York University, Toronto, Canada.
Pain. 2013 Jun;154(6):813-23. doi: 10.1016/j.pain.2013.02.006. Epub 2013 Feb 26.
Although previous research has examined the relationships between caregiver proximal soothing and infant pain, there is a paucity of work taking infant age into account, despite the steep developmental trajectory that occurs across the infancy period. Moreover, no studies have differentially examined the relationships between caregiver proximal soothing and initial infant pain reactivity and pain regulation. This study examined how much variance in pain reactivity and pain regulation was accounted for by caregiver proximal soothing at 4 routine immunizations (2, 4, 6, and 12 months) across the first year of life, controlling for preneedle distress. One latent growth model was replicated at each of the 4 infant ages, using a sample of 760 caregiver-infant dyads followed longitudinally. Controlling for preneedle infant distress, caregiver proximal soothing accounted for little to no variance in infant pain reactivity or regulation at all 4 ages. Preneedle distress and pain reactivity accounted for the largest amount of variance in pain regulation, with this increasing after 2 months. It was concluded that within each immunization appointment across the first year of life, earlier infant pain behaviour is a stronger predictor of subsequent infant pain behaviour than caregiver proximal soothing. Given the longer-term benefits that have been demonstrated for proximal soothing during distressing contexts, caregivers are still encouraged to use proximal soothing during infant immunizations.
尽管先前的研究已经考察了照顾者近侧安抚与婴儿疼痛之间的关系,但考虑到婴儿期发生的急剧发展轨迹,很少有工作考虑婴儿年龄。此外,没有研究分别检查照顾者近侧安抚与婴儿初始疼痛反应和疼痛调节之间的关系。本研究考察了在生命的第一年的 4 次常规免疫接种(2、4、6 和 12 个月)期间,照顾者近侧安抚对疼痛反应和疼痛调节的差异有多大,同时控制了针头前的痛苦。在每个婴儿年龄,使用 760 对纵向随访的照顾者-婴儿对进行了 1 个潜在增长模型的复制。在所有 4 个年龄中,在控制针头前婴儿痛苦的情况下,照顾者近侧安抚对婴儿疼痛反应或调节几乎没有差异。针头前痛苦和疼痛反应对疼痛调节的差异最大,在 2 个月后增加。因此,在生命的第一年的每个免疫接种期间,婴儿早期的疼痛行为是后续婴儿疼痛行为的更强预测因素,而不是照顾者的近侧安抚。考虑到在痛苦环境中近侧安抚已显示出更长期的益处,仍鼓励照顾者在婴儿免疫接种期间使用近侧安抚。