McDowell Brona C, Duffy Catherine, Lundy Claire
Belfast Health and Social Care Trust, Musgrave Park Hospital, Stockman's Lane, Belfast, Northern Ireland, United Kingdom.
Belfast Health and Social Care Trust, Musgrave Park Hospital, Stockman's Lane, Belfast, Northern Ireland, United Kingdom.
Res Dev Disabil. 2017 Jan;60:277-284. doi: 10.1016/j.ridd.2016.10.006. Epub 2016 Oct 25.
While pain is reportedly more prevalent in more functionally impaired children with cerebral palsy, information is scant in those with poor communication skills.
Young people (4-27 years) with severe forms of cerebral palsy were recruited from a population-based register. The Child Health Questionnaire (CHQ) provided information on general health and bodily pain; the Paediatric Pain Profile (PPP) was used for participants with limited communication; and the Spinal Alignment and Range of Motion Measure (SAROMM) described musculoskeletal impairment.
123 young people (GMFCS IV=55 and V=68) and their families/carers participated. Fourteen percent of CHQ responses (n=123) reported severe/very severe pain in recent weeks, whilst 7% reported pain every/almost every day. CHQ pain report was significantly higher for young people in GMFCS level V and correlated significantly with both global health and musculoskeletal impairment. High levels of pain were recorded on the PPP for non-communicating children but only a weak correlation between PPP and CHQ scores was detected.
Managing pain in young people with severe musculoskeletal and cognitive impairment presents a huge challenge to carers and professionals. The PPP may represent a useful adjunct in those young people with severe communication difficulties.
据报道，功能障碍更严重的脑瘫儿童疼痛更为普遍，但沟通能力较差的儿童相关信息却很少。
从基于人群的登记册中招募患有严重脑瘫的年轻人（4 - 27岁）。儿童健康问卷（CHQ）提供了关于总体健康和身体疼痛的信息；儿科疼痛概况（PPP）用于沟通能力有限的参与者；脊柱排列和活动范围测量（SAROMM）描述了肌肉骨骼损伤情况。
123名年轻人（GMFCS IV级 = 55人，V级 = 68人）及其家庭/照顾者参与了研究。CHQ的回答中有14%（n = 123）报告在最近几周有严重/非常严重的疼痛，而7%报告每天/几乎每天都疼痛。GMFCS V级的年轻人CHQ疼痛报告显著更高，且与总体健康和肌肉骨骼损伤均显著相关。不会说话的儿童在PPP上记录到高水平的疼痛，但PPP与CHQ分数之间仅检测到微弱的相关性。
管理患有严重肌肉骨骼和认知障碍的年轻人的疼痛对照顾者和专业人员来说是一个巨大的挑战。PPP可能对那些有严重沟通困难的年轻人是一种有用的辅助工具。
