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针对转诊至专科诊所的患有儿童慢性疼痛疾病的患者,疼痛强度与功能障碍的生物心理社会模型的验证及临床应用

Validation and clinical application of a biopsychosocial model of pain intensity and functional disability in patients with a pediatric chronic pain condition referred to a subspecialty clinic.

作者信息

Vetter Thomas R, McGwin Gerald, Bridgewater Cynthia L, Madan-Swain Avi, Ascherman Lee I

机构信息

Department of Anesthesiology, University of Alabama School of Medicine, JT862, 619 19th Street South, Birmingham, AL 35249-6810, USA.

出版信息

Pain Res Treat. 2013;2013:143292. doi: 10.1155/2013/143292. Epub 2013 Oct 22.

Abstract

Background. Pediatric chronic pain is considered to be a multidimensional construct that includes biological, psychological, and social components. Methods. The 99 enrolled study patients (mean age 13.2 years, 71% female, 81% Caucasian) and an accompanying parent completed a series of health-related questionnaires at the time of their initial appointment in a pediatric chronic pain medicine clinic. Results. Significant correlations (r ≥ 0.30, P < 0.05) were observed between pediatric chronic pain intensity and patient anxiety, patient depression, patient pain coping, parent chronic pain intensity, and parent functional disability. Pediatric chronic pain intensity was significantly associated with patient anxiety (P = 0.002). Significant correlations (r ≥ 0.30, P < 0.05) were observed between pediatric functional disability and patient chronic pain intensity, patient anxiety, patient depression, patient pain coping, parent chronic pain intensity, parent functional disability, parent anxiety, parent depression, and parent stress. Pediatric functional disability was significantly associated with patient chronic pain intensity (P = 0.025), patient anxiety (P = 0.021), patient pain coping (P = 0.009), and parent functional disability (P = 0.027). Conclusions. These findings provide empirical support of a multidimensional Biobehavioral Model of Pediatric Pain. However, the practical clinical application of the present findings and much of the similar previously published data may be tenuous.

摘要

背景。儿童慢性疼痛被认为是一个多维度的概念,包括生物、心理和社会成分。方法。99名入选的研究患者(平均年龄13.2岁,71%为女性,81%为白种人)及其陪同的家长在小儿慢性疼痛医学诊所初次就诊时完成了一系列与健康相关的问卷。结果。观察到儿童慢性疼痛强度与患者焦虑、患者抑郁、患者疼痛应对、家长慢性疼痛强度和家长功能障碍之间存在显著相关性(r≥0.30,P<0.05)。儿童慢性疼痛强度与患者焦虑显著相关(P = 0.002)。观察到儿童功能障碍与患者慢性疼痛强度、患者焦虑、患者抑郁、患者疼痛应对、家长慢性疼痛强度、家长功能障碍、家长焦虑、家长抑郁和家长压力之间存在显著相关性(r≥0.30,P<0.05)。儿童功能障碍与患者慢性疼痛强度(P = 0.025)、患者焦虑(P = 0.021)、患者疼痛应对(P = 0.009)和家长功能障碍(P = 0.027)显著相关。结论。这些发现为儿童疼痛的多维度生物行为模型提供了实证支持。然而,目前这些发现以及许多之前发表的类似数据在实际临床应用中可能并不稳固。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda6/3819919/f7bc6546353c/PRT2013-143292.001.jpg

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