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基于社区的儿童慢性疼痛中父母因素的统一多因素模型

Unified Multifactorial Model of Parental Factors in Community-Based Pediatric Chronic Pain.

作者信息

Brown Donnamay T, Claus Benedikt B, Könning Anna, Wager Julia

机构信息

German Paediatric Pain Centre, Children's and Adolescents' Hospital, Witten/Herdecke University Datteln, Germany.

PedScience Research Institute, Datteln, Germany.

出版信息

J Pediatr Psychol. 2022 Feb 14;47(2):121-131. doi: 10.1093/jpepsy/jsab085.

Abstract

OBJECTIVE

The combination of parental chronic pain and internalizing characteristics are relevant to chronic pain experiences in their children. A promising unified multifactorial intergenerational model of chronic pain was published in 2019; however, this model was only generalizable to children with severe chronic pain and some factors had limitations. This study aimed to determine validity of an adapted multifactorial model, including parent and child chronic pain status, pain characteristics, pain-related functioning, and internalizing symptoms, in a community setting. Subgroup analyses based on presence of chronic pain in parents and children were explored to determine whether effects were stronger in certain subsamples.

METHODS

Adolescents (N = 1,450, Mage=12.7 years, 50% female), and their parents (82% mothers), were recruited from five schools to complete online surveys. Structural equation modeling was used to investigate interrelated pain-related experiences between parents and their offspring.

RESULTS

The adapted unified multifactorial model had good model fit in the community sample. Significant weak associations were found between all parent and child factors. The strongest associations were found in the subsample of parents and children with chronic pain. In all subgroups, internalizing factors were the most strongly linked intergenerational constructs.

CONCLUSIONS

Our results support the validity of the unified multifactorial model of parental factors in pediatric chronic pain, although associations were weaker in the community sample than those previously reported in a clinical sample. In children who develop chronic pain, it is important to consider their parent's chronic pain and internalizing symptoms to best manage intergenerational effects.

摘要

目的

父母慢性疼痛与内化特征相结合与他们孩子的慢性疼痛经历相关。2019年发表了一个有前景的慢性疼痛统一多因素代际模型;然而,该模型仅适用于患有严重慢性疼痛的儿童,且一些因素存在局限性。本研究旨在确定一个适应性多因素模型在社区环境中的有效性,该模型包括父母和孩子的慢性疼痛状况、疼痛特征、疼痛相关功能以及内化症状。基于父母和孩子是否存在慢性疼痛进行亚组分析,以确定某些亚样本中的效应是否更强。

方法

从五所学校招募青少年(N = 1450,平均年龄 = 12.7岁,50%为女性)及其父母(82%为母亲),以完成在线调查。采用结构方程模型研究父母与其后代之间与疼痛相关的相互关联经历。

结果

适应性统一多因素模型在社区样本中具有良好的模型拟合度。在所有父母和孩子因素之间发现了显著的弱关联。在患有慢性疼痛的父母和孩子亚样本中发现了最强的关联。在所有亚组中,内化因素是代际间联系最紧密的结构。

结论

我们的结果支持父母因素在儿童慢性疼痛中的统一多因素模型的有效性,尽管社区样本中的关联比先前临床样本中报告的关联要弱。对于患有慢性疼痛的儿童,考虑其父母的慢性疼痛和内化症状对于最佳管理代际效应很重要。

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