Division of Pain Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Division of Pain Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
J Pain. 2020 Mar-Apr;21(3-4):355-363. doi: 10.1016/j.jpain.2019.08.002. Epub 2019 Aug 8.
Burn injuries are significantly painful and associated with physical and psychological impairment. However, little research to-date has examined the potential role of the subjective experience of pain in either physical or psychological impairment in this population. This may be particularly important to examine, given that the pain experience can often be a significant barrier to recovery in other pediatric populations. The current study examined the cross-sectional and predictive relationships between patient-reported experience of pain (operationalized as PROMIS pain interference and self-reported pain intensity) and physical and psychosocial outcomes. Data were gathered as part of the Burn Model System National Database (1994-2018) with the data request inclusive of pediatric self-report PROMIS measures, child PTSD, and post-traumatic growth symptoms assessed at 6- and 12-month postdischarge following initial injury. A total of 65 youth between the ages of 6 and 16 years at the time of their injury were included in the dataset. Correlational and regression analyses indicated that pain interference was cross-sectionally and longitudinally associated with decreased physical functioning, depressive symptoms, and peer relationships. Pain intensity was significantly associated with and predictive of physical functioning and pain interference. Results of the current study are an important first step in understanding the pain experience and associated outcomes in youth with a history of burn injuries. Future research is needed to further examine these relationships. PERSPECTIVE: This study presents preliminary findings from a national database on pain-related outcomes both cross-sectionally and longitudinally in youth with a history of burn injury. To-date, pain-related outcomes are poorly understood in this population and the results of this study serve to inform future research and treatment-related efforts.
烧伤会带来明显的疼痛，并导致身体和心理功能受损。然而，迄今为止，很少有研究探讨这一人群中疼痛的主观体验在身体或心理功能障碍方面的潜在作用。鉴于在其他儿科人群中，疼痛体验往往是康复的重大障碍，因此，这一点尤其值得研究。本研究考察了患者报告的疼痛体验（操作性定义为 PROMIS 疼痛干扰和自我报告的疼痛强度）与身体和心理社会结果之间的横断面和预测关系。数据是作为烧伤模型系统国家数据库（1994-2018 年）的一部分收集的，数据请求包括儿科自我报告的 PROMIS 测量、儿童 PTSD 和创伤后成长症状，在初始损伤后 6 个月和 12 个月进行评估。数据集共纳入 65 名年龄在 6 至 16 岁之间的受伤青少年。相关和回归分析表明，疼痛干扰与身体功能下降、抑郁症状和同伴关系呈横断面和纵向相关。疼痛强度与身体功能和疼痛干扰显著相关，并具有预测性。本研究的结果是了解有烧伤史的青少年疼痛体验和相关结果的重要的第一步。需要进一步研究来进一步探讨这些关系。观点：本研究报告了烧伤青少年疼痛相关结果的初步发现，包括横断面和纵向研究。迄今为止，该人群的疼痛相关结果尚不清楚，本研究结果有助于为未来的研究和治疗相关工作提供信息。
