Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine.
Department for Psychology, Centre for Pain Research, University of Bath.
J Pediatr Psychol. 2020 Apr 1;45(3):281-298. doi: 10.1093/jpepsy/jsaa005.
Parent responses can have a major impact on their child's pain. The purpose of this systematic review is to (a) identify and describe measures assessing pain-related cognitive, affective, and behavioral responses in parents of children with chronic pain and (b) meta-analyze reported correlations between parent constructs and child outcomes (i.e., pain intensity, functional disability, and school functioning). Prospero protocol registration ID: CRD42019125496.
We conducted a systematic search of studies including a measure of parent/caregiver responses to their child's chronic pain. Study characteristics and correlations between parent measures and child outcomes were extracted. Data were summarized and meta-analyzed.
Seventy-nine met inclusion criteria using 18 different measures of cognitive/affective (n = 3), behavioral (n = 5), and multidimensional responses (n = 10). Measures were used a median of three times (range 1-48), predominantly completed by mothers (88%), and primarily in mixed pain samples. Psychometrics of measures were generally adequate. Meta-analyses were based on 42 papers across five measures. Results showed that each of the cognitive, affective, and behavioral parent constructs we examined was significantly associated with pain-related functional disability. A small number of measures assessing parent cognitions and affective functioning were associated with higher child pain intensity; however, the majority were not.
Findings demonstrate that there is a wealth of measures available, with adequate reliability overall but a lack of psychometrics on temporal stability. Synthesizing data across studies revealed small effects between parent responses and child functioning, and even smaller and/or absent effects on child pain intensity.
父母的反应会对孩子的疼痛产生重大影响。本系统评价的目的是：(a) 识别和描述评估慢性疼痛儿童父母的与疼痛相关的认知、情感和行为反应的测量方法；(b) 对报告的父母结构与儿童结果（即疼痛强度、功能障碍和学业功能）之间的相关性进行荟萃分析。Prospéro 协议注册 ID：CRD42019125496。
我们对包括评估父母/照顾者对其子女慢性疼痛反应的措施的研究进行了系统搜索。提取研究特征和父母测量与儿童结局之间的相关性。对数据进行总结和荟萃分析。
使用 18 种不同的认知/情感（n=3）、行为（n=5）和多维反应（n=10）测量方法，有 79 项符合纳入标准。这些方法的使用中位数为 3 次（范围 1-48），主要由母亲（88%）完成，主要用于混合疼痛样本。测量方法的心理计量学一般是足够的。荟萃分析基于 42 篇论文，涉及 5 个测量方法。结果表明，我们研究的认知、情感和行为父母结构中的每一个都与与疼痛相关的功能障碍显著相关。少数评估父母认知和情感功能的测量方法与较高的儿童疼痛强度有关；然而，大多数方法没有。
研究结果表明，有大量的测量方法可供使用，整体可靠性较高，但在时间稳定性方面缺乏心理计量学。跨研究综合数据显示，父母反应与儿童功能之间存在较小的效应，与儿童疼痛强度之间的效应更小或不存在。
