父母对儿童慢性疼痛反应的种族差异。

Racial Differences in Parental Responses to Children's Chronic Pain.

作者信息

El-Behadli Ana F, Gansert Patricia, Logan Deirdre E

机构信息

*Department of Clinical Psychology, UT Southwestern Medical Center †Center for Cancer and Blood Disorders, Children's Medical Center, Dallas, TX ‡Institute for Applied Research in Youth Development, Tufts University, Medford §Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Children's Hospital ∥Department of Psychiatry, Harvard Medical School, Boston, MA.

出版信息

Clin J Pain. 2017 Jun;33(6):503-508. doi: 10.1097/AJP.0000000000000424.

DOI:10.1097/AJP.0000000000000424

PMID:27479643

Abstract

OBJECTIVE

Parental responses to children's pain are related to how youth cope with chronic pain. However, little research has explored cultural differences in the 4 major pain response categories (ie, protect, minimize, distract, and monitor). This study compared parental responses to children's pain between minority parents (ie, black, Hispanic, multiracial) and parents of white children.

MATERIALS AND METHODS

Participants included 234 patients, ages 8 to 17, with chronic pain (73.5% female; age M [SD]=13.91 [2.38]; 50% white, 15.39% black, 20.90% Hispanic, 13.68% multiracial). Patients' parents completed the Adult Responses to Children's Symptoms. Parental responses included: protect, monitor, minimize, and distrct. For between-group comparisons, white participants (N=117) were matched on age and sex with black (N=36), Hispanic (N=49), and multiracial (N=32) participants.

RESULTS

Paired-samples t tests revealed that protectiveness was higher for parents of black children (t48=-3.84, P<0.001, black M [SD]=1.93 [0.69], white M [SD]=0.94 [0.77], Cohen d=1.09) and parents of Hispanic children (t71=-7.10, P<0.001, Hispanic M [SD]=1.65 [0.76], white M [SD]=0.94 [0.77], Cohen d=1.52) compared with parents of white children. In addition, parents of black children (t40=-2.90, P=0.006, black M [SD]=3.55 [0.49], white M [SD]=2.89 [0.93], Cohen d=0.80) and parents of Hispanic children (t71=-3.62, P<0.001, Hispanic M [SD]=3.35 [0.69], white M [SD]=2.89 [0.93], Cohen d=0.81) were significantly more monitoring their children than were parents of white children. Parents of Hispanic children were also significantly more minimizing than parents of white children (t71=-3.68, P<0.001, Hispanic M [SD]=0.88 [0.75], white M [SD]=0.51 [0.58], Cohen d=0.80). No other significant differences were found.

DISCUSSION

Results highlight the need to adapt pediatric chronic pain interventions to family culture and context. Further research is needed to understand pediatric chronic pain from a cross-cultural perspective.

摘要

目的

父母对孩子疼痛的反应与青少年应对慢性疼痛的方式有关。然而，很少有研究探讨四大疼痛反应类别（即保护、最小化、分散注意力和监测）中的文化差异。本研究比较了少数族裔父母（即黑人、西班牙裔、多种族）与白人孩子的父母对孩子疼痛的反应。

材料与方法

研究对象包括234名8至17岁的慢性疼痛患者（73.5%为女性；年龄M[标准差]=13.91[2.38]；50%为白人，15.39%为黑人，20.90%为西班牙裔，13.68%为多种族）。患者的父母完成了《成人对儿童症状的反应》。父母的反应包括：保护、监测、最小化和分散注意力。为了进行组间比较，白人参与者（N = 117）在年龄和性别上与黑人（N = 36）、西班牙裔（N = 49）和多种族（N = 32）参与者进行了匹配。

结果

配对样本t检验显示，黑人孩子的父母（t48 = -3.84，P < 0.001，黑人M[标准差]=1.93[0.69]，白人M[标准差]=0.94[0.77]，科恩d = 1.09）和西班牙裔孩子的父母（t71 = -7.10，P < 0.001，西班牙裔M[标准差]=1.65[0.76]，白人M[标准差]=0.94[0.77]，科恩d = 1.52）比白人孩子的父母更具保护欲。此外，黑人孩子的父母（t40 = -2.90，P = 0.006，黑人M[标准差]=3.55[0.49]，白人M[标准差]=2.89[0.93]，科恩d = 0.80）和西班牙裔孩子的父母（t71 = -3.62，P < 0.001，西班牙裔M[标准差]=3.35[0.69]，白人M[标准差]=2.89[0.93]，科恩d = 0.81）比白人孩子的父母对孩子的监测明显更多。西班牙裔孩子的父母在最小化方面也比白人孩子的父母明显更多（t71 = -3.68，P < 0.001，西班牙裔M[标准差]=0.88[0.75]，白人M[标准差]=0.51[0.58]，科恩d = 0.80）。未发现其他显著差异。