Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
Department of Psychiatry, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN, USA.
Pain. 2018 Jun;159(6):1083-1089. doi: 10.1097/j.pain.0000000000001192.
Pain is experienced within and influenced by social environments. For children with chronic pain, the child-parent relationship and parental beliefs about pain are particularly important and may influence pain outcomes. Pain-related injustice perceptions have recently been identified as an important cognitive-emotional factor for children with pain. The current study aimed to better understand the pain-related injustice perceptions of children with chronic pain and their parents. The sample consisted of 253 pediatric chronic pain patients (mean age = 14.1 years, 74% female) presenting to a tertiary pain clinic. Patients completed measures of pain intensity, pain-related injustice perceptions, stress, functional disability, and quality of life. Parents completed a measure of pain-related injustice perceptions about their child's pain. Child-parent dyads were categorized into 1 of 4 categories based on the degree of concordance or discordance between their scores on the injustice measures. One-way analysis of variances examined differences in pain intensity, stress, functional disability, and quality of life across the 4 dyad categories. Our findings indicated that both the degree (concordant vs discordant) and direction (discordant low child-high parent vs discordant high child-low parent) of similarity between child and parent injustice perceptions were associated with child-reported pain intensity, stress, functional disability, and quality of life. The poorest outcomes were reported when children considered their pain as highly unjust, but their parents did not. These findings highlight the important role of parents in the context of pain-related injustice perceptions in pediatric chronic pain.
疼痛是内在体验，并受到社会环境的影响。对于患有慢性疼痛的儿童来说，亲子关系和父母对疼痛的信念尤为重要，可能会影响疼痛的结果。最近，人们发现与疼痛相关的不公正认知是疼痛儿童的一个重要认知-情感因素。本研究旨在更好地理解患有慢性疼痛的儿童及其父母的与疼痛相关的不公正认知。样本由 253 名患有慢性疼痛的儿科患者组成（平均年龄=14.1 岁，74%为女性），他们在一家三级疼痛诊所就诊。患者完成了疼痛强度、与疼痛相关的不公正认知、压力、功能障碍和生活质量的测量。父母完成了一项关于孩子疼痛的不公正认知的测量。根据不公正测量得分的一致性或不一致性，将儿童-父母对子分为 4 个类别之一。单因素方差分析考察了 4 个对子类别之间在疼痛强度、压力、功能障碍和生活质量方面的差异。研究结果表明，儿童和父母不公正认知之间的相似程度（一致性与不一致性）和方向（不一致的低儿童-高父母与不一致的高儿童-低父母）与儿童报告的疼痛强度、压力、功能障碍和生活质量有关。当儿童认为自己的疼痛极不公正，但父母不这么认为时，报告的结果最差。这些发现强调了父母在儿童慢性疼痛的与疼痛相关的不公正认知背景下的重要作用。
