreement exists between dyads regarding catastrophizing and readiness to change, differences were noted in biopsychosocial perspective and dominant readiness to change stage before an initial pain clinic encounter. Findings are considered in terms of future research to advance knowledge regarding the role these factors may play in treatment adherence and outcomes.

摘要

目的

了解患有慢性肌肉骨骼疼痛的寻求治疗的青少年及其父母中,与疼痛相关的信念和改变意愿之间的关系。

方法

在一家多学科疼痛管理诊所进行初次评估时,共招募了102对青少年-父母二元组。二元组完成了自我报告测量,以评估疼痛、灾难化思维、对疼痛的生物心理社会观点的认同,以及采用自我管理方法应对疼痛的改变意愿/动机。

结果

发现青少年-父母二元组在疼痛灾难化和改变意愿的报告上存在一致性;然而,青少年比父母更不太可能将疼痛视为“受情感和情绪影响”。更大的疼痛灾难化与更低的改变意愿相关这一假设得到了部分支持。报告对生物心理社会观点认同程度较低的青少年和父母,不太愿意采用自我管理方法来应对疼痛。对于父母而言,对疼痛的生物心理社会观点的认同与改变意愿阶段的一致性更高。

讨论

本研究记录了患有慢性疼痛的青少年及其父母在疼痛灾难化、疼痛的生物心理社会观点以及采用自我管理方法应对疼痛的意愿之间的初步关系。尽管二元组在灾难化和改变意愿方面存在一致性,但在初次疼痛诊所就诊之前,在生物心理社会观点和主要的改变意愿阶段方面存在差异。从未来研究的角度考虑这些发现,以推进对这些因素在治疗依从性和结果中可能发挥的作用的认识。

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