慢性疼痛儿童心理治疗的系统评价与荟萃分析
Systematic review and meta-analysis of psychological therapies for children with chronic pain.
作者信息
Fisher Emma, Heathcote Lauren, Palermo Tonya M, de C Williams Amanda C, Lau Jennifer, Eccleston Christopher
机构信息
Centre for Pain Research, University of Bath, Department of Experimental Psychology, University of Oxford, Department of Anaesthesiology & Pain Medicine, University of Washington, Clinical Health Psychology, University College London, and University College London Hospitals, and Psychology Department, Kings College London
Centre for Pain Research, University of Bath, Department of Experimental Psychology, University of Oxford, Department of Anaesthesiology & Pain Medicine, University of Washington, Clinical Health Psychology, University College London, and University College London Hospitals, and Psychology Department, Kings College London.
出版信息
J Pediatr Psychol. 2014 Sep;39(8):763-82. doi: 10.1093/jpepsy/jsu008. Epub 2014 Mar 6.
OBJECTIVES
This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children.
METHODS
Randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions including headache, abdominal, musculoskeletal, or neuropathic pain were searched for. Pain symptoms, disability, depression, anxiety, and sleep outcomes were extracted. Risk of bias was assessed and quality of the evidence was rated using GRADE.
RESULTS
35 included studies revealed that across all chronic pain conditions, psychological interventions reduced pain symptoms and disability posttreatment. Individual pain conditions were analyzed separately. Sleep outcomes were not reported in any trials. Optimal dose of treatment was explored. For headache pain, higher treatment dose led to greater reductions in pain. No effect of dosage was found for other chronic pain conditions.
CONCLUSIONS
Evidence for psychological therapies treating chronic pain is promising. Recommendations for clinical practice and research are presented.
目的
本系统评价和荟萃分析探讨了心理治疗对儿童慢性疼痛管理的效果。
方法
检索了针对患有慢性疼痛（包括头痛、腹痛、肌肉骨骼疼痛或神经性疼痛）的儿童（<18岁）进行心理干预的随机对照试验。提取疼痛症状、残疾、抑郁、焦虑和睡眠结果。评估偏倚风险并使用GRADE对证据质量进行评级。
结果
35项纳入研究表明，在所有慢性疼痛情况下，心理干预均能减轻治疗后的疼痛症状和残疾程度。对个体疼痛情况进行了单独分析。所有试验均未报告睡眠结果。探索了最佳治疗剂量。对于头痛疼痛，较高的治疗剂量可导致疼痛更大程度的减轻。对于其他慢性疼痛情况，未发现剂量效应。
结论
心理治疗慢性疼痛的证据很有前景。提出了临床实践和研究建议。
Zotero 插件