Rosenbloom Brittany N, Slepian P Maxwell, Pagé M Gabrielle, Isaac Lisa, Campbell Fiona, Stinson Jennifer, Katz Joel
Department of Psychology, York University, Toronto, ON M3J 1P3, Canada.
Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON M5G 2C4, Canada.
Children (Basel). 2021 Apr 30;8(5):360. doi: 10.3390/children8050360.
Pediatric chronic post-surgical pain is a surgical complication associated with various levels of functional limitation. Two commonly used measures of functional limitations in youth are the Functional Disability Inventory (FDI) and the PROMIS Pediatric Pain Interference Scale (PPIS), where the former is general, and the latter, pain specific. The aim of the present study was to prospectively compare pre-surgical youth and parent risk factors for youth functional limitations, assessed by the FDI and PPIS, 12 months after major pediatric surgery. Risk factors for the FDI and PPIS were compared in 79 dyads consisting of youth (58% female, = 14.56 years; SD = 2.31) undergoing major surgery and one of their parents. The FDI and PPIS were highly correlated prior to surgery ( = 0.698, < 0.001) and even more so 12 months after surgery ( = 0.807, < 0.001). Parent pre-surgical anxiety sensitivity and youth pre-surgical functional disability significantly predicted 12-month FDI ((6,56) = 4.443, = 0.001, Adjusted R = 0.25), whereas parent pre-surgical anxiety sensitivity, trait anxiety, pain anxiety, as well as youth pain-related anxiety and worry significantly predicted 12-month PPIS ((6,45) = 4.104, = 0.002, Adjusted R = 0.27). Risk factors for 12-month general and pain-specific functional limitations differ by dyad member and type. Functional limitations in youth after surgery are predicted by youth and parent factors, however the risk factors differ between the FDI and the PPIS.
小儿慢性术后疼痛是一种与不同程度功能受限相关的手术并发症。青少年功能受限的两种常用测量方法是功能残疾量表（FDI）和患者报告结果测量信息系统小儿疼痛干扰量表（PPIS），前者具有普遍性，后者则专门针对疼痛。本研究的目的是前瞻性比较接受大型小儿手术后12个月时，通过FDI和PPIS评估的术前青少年及其父母的功能受限风险因素。对79对由接受大型手术的青少年（58%为女性，平均年龄 = 14.56岁；标准差 = 2.31）及其父母之一组成的二元组进行了FDI和PPIS风险因素比较。术前FDI和PPIS高度相关（相关系数 = 0.698，P < 0.001），术后12个月时相关性更强（相关系数 = 0.807，P < 0.001）。父母术前焦虑敏感性和青少年术前功能残疾显著预测了术后12个月的FDI（F(6,56) = 4.443，P = 0.001，调整后R² = 0.25），而父母术前焦虑敏感性、特质焦虑、疼痛焦虑以及青少年疼痛相关焦虑和担忧显著预测了术后12个月的PPIS（F(6,45) = 4.104，P = 0.002，调整后R² = 0.27）。术后12个月一般和疼痛特异性功能受限的风险因素因二元组成员和类型而异。青少年术后的功能受限可由青少年和父母因素预测，但FDI和PPIS的风险因素有所不同。
