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童年创伤可预测乳腺癌幸存者的癌症治疗相关疼痛。

Childhood Trauma Predicts Cancer Treatment-Related Pain in Breast Cancer Survivors.

机构信息

Author Affiliations: School of Nursing, University of Michigan, Ann Arbor (Mrs Kanzawa-Lee, Ms Bridges, and Dr Lavoie Smith); Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts (Dr Knoerl); Department of Anesthesiology, University of Michigan, Ann Arbor (Drs Williams, Clauw, and Harte and Mrs Kolarik and Houghtby).

出版信息

Cancer Nurs. 2020 Jul/Aug;43(4):E207-E216. doi: 10.1097/NCC.0000000000000687.

Abstract

BACKGROUND

Childhood trauma has been linked to neuropathic pain in noncancer populations, but its relationship with cancer treatment-related neuropathic pain is unknown.

OBJECTIVE

This secondary data analysis of a prospective, longitudinal, observational study aimed to explore the relationship of childhood trauma experience with pain severity, pain interference, and neuropathic symptom severity (NSS) 12 months after surgery in women receiving treatment for stage 0 to III breast cancer.

METHODS

Women (N = 44) recruited from a comprehensive cancer center self-reported childhood trauma experience, pain severity, pain interference, NSS, co-occurring symptoms, and pain beliefs via questionnaires. Descriptive statistics were used to describe childhood trauma experience. Linear regression was used to model childhood trauma and other predictors on pain variables 12 months after surgery.

RESULTS

Childhood trauma predicted pain severity and pain interference 12 months after surgery (P < .05), as did baseline pain severities and helplessness-pain catastrophizing. Age predicted only NSS. Together, the best models predicted 31.6% to 40.9% of the variance in pain severities at 12 months (P < .001).

CONCLUSIONS

Childhood trauma exposure was a significant predictor of pain 12 months after breast cancer surgery and adjuvant treatment. Younger and helplessness-pain catastrophizing women are also at risk. Research is needed to identify preventive neuropathic pain interventions for high-risk women.

IMPLICATIONS FOR PRACTICE

Women receiving breast cancer treatment should proactively be assessed for childhood trauma history, possibly by using discreet previsit questionnaires. Childhood trauma survivors may be at high risk for poor pain outcomes and may benefit from tailored pain interventions.

摘要

背景

童年创伤与非癌症人群的神经性疼痛有关,但它与癌症治疗相关的神经性疼痛的关系尚不清楚。

目的

本研究是一项前瞻性、纵向、观察性研究的二次数据分析,旨在探讨童年创伤经历与接受 0 期至 3 期乳腺癌治疗的女性手术后 12 个月时疼痛严重程度、疼痛干扰和神经性症状严重程度(NSS)之间的关系。

方法

从一家综合性癌症中心招募的女性(N=44)通过问卷自我报告童年创伤经历、疼痛严重程度、疼痛干扰、NSS、共病症状和疼痛信念。采用描述性统计来描述童年创伤经历。线性回归用于对手术后 12 个月的疼痛变量进行童年创伤和其他预测因子的建模。

结果

童年创伤预测了手术后 12 个月的疼痛严重程度和疼痛干扰(P<.05),基线疼痛严重程度和无助-疼痛灾难化也是如此。年龄仅预测 NSS。最佳模型共同预测了术后 12 个月疼痛严重程度的 31.6%至 40.9%(P<.001)。

结论

童年创伤暴露是乳腺癌手术后和辅助治疗 12 个月时疼痛的一个重要预测因子。年轻和无助-疼痛灾难化的女性也有风险。需要研究以确定针对高风险女性的预防性神经性疼痛干预措施。

实践意义

接受乳腺癌治疗的女性应主动评估其童年创伤史,可能通过使用 discreet 预访问卷来进行。童年创伤幸存者可能面临不良疼痛结局的高风险,可能受益于量身定制的疼痛干预措施。

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