Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, United States.
Pain. 2019 Feb;160(2):367-374. doi: 10.1097/j.pain.0000000000001403.
Having a child with chronic pain impacts a parent's life. Reciprocally, parent cognitive, affective, and behavioral responses to the child's chronic pain can influence the child's pain experience. The purpose of this study is to develop a brief self-report screening tool (Parent Risk and Impact Screening Measure [PRISM]) of parent psychosocial functioning and behavioral responses to child pain. This measure assesses parents' reports of their own stress, health, psychosocial functioning, and disruption in activities due to their child's pain and related disability. In an effort to preliminarily validate this screening tool, we examined the PRISM in relation to existing measures of parent distress, parent behavior, and child functioning. An initial 30-item PRISM was administered to 229 parents of children with persistent pain. Parents also reported on distress, protectiveness, pain catastrophizing and family impact, and youth completed measures of pain, pain-related disability, and quality of life. Item refinement resulted in a final 12-item PRISM tool. The PRISM demonstrates strong internal consistency, and initial support for construct validity was shown by associations with parent distress, protectiveness, and catastrophizing. Results also revealed higher PRISM scores are associated with higher child pain intensity, greater functional disability, and poorer quality of life. Cutoff scores were determined to identify parents at differing levels of risk. The PRISM is a brief and clinically important means of screening parent distress and behaviors associated with child pain-related dysfunction. Further validation will use PRISM in longitudinal studies, particularly testing PRISM scores as a predictor of parent and child outcomes over time.
有一个患有慢性疼痛的孩子会影响父母的生活。反过来，父母对孩子慢性疼痛的认知、情感和行为反应也会影响孩子的疼痛体验。本研究的目的是开发一种简短的自我报告筛查工具（父母风险和影响筛查量表 [PRISM]），用于评估父母的心理社会功能和对孩子疼痛的行为反应。该测量工具评估了父母对自己的压力、健康、心理社会功能以及因孩子疼痛和相关残疾而导致的活动中断的报告。为了初步验证这个筛查工具，我们研究了 PRISM 与父母痛苦、父母行为和儿童功能的现有测量方法之间的关系。我们向 229 名患有持续性疼痛的儿童的父母发放了初始的 30 项 PRISM 问卷。父母还报告了痛苦、保护欲、疼痛灾难化和家庭影响，以及青少年完成了疼痛、与疼痛相关的残疾和生活质量的测量。通过对项目进行细化，得到了最终的 12 项 PRISM 工具。PRISM 具有很强的内部一致性，与父母的痛苦、保护欲和灾难化相关的初步结构有效性支持。结果还表明，PRISM 得分较高与儿童疼痛强度较高、功能残疾较大以及生活质量较差相关。确定了区分不同风险水平的父母的临界分数。PRISM 是一种简短且具有临床意义的方法，可用于筛查与儿童疼痛相关功能障碍相关的父母痛苦和行为。进一步的验证将在纵向研究中使用 PRISM，特别是测试 PRISM 分数作为随时间推移预测父母和儿童结果的指标。
