Pediatric Pain Rehabilitation Program, Boston Children's Hospital.
Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA.
Clin J Pain. 2018 Oct;34(10):890-899. doi: 10.1097/AJP.0000000000000616.
To provide a descriptive account of long-term functioning (≥5 y posttreatment) among youth who completed intensive interdisciplinary pain treatment (IIPT) for pediatric chronic pain conditions.
A total of 95 patients (mean age at follow-up=20.0 y) treated at least 5 years previously at a single IIPT program completed questionnaires assessing pain, functional disability, health care utilization, academic/career achievement, and quality of life. Data analyses focused on pain, functioning, and progress toward developmental goals at long-term follow-up.
The majority of respondents report significant reduction in pain compared with preadmission (P<0.001). Five years posttreatment, average functional disability scores were in the minimal range, with statistically significant decrease in functional disability from time of admission (P<0.001). Nearly 80% of respondents characterized themselves as having no functional difficulties at follow-up. Clinically significant improvement was established for both pain and function. Respondents generally reported developmentally appropriate status, with 89% graduating high school on schedule.
Results show long-term positive functioning among individuals who underwent intensive rehabilitation treatment for chronic pain as children or adolescents. Despite experiencing one or more pain flares at some point after treatment, most former IIPT patients report minimal to no ongoing functional disability, complete or partial resolution of pain symptoms, and developmentally appropriate progress toward goals (eg, school completion, independent living).
描述完成强化多学科疼痛治疗(IIPT)的青少年在儿童慢性疼痛疾病治疗后 5 年以上的长期功能(≥5 年)情况。
在单一 IIPT 项目中接受治疗至少 5 年的 95 名患者(随访时的平均年龄为 20.0 岁)完成了评估疼痛、功能障碍、医疗保健利用、学业/职业成就和生活质量的问卷。数据分析主要集中在长期随访时的疼痛、功能和向发育目标的进展情况。
大多数受访者报告与入院前相比疼痛显著减轻(P<0.001)。治疗后 5 年,平均功能障碍评分处于最低范围,与入院时相比功能障碍有统计学显著下降(P<0.001)。近 80%的受访者表示自己在随访时没有功能障碍。疼痛和功能均有显著改善。受访者通常报告处于发育适当的状态,89%的人按时完成高中学业。
结果表明,接受儿童或青少年慢性疼痛强化康复治疗的个体具有长期积极的功能。尽管在治疗后某个时候经历过一次或多次疼痛发作,但大多数前 IIPT 患者报告几乎没有持续的功能障碍,疼痛症状完全或部分缓解,以及向目标的发育适当进展(例如,完成学业、独立生活)。