Schwartz Lindsay F, Seidman Laura C, Zeltzer Lonnie K, Tsao Jennie C I
University of Illinois at Chicago, Chicago, IL, USA.
Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
J Pain Manag. 2013;6(2):135-145.
Body maps have long been used to assess pain location in adult and pediatric chronic pain patients. Assessing agreement between parent and child reports of pain location using such maps may help establish a unified picture of children's pain experience. However, few studies have examined the extent of agreement between mothers and children on the location of the child's pain. Using kappa coefficients and other determinants of the magnitude of kappa we assessed mother-child concordance in pain location using body maps with 21 standardized areas in 41 children with chronic pain (65.9% female, mean age = 14.60) and their mothers. The highest level of agreement was found for the abdominal region; agreement for the head region was moderate and not superior to the other body areas. Approximately half of the body map areas yielded poor to fair mother-child agreement, while the other half yielded moderate or better agreement. There was more agreement between mothers and sons than between mothers and daughters on the total number of body areas considered painful, but there were no effects of pubertal status, race, and ethnicity on agreement. Our results are consistent with previous studies indicating that parent assessments of children's pain do not necessarily mimic their child's report. Future research should test additional psychosocial factors that may contribute to parent-child discordance regarding the location of the child's pain.
身体图长期以来一直用于评估成人和儿童慢性疼痛患者的疼痛位置。使用此类身体图评估父母与孩子关于疼痛位置报告之间的一致性,可能有助于建立儿童疼痛体验的统一图景。然而,很少有研究考察母亲与孩子在孩子疼痛位置上的一致程度。我们使用卡帕系数及其他卡帕值大小的决定因素,通过具有21个标准化区域的身体图,评估了41名慢性疼痛儿童(65.9%为女性,平均年龄 = 14.60岁)及其母亲在疼痛位置上的母子一致性。腹部区域的一致性水平最高;头部区域的一致性为中等,并不优于其他身体部位。大约一半的身体图区域母子一致性较差至一般,而另一半区域的一致性为中等或更好。在认为疼痛的身体区域总数上,母亲与儿子之间的一致性高于母亲与女儿之间,但青春期状态、种族和民族对一致性没有影响。我们的结果与之前的研究一致,表明父母对孩子疼痛的评估不一定与孩子的报告相符。未来的研究应测试可能导致父母与孩子在孩子疼痛位置上不一致的其他心理社会因素。