Noel Melanie, Palermo Tonya M, Essner Bonnie, Zhou Chuan, Levy Rona L, Langer Shelby L, Sherman Amanda L, Walker Lynn S
Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington.
Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; Department of Psychiatry, University of Washington School of Medicine, Seattle, Washington.
J Pain. 2015 Jan;16(1):31-41. doi: 10.1016/j.jpain.2014.10.005. Epub 2014 Oct 22.
The widely used Adult Responses to Children's Symptoms measures parental responses to child symptom complaints among youth aged 7 to 18 years with recurrent/chronic pain. Given developmental differences between children and adolescents and the impact of developmental stage on parenting, the factorial validity of the parent-report version of the Adult Responses to Children's Symptoms with a pain-specific stem was examined separately in 743 parents of 281 children (7-11 years) and 462 adolescents (12-18 years) with chronic pain or pain-related chronic illness. Factor structures of the Adult Responses to Children's Symptoms beyond the original 3-factor model were also examined. Exploratory factor analysis with oblique rotation was conducted on a randomly chosen half of the sample of children and adolescents as well as the 2 groups combined to assess underlying factor structure. Confirmatory factor analysis was conducted on the other randomly chosen half of the sample to cross-validate factor structure revealed by exploratory factor analyses and compare it to other model variants. Poor loading and high cross-loading items were removed. A 4-factor model (Protect, Minimize, Monitor, and Distract) for children and the combined (child and adolescent) sample and a 5-factor model (Protect, Minimize, Monitor, Distract, and Solicitousness) for adolescents was superior to the 3-factor model proposed in previous literature. Future research should examine the validity of derived subscales and developmental differences in their relationships with parent and child functioning.
This article examined developmental differences in the structure of a widely used measure of caregiver responses to chronic pain or pain-related chronic illness in youth. Results suggest that revised structures that differ across developmental groups can be used with youth with a range of clinical pain-related conditions.
广泛使用的《成人对儿童症状的反应》量表用于测量7至18岁患有复发性/慢性疼痛的青少年出现症状时父母的反应。鉴于儿童和青少年之间的发育差异以及发育阶段对养育方式的影响，我们分别对281名儿童（7至11岁）和462名青少年（12至18岁）患有慢性疼痛或与疼痛相关的慢性疾病的743名家长进行了研究，检验了带有疼痛特定主干的《成人对儿童症状的反应》家长报告版本的因子效度。我们还研究了《成人对儿童症状的反应》超出原始三因素模型的因子结构。对随机抽取的一半儿童和青少年样本以及合并后的两组进行了带有斜交旋转的探索性因子分析，以评估潜在的因子结构。对另一半随机抽取的样本进行验证性因子分析，以交叉验证探索性因子分析揭示的因子结构，并将其与其他模型变体进行比较。去除了载荷较差和交叉载荷较高的项目。儿童及合并样本（儿童和青少年）的四因素模型（保护、最小化、监测和分散注意力）以及青少年的五因素模型（保护、最小化、监测、分散注意力和关切）优于先前文献中提出的三因素模型。未来的研究应检验派生分量表的效度及其与父母和儿童功能关系中的发育差异。
本文研究了一种广泛使用的测量照顾者对青少年慢性疼痛或与疼痛相关的慢性疾病反应的量表在结构上的发育差异。结果表明，不同发育组的修订结构可用于患有一系列临床疼痛相关疾病的青少年。
