McMurtry C Meghan, Pillai Riddell Rebecca, Taddio Anna, Racine Nicole, Asmundson Gordon J G, Noel Melanie, Chambers Christine T, Shah Vibhuti
*Department of Psychology, University of Guelph, Guelph †Children's Health Research Institute ‡Department of Paediatrics, Western University, London §Department of Psychology, York University ∥The Hospital for Sick Children ¶Department of Psychiatry #Leslie Dan Faculty of Pharmacy ¶¶Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto ∥∥Mount Sinai Hospital, Toronto, ON **Department of Psychology, University of Regina, Regina, SK ‡‡Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University §§Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada ††Department of Psychology, University of Calgary, AB, Canada.
Clin J Pain. 2015 Oct;31(10 Suppl):S3-11. doi: 10.1097/AJP.0000000000000272.
Vaccine injections are the most common painful needle procedure experienced throughout the lifespan. Many strategies are available to mitigate this pain; however, they are uncommonly utilized, leading to unnecessary pain and suffering. Some individuals develop a high level of fear and subsequent needle procedures are associated with significant distress.
The present work is part of an update and expansion of a 2009 knowledge synthesis to include the management of vaccine-related pain across the lifespan and the treatment of individuals with high levels of needle fear. This article will provide a conceptual foundation for understanding: (a) painful procedures and their role in the development and maintenance of high levels of fear; (b) treatment strategies for preventing or reducing the experience of pain and the development of fear; and (c) interventions for mitigating high levels of fear once they are established.
First, the general definitions, lifespan development and functionality, needle procedure-related considerations, and assessment of the following constructs are provided: pain, fear, anxiety, phobia, distress, and vasovagal syncope. Second, the importance of unmitigated pain from needle procedures is highlighted from a developmental perspective. Third, the prevalence, course, etiology, and consequences of high levels of needle fear are described. Finally, the management of needle-related pain and fear are outlined to provide an introduction to the series of systematic reviews in this issue.
Through the body of work in this supplement, the authors aim to provide guidance in how to treat vaccination-related pain and its sequelae, including high levels of needle fear.
疫苗注射是人们一生中最常经历的疼痛性针刺操作。有许多策略可减轻这种疼痛;然而,这些策略很少被采用,导致了不必要的疼痛和痛苦。一些人会产生高度恐惧,随后的针刺操作会带来极大的痛苦。
本研究是对2009年知识综合的更新和扩展的一部分,内容包括全生命周期疫苗相关疼痛的管理以及对高度恐惧针头的个体的治疗。本文将为理解以下内容提供概念基础:(a)疼痛性操作及其在高度恐惧的形成和维持中的作用;(b)预防或减轻疼痛体验和恐惧形成的治疗策略;(c)在高度恐惧形成后减轻恐惧的干预措施。
首先,给出了以下概念的一般定义、全生命周期发展及功能、与针刺操作相关的考量以及评估:疼痛、恐惧、焦虑、恐惧症、痛苦和血管迷走性晕厥。其次,从发育角度强调了针刺操作导致的未缓解疼痛的重要性。第三,描述了高度针头恐惧的患病率、病程、病因和后果。最后,概述了与针头相关的疼痛和恐惧的管理,为本期系列系统评价提供介绍。
通过本增刊中的一系列研究,作者旨在为如何治疗疫苗接种相关疼痛及其后遗症(包括高度针头恐惧)提供指导。