Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
McGill University Health Centre, Montreal, Quebec, Canada.
Eur J Pediatr. 2018 Jun;177(6):891-902. doi: 10.1007/s00431-018-3127-9. Epub 2018 Apr 11.
The objective was to describe the pain and quality of life among children and adolescents with any osteogenesis imperfecta (OI) type over one intravenous bisphosphonate treatment cycle from a child and parental perspective. A prospective, observational study was conducted, where children and adolescents evaluated their pain intensity, location, and quality, as well as quality of life before, 1 week after treatment, and 6 months later. Quality of life was also evaluated from the parental perspective at the same three time points. Thirty-three child/parent dyads participated. The results showed that pain intensity on the 0-10 self-report scale after the Zoledronate infusion (median = 0, range = 0-6) was not different from pre (median = 2, range = 0-10) and 6-months post-scores (median = 2, range = 0-8) (p = 0.170). Children and adolescents with OI reported experiencing pain mainly in the ankles and the anterior and posterior shoulders. They selected evaluative pain descriptors such as uncomfortable (n = 16, 48%) and annoying (n = 13, 39%). Children and adolescents' functioning and quality of life did not change significantly across the bisphosphonate treatment cycle (p = 0.326), parents perceived an improvement immediately after the treatment compared to before (p = 0.016).
Children and adolescents with OI experience mild, yet complex pain localized across several body areas. There is little fluctuation in the pain intensity and functioning of children with OI undergoing bisphosphonate treatment. What is Known: • Acute and chronic musculoskeletal pain remains a major issue in OI. • Pain has a negative impact on quality of life. What is New: • New and unpublished methods and findings describing the pain and quality of life of children and adolescents with OI over one intravenous bisphosphonate treatment cycle from a child- and parental-proxy perspective. • Children and adolescents with OI experience pain intensity that is mild, yet complex in quality and localized across several body areas.
本研究旨在从患儿和家长的角度描述任何类型成骨不全症(OI)患儿接受一次静脉用双膦酸盐治疗周期过程中的疼痛和生活质量。开展了一项前瞻性观察研究,患儿和青少年在治疗前、治疗后 1 周和 6 个月时评估其疼痛强度、部位和性质以及生活质量,家长在同样的三个时间点从自身角度评估患儿的生活质量。共有 33 对患儿-家长参与研究。结果显示,唑来膦酸输注后 0-10 自我报告量表上的疼痛强度(中位数=0,范围=0-6)与治疗前(中位数=2,范围=0-10)和 6 个月后(中位数=2,范围=0-8)的评分无差异(p=0.170)。OI 患儿报告的疼痛主要发生在踝关节、前肩和后肩,他们选择了“不舒服”(n=16,48%)和“烦人”(n=13,39%)等描述性词语来形容疼痛。双膦酸盐治疗周期内患儿的功能和生活质量无显著变化(p=0.326),治疗后家长即刻感知到患儿的生活质量改善(p=0.016)。
OI 患儿经历着多部位、轻度但复杂的疼痛。接受双膦酸盐治疗的 OI 患儿疼痛强度和功能波动较小。
• 急性和慢性肌肉骨骼疼痛仍然是 OI 的主要问题。• 疼痛对生活质量有负面影响。
• 描述了从患儿和家长角度观察到的 OI 患儿在接受一次静脉用双膦酸盐治疗周期过程中的疼痛和生活质量的新的、未经发表的方法和发现。• OI 患儿经历着性质轻度但复杂、部位多且局限的疼痛。