Department of Pediatrics, Hematology/Oncology, University of Mississippi Medical Center.
Department of Pediatrics, Oregon Health & Science University.
J Pediatr Psychol. 2018 Apr 1;43(3):237-242. doi: 10.1093/jpepsy/jsx114.
To apply a biopsychosocial framework to understand factors influencing pain in survivors of pediatric cancer to inform pain prevention efforts and highlight the need for interdisciplinary care.
This topical review draws from both pediatric cancer survivorship research and chronic noncancer pain research to illustrate how components of a preventative model can be applied to pain in survivorship.
Pain is a common experience among long-term survivors of pediatric cancer. The pain experience in survivorship can be conceptualized in terms of biological disease and treatment factors, cognitive and affective factors, and social and contextual factors. We review literature pertinent to each of these biopsychosocial factors and tailor an existing public health prevention framework for pain in survivors of pediatric cancer.
Classifying survivors of pediatric cancer into pain risk categories based on their daily experiences of pain, pain-related functional impairment, and distress could help guide the implementation of pain-related prevention and intervention strategies in this population. Future research is needed to establish the efficacy of screening measures to identify patients in need of psychosocial pain and pain-related fear management services, and interdisciplinary pediatric chronic pain management programs in survivors of pediatric cancer.
运用生物-心理-社会框架理解影响儿科癌症幸存者疼痛的因素，为疼痛预防工作提供信息，并强调跨学科护理的必要性。
本专题综述借鉴了儿科癌症生存研究和慢性非癌症疼痛研究，说明预防性模型的组成部分如何应用于生存中的疼痛。
疼痛是儿科癌症长期幸存者的常见经历。生存中的疼痛体验可以根据生物疾病和治疗因素、认知和情感因素以及社会和环境因素来概念化。我们回顾了与这些生物心理社会因素相关的文献，并为儿科癌症幸存者的疼痛制定了一个现有的公共卫生预防框架。
根据幸存者日常的疼痛体验、与疼痛相关的功能障碍和痛苦，将儿科癌症幸存者分为疼痛风险类别，这有助于指导该人群实施疼痛相关的预防和干预策略。未来需要研究建立筛查措施的有效性，以确定需要心理社会疼痛和疼痛相关恐惧管理服务以及儿科慢性疼痛管理计划的患者。
