Department of Psychology, University of New Mexico, Albuquerque, New Mexico.
Pain Management, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.; Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri.; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri..
J Pain. 2018 Nov;19(11):1275-1284. doi: 10.1016/j.jpain.2018.05.002. Epub 2018 May 17.
Targeting parents' responses to their child's pain during intensive interdisciplinary pain treatment (IIPT) could influence child functioning. This longitudinal, observational study investigated changes in these responses and concurrent relationships between parent responses and changes in levels of child functioning and pain. Parents of youths 10 to 19 years of age (mean = 15 years, SD = 1.98 years) participated in twice weekly, parent-only groups while their teens were enrolled in IIPT (mean length of treatment = 3.93 weeks, SD = 1.16 weeks). Parent responses to child symptoms, as well as child pain and functional disability, were assessed weekly during treatment (n = 114) and at 3 follow-up visits: 1 month (n = 96), 6 months (n = 68), and 12 months (n = 45). Longitudinal multilevel modeling analyses indicated statistically significant decreases during treatment in parents' protective, monitoring, and minimizing responses and further improvement in all responses during follow-up. These changes were associated with concurrent changes in child disability. However, changes in parent behaviors occurred independently from changes in child pain levels. Baseline child characteristics affected neither baseline parent responses to pain nor changes over time. Results indicate that, in the context of IIPT, parental responses are amenable to change and that these changes may impact child pain-related functioning, providing further support for the role of parent-specific programming within IIPT. PERSPECTIVE: During intensive IIPT, parents made statistically significant changes in responses to their child's pain, which was associated with improvements in child disability, but not child pain. Changes were sustained through 1-year follow-up. Targeting parental responses to child pain is feasible and may relate to improved child functioning.
针对父母在密集跨学科疼痛治疗（IIPT）中对孩子疼痛的反应，可能会影响孩子的功能。这项纵向观察性研究调查了这些反应的变化，以及父母反应与孩子功能和疼痛水平变化之间的并发关系。10 至 19 岁青少年（平均年龄 15 岁，标准差 1.98 岁）的父母参加了每周两次的父母小组，而他们的孩子则参加了 IIPT（平均治疗时间为 3.93 周，标准差为 1.16 周）。在治疗期间（n=114）和 3 次随访时（1 个月（n=96）、6 个月（n=68）和 12 个月（n=45）），每周评估父母对孩子症状的反应，以及孩子的疼痛和功能障碍。纵向多层模型分析表明，在治疗期间，父母的保护、监测和最小化反应显著下降，在随访期间所有反应进一步改善。这些变化与孩子残疾的同时变化有关。然而，父母行为的变化与孩子疼痛水平的变化无关。基线儿童特征既不影响基线父母对疼痛的反应，也不影响随时间的变化。结果表明，在 IIPT 的背景下，父母的反应是可以改变的，这些变化可能会影响孩子与疼痛相关的功能，进一步支持 IIPT 中针对父母的特定方案的作用。观点：在密集的 IIPT 期间，父母对孩子疼痛的反应发生了统计学上显著的变化，这与孩子残疾的改善有关，但与孩子疼痛无关。这些变化在 1 年的随访中得以维持。针对儿童疼痛的父母反应是可行的，可能与改善儿童功能有关。
