Evidence to Care, Bloorview Research Institute, Department of Occupational Science and Occupational Therapy,
Evidence to Care.
Pediatrics. 2015 Oct;136(4):e947-60. doi: 10.1542/peds.2015-0273.
Chronic pain in children with cerebral palsy (CP) is underrecognized, leading to detriments in their physical, social, and mental well-being. Our objective was to identify, describe, and critique pediatric chronic pain assessment tools and make recommendations for clinical use for children with CP. Secondly, develop an evidence-informed toolbox to support clinicians in the assessment of chronic pain in children with disabilities.
Ovid Medline, Cumulative Index to Nursing and Allied Health Literature, and Embase databases were systematically searched by using key terms "chronic pain" and "clinical assessment tool" between January 2012 and July 2014. Tools from multiple pediatric health conditions were explored contingent on inclusion criteria: (1) children 1 to 18 years; (2) assessment focus on chronic pain; (3) psychometric properties reported; (4) written in English between 1980 and 2014. Pediatric chronic pain assessment tools were extracted and corresponding validation articles were sought for review. Detailed tool descriptions were composed and each tool underwent a formal critique of psychometric properties and clinical utility.
Of the retrieved 2652 articles, 250 articles met eligibility, from which 52 chronic pain assessment tools were retrieved. A consensus among interprofessional working group members determined 7 chronic pain interference tools to be of importance. Not all tools have been validated with children with CP nor is there 1 tool to meet the needs of all children experiencing chronic pain.
This study has systematically reviewed and recommended, through expert consensus, valid and reliable chronic pain interference assessment tools for children with disabilities.
脑瘫（CP）儿童的慢性疼痛未得到充分认识，导致其身体、社交和心理健康受损。我们的目标是识别、描述和评价儿科慢性疼痛评估工具，并为 CP 儿童的临床应用提出建议。其次，开发一个基于证据的工具包，以支持临床医生评估残疾儿童的慢性疼痛。
使用关键词“慢性疼痛”和“临床评估工具”，对 Ovid Medline、Cumulative Index to Nursing and Allied Health Literature 和 Embase 数据库进行了系统检索，检索时间为 2012 年 1 月至 2014 年 7 月。根据纳入标准探索了多种儿科疾病的工具：（1）年龄 1 至 18 岁；（2）评估重点为慢性疼痛；（3）报告心理测量学特性；（4）2014 年以前用英语撰写。提取儿科慢性疼痛评估工具，并寻找相应的验证文章进行综述。详细描述了工具，并对每个工具的心理测量学特性和临床实用性进行了正式评价。
从检索到的 2652 篇文章中，有 250 篇符合入选标准，其中有 52 篇慢性疼痛评估工具符合入选标准。跨专业工作组的成员达成共识，认为有 7 种慢性疼痛干扰工具非常重要。并非所有工具都经过 CP 儿童验证，也没有一种工具能满足所有经历慢性疼痛的儿童的需求。
本研究通过专家共识，系统地回顾并推荐了适用于残疾儿童的有效且可靠的慢性疼痛干扰评估工具。
