University of California, Los Angeles, California, USA.
Santa Casa São Paulo School of Medical Sciences, São Paulo, Brazil.
J Pain Symptom Manage. 2020 Dec;60(6):1079-1091. doi: 10.1016/j.jpainsymman.2020.07.006. Epub 2020 Aug 7.
Sickle cell disease (SCD) is associated with recurrent pain that could lead to abnormal sensory patterns (ASPs).
The purpose of this study is to compare children with SCD who had normal sensory patterns (NSPs) and ASPs in pain experience, physical function, pain coping, and pain catastrophizing.
Children with quantitative sensory testing data were selected from a larger study that examined pain and symptoms in children with SCD. Comparisons were made between children with NSP (n = 35; 13.9 ± 1.9 years) and ASP (n = 13; 12.8 ± 1.9 years). Children completed the Adolescent Pediatric Pain Tool, Functional Disability Inventory, Pain Coping Questionnaire, and Pain Catastrophizing Scale.
No significant differences were found in pain intensity (2.9 ± 3.0 vs. 2.6 ± 2.8 on 0-10 Visual Analogue Scale) between the NSP and ASP, respectively. The most common marked pain sites for both groups were lower extremities (22.9%), head and neck (20.8%), and upper extremities (20.8%). Functional Disability Inventory scores were significantly worse in ASP (38.5%) compared with NSP (11.4%). The ASP group had significantly worse scores in emotion-focused pain coping subscales.
Children with SCD with ASP had worse functional disability, were expressing more affective pain quality, and had emotion-focused pain coping compared with NSP. Future studies are needed to examine the effectiveness of physical activities on the physical function as well as psychosocial interventions such as peer support and creative arts expression to minimize development of ASP in children with SCD.
镰状细胞病(SCD)与反复发作的疼痛有关,可能导致异常感觉模式(ASPs)。
本研究旨在比较具有正常感觉模式(NSP)和 ASP 的 SCD 患儿在疼痛体验、身体功能、疼痛应对和疼痛灾难化方面的差异。
从一项研究中选择了具有定量感觉测试数据的儿童,该研究检查了 SCD 患儿的疼痛和症状。将 NSP(n=35;13.9±1.9 岁)和 ASP(n=13;12.8±1.9 岁)的儿童进行比较。儿童完成了青少年儿科疼痛工具、功能障碍量表、疼痛应对问卷和疼痛灾难化量表。
NSP 和 ASP 之间的疼痛强度无显著差异(分别为 2.9±3.0 和 2.6±2.8 在 0-10 视觉模拟量表上)。两组最常见的明显疼痛部位是下肢(22.9%)、头颈部(20.8%)和上肢(20.8%)。与 NSP 相比,ASP 的功能障碍量表评分明显更差(38.5%)。ASP 组在情绪聚焦的疼痛应对子量表中的得分明显更差。
与 NSP 相比,SCD 伴有 ASP 的儿童功能障碍更差,表现出更多的情感性疼痛质量,并且情绪聚焦的疼痛应对方式更多。需要进一步研究来评估体育活动对身体功能的有效性,以及同伴支持和创意艺术表达等心理社会干预措施,以尽量减少 SCD 儿童 ASP 的发展。