Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Graham Street, South Brisbane, 4101, QLD, Australia.
Pegg Leditschke Paediatric Burns Centre, Queensland Children's Hospital, Graham Street, South Brisbane, QLD, 4101, Australia.
BMC Public Health. 2020 Mar 4;20(1):284. doi: 10.1186/s12889-020-8366-9.
Paediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients' pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress, and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers; however, their degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is unclear.
A non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients' physical pain along with theirs and/or their caregiver's anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples' perspectives of health.
Of the 3178 identified references, 17 were eligible. These include distraction based techniques (n = 8), hypnosis/familiar imagery (n = 2), therapeutic approaches (n = 4), and patient preparation/procedural control (n = 3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased 'patient control' reduced patient and caregiver anxiety; and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples' perspectives of health; and few targeted caregivers or focused on reducing their symptoms.
The development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.
儿科烧伤是一种高度疼痛和创伤性的伤害，在原住民和托雷斯海峡岛民中更为常见。儿科烧伤患者的疼痛仍然无法通过药物干预得到很好的控制，导致患者及其照顾者的焦虑、痛苦和创伤增加。非药物心理社会干预措施已被证明在减少儿科烧伤患者及其照顾者的疼痛和心理痛苦方面是有效的；然而，其在原住民和托雷斯海峡岛民中的有效性和适宜性尚不清楚。
通过四个数据库进行了非日期限制的系统评价。确定并纳入了评估儿科烧伤患者身体疼痛以及他们和/或他们的照顾者的焦虑、痛苦或创伤症状的心理社会干预措施的英文研究。纳入的研究评估了其减少一个感兴趣的结果的能力，以及其对原住民和托雷斯海峡岛民健康观点的反映程度。
在 3178 篇鉴定文献中，有 17 篇符合条件。这些研究包括分散注意力技术（n=8）、催眠/熟悉意象（n=2）、治疗方法（n=4）和患者准备/程序控制（n=3）。纳入的研究中，分散注意力技术结合程序准备可以减轻疼痛，而出院准备和增加“患者控制”可以减轻患者和照顾者的焦虑；基于互联网的认知行为疗法可以减少短期但不能减少长期创伤后应激症状。没有干预措施反映了原住民和托雷斯海峡岛民的健康观点；而且很少有干预措施针对照顾者或关注减轻他们的症状。
需要开发和评估心理社会干预措施，以适当地满足原住民和托雷斯海峡岛民儿科烧伤患者的需求。
