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小儿门诊慢性疼痛评估一年后的治疗结果:青少年疼痛患者的慢性疼痛分级(CPG)

[Therapy outcome one year after pediatric outpatient chronic pain evaluation : Chronic Pain Grading (CPG) for adolescent pain patients].

作者信息

Stahlschmidt L, Barth F, Zernikow B, Wager J

机构信息

Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland.

出版信息

Schmerz. 2017 Dec;31(6):601-609. doi: 10.1007/s00482-017-0215-0.

Abstract

BACKGROUND

Interdisciplinary pain treatment has been shown to be effective for children and adolescents with chronic pain, both in an outpatient and inpatient setting. Until now, the effectiveness has been analyzed with various outcome measures. Although it has only rarely been used for adolescents so far, Chronic Pain Grading (CPG) developed by Von Korff could be an appropriate general outcome measure.

OBJECTIVE

The study aims at prospectively investigating and comparing the therapy outcome one year after initial presentation for both outpatients and inpatients using the CPG.

MATERIALS AND METHODS

Data of 258 adolescents were gathered at initial presentation and one year later and analyzed using the CPG. Changes from pretreatment to follow-up and predictors of good therapy outcome were investigated for the whole sample and separately for outpatients and inpatients.

RESULTS

Compared to inpatients, outpatients were characterized by a lower CPG both before and one year after initial presentation. Large effects were found both for outpatient and inpatient therapy regarding the improvement of the CPG. In outpatient therapy, boys were two times more likely to display therapy success.

CONCLUSION

The study shows that the CPG is an appropriate outcome measure to display the long-term effectiveness of an inpatient and outpatient interdisciplinary pain treatment. The interdisciplinary pain treatment needs to be better tailored to girls to improve its effectiveness.

摘要

背景

跨学科疼痛治疗已被证明对患有慢性疼痛的儿童和青少年有效,无论是在门诊还是住院环境中。到目前为止,已使用各种结果指标对其有效性进行了分析。尽管到目前为止它很少用于青少年,但冯·科夫(Von Korff)开发的慢性疼痛分级(CPG)可能是一种合适的总体结果指标。

目的

本研究旨在前瞻性地调查和比较使用CPG对门诊患者和住院患者初次就诊一年后的治疗结果。

材料与方法

收集了258名青少年初次就诊时和一年后的数据,并使用CPG进行分析。对整个样本以及门诊患者和住院患者分别调查了从治疗前到随访的变化以及良好治疗结果的预测因素。

结果

与住院患者相比,门诊患者在初次就诊前和一年后的CPG较低。门诊治疗和住院治疗在CPG改善方面均发现有显著效果。在门诊治疗中,男孩治疗成功的可能性是女孩的两倍。

结论

该研究表明,CPG是显示住院和门诊跨学科疼痛治疗长期有效性的合适结果指标。跨学科疼痛治疗需要更好地针对女孩进行调整,以提高其有效性。

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