Petigas Lucie, Newman Christopher J
Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland.
Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Brain Sci. 2021 Mar 23;11(3):408. doi: 10.3390/brainsci11030408.
Pain is a frequent issue in children with profound intellectual and multiple disabilities (PIMD). Its identification and treatment can prove highly challenging for primary care physicians, mainly because of the children's limited communication abilities. We used an online survey to explore paediatricians' views regarding the experience and management of pain in children with PIMD and invited 480 professionals working in the canton of Vaud, Switzerland, to take part. We received 121 responses (participation rate 25.5%). A large majority of respondents provided care to children with PIMD. All paediatricians considered that these children feel pain at least as much as typically developing children. However, paediatricians had mixed views on their tolerance to pain. More than 90% held the view that their pain is under-assessed and undertreated. The principal barriers they reported to appropriate management were communication limitations with the child, difficulties in pain assessment, lack of knowledge about children with disabilities and lack of experience. Paediatricians have complex opinions regarding how children with PIMD experience pain and how to manage this problem. Professional education and training on the specificities of children with PIMD, including how to address their pain, seem necessary to foster paediatricians' ability and confidence in approaching this complex issue.
疼痛是重度智力和多重残疾（PIMD）儿童中常见的问题。对初级保健医生来说，识别和治疗这种疼痛极具挑战性，主要原因是这些儿童的沟通能力有限。我们通过在线调查来探究儿科医生对PIMD儿童疼痛体验及管理的看法，并邀请了瑞士沃州的480名专业人员参与。我们收到了121份回复（参与率25.5%）。绝大多数受访者为PIMD儿童提供护理。所有儿科医生都认为这些儿童感受到的疼痛至少与发育正常的儿童一样多。然而，儿科医生对他们对疼痛的耐受性看法不一。超过90%的人认为他们的疼痛评估不足且治疗不足。他们报告的适当管理的主要障碍包括与儿童沟通受限、疼痛评估困难、对残疾儿童缺乏了解以及缺乏经验。儿科医生对PIMD儿童如何体验疼痛以及如何处理这个问题有着复杂的看法。针对PIMD儿童的特殊性，包括如何处理他们的疼痛，进行专业教育和培训，似乎有必要提高儿科医生处理这个复杂问题的能力和信心。
