Centre for Epidemiology Versus Arthritis, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK.
Eur J Pain. 2020 Oct;24(9):1785-1796. doi: 10.1002/ejp.1626. Epub 2020 Jul 19.
Adolescents with musculoskeletal disorders experience acute exacerbations in pain, colloquially called "pain flares" in adult literature. This study aimed to explore adolescents' lived experience of pain flares, including what pain flares are, why they occur, how they are managed and what lasting effects they have on adolescents.
A sample of 10 adolescents diagnosed with juvenile idiopathic arthritis or chronic idiopathic pain syndrome were recruited from a tertiary hospital in the UK. Data were collected using semi-structured interviews and visual aids, and analysed using interpretative phenomenological analysis.
Four broad themes were identified which describe as a journey of change from participants: (a) daily life with pain, where adolescents report a level of pain that is "normal" for them which they can tolerate and continue their daily routines around; (b) pre-flare period, where adolescents begin to notice pain increasing beyond normal levels and employ preventative strategies to reduce the risk of symptoms developing into a flare; (c) flare period, where adolescents describe the symptoms, frequency, duration, impact and their attempts to manage flares; to their (d) post-flare period, where symptoms begin to return to baseline levels and adolescents take actions to regain the level of normality experienced in daily life.
This study has identified a number of components of the pain flare experience. Findings show that pain flares are more than an increase in pain intensity; they are multi-layered and require other features to change. These findings help to differentiate pain flares from typical fluctuations in pain.
患有肌肉骨骼疾病的青少年会经历疼痛的急性加重，在成人文献中俗称为“疼痛发作”。本研究旨在探讨青少年对疼痛发作的真实体验，包括疼痛发作是什么、为什么会发生、如何管理以及对青少年有哪些持久影响。
从英国一家三级医院招募了 10 名被诊断患有青少年特发性关节炎或慢性特发性疼痛综合征的青少年。使用半结构化访谈和视觉辅助工具收集数据，并使用解释性现象学分析进行分析。
确定了四个广泛的主题，描述了参与者经历的变化之旅：(a) 日常生活中的疼痛，青少年报告他们能够忍受的“正常”疼痛水平，并围绕日常生活继续进行日常活动；(b) 发作前阶段，青少年开始注意到疼痛超出正常水平，并采取预防策略来降低症状发展为发作的风险；(c) 发作期，青少年描述症状、频率、持续时间、影响以及他们试图管理发作的尝试；到他们的(d) 发作后阶段，症状开始恢复到基线水平，青少年采取行动恢复日常生活中的正常水平。
本研究确定了疼痛发作体验的一些组成部分。研究结果表明，疼痛发作不仅仅是疼痛强度的增加；它们是多层次的，需要其他特征发生变化。这些发现有助于将疼痛发作与疼痛的典型波动区分开来。
