Higgins Kristen S, Birnie Kathryn A, Chambers Christine T, Wilson Anna C, Caes Line, Clark Alexander J, Lynch Mary, Stinson Jennifer, Campbell-Yeo Marsha
Dalhousie University, Halifax, NS, Canada IWK Health Centre, Halifax, NS, Canada Oregon Health & Science University, Portland, OR, USA National University of Ireland, Galway, Ireland QEII Health Sciences Centre, Halifax, NS, Canada The Hospital for Sick Children, Toronto, ON, Canada University of Toronto, Toronto, ON, Canada.
Pain. 2015 Nov;156(11):2256-2266. doi: 10.1097/j.pain.0000000000000293.
Offspring of parents with chronic pain may be at risk for poorer outcomes than offspring of healthy parents. The objective of this research was to provide a comprehensive mixed-methods systematic synthesis of all available research on outcomes in offspring of parents with chronic pain. A systematic search was conducted for published articles in English examining pain, health, psychological, or family outcomes in offspring of parents with chronic pain. Fifty-nine eligible articles were identified (31 population-based, 25 clinical, 3 qualitative), including offspring from birth to adulthood and parents with varying chronic pain diagnoses (eg, mixed pain samples, arthritis). Meta-analysis was used to synthesize the results from population-based and clinical studies, while meta-ethnography was used to synthesize the results of qualitative studies. Increased pain complaints were found in offspring of mothers and of fathers with chronic pain and when both parents had chronic pain. Newborns of mothers with chronic pain were more likely to have adverse birth outcomes, including low birthweight, preterm delivery, caesarian section, intensive care admission, and mortality. Offspring of parents with chronic pain had greater externalizing and internalizing problems and poorer social competence and family outcomes. No significant differences were found on teacher-reported externalizing problems. The meta-ethnography identified 6 key concepts (developing independence, developing compassion, learning about health and coping, missing out, emotional health, and struggles communicating with parents). Across study designs, offspring of parents with chronic pain had poorer outcomes than other offspring, although the meta-ethnography noted some constructive impact of having a parent with chronic pain.
与健康父母的后代相比,患有慢性疼痛的父母的后代可能面临更差的结果风险。本研究的目的是对所有关于患有慢性疼痛的父母的后代结局的现有研究进行全面的混合方法系统综述。我们对已发表的英文文章进行了系统检索,以研究患有慢性疼痛的父母的后代的疼痛、健康、心理或家庭结局。共识别出59篇符合条件的文章(31篇基于人群的研究、25篇临床研究、3篇定性研究),包括从出生到成年的后代以及患有不同慢性疼痛诊断的父母(例如,混合性疼痛样本、关节炎)。荟萃分析用于综合基于人群的研究和临床研究的结果,而元民族志用于综合定性研究的结果。研究发现,患有慢性疼痛的母亲和父亲的后代以及父母双方都患有慢性疼痛时,后代的疼痛主诉会增加。患有慢性疼痛的母亲所生的新生儿更有可能出现不良出生结局,包括低出生体重、早产、剖宫产、入住重症监护病房和死亡率。患有慢性疼痛的父母的后代有更多的外化和内化问题,社交能力和家庭结局更差。在教师报告的外化问题上未发现显著差异。元民族志确定了6个关键概念(培养独立性、培养同情心、了解健康和应对、错过机会、情绪健康以及与父母沟通困难)。在所有研究设计中,患有慢性疼痛的父母的后代的结局比其他后代更差,尽管元民族志指出有一位患有慢性疼痛的父母也有一些建设性的影响。