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脑瘫儿童和青少年的疼痛体验。

Lived experiences of pain in children and young people with cerebral palsy.

机构信息

Discipline of Child & Adolescent Health, Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.

School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia.

出版信息

Dev Med Child Neurol. 2022 Mar;64(3):364-371. doi: 10.1111/dmcn.15061. Epub 2021 Sep 23.

Abstract

AIM

To explore the lived experiences of pain in children and young people with cerebral palsy (CP).

METHOD

Participants were recruited from the Sydney Children's Hospitals Network and the New South Wales/Australian Capital Territory CP Registers. Inclusion criteria were as follows: CP; aged 9 to 17 years; current/past experience of pain; fluent in English; no greater than mild intellectual disability. Purposive sampling ensured representation across age, motor subtypes, and Gross Motor Function Classification System (GMFCS) levels. Semi-structured face-to-face interviews were conducted. Data were analysed following an interpretative phenomenological approach.

RESULTS

Ten participants (three male) were included (mean age 14y 5mo, SD 2y), GMFCS levels I (n=4), II (n=3), III (n=2), and IV (n=1). Analysis led to three superordinate themes: (1) Everybody's experience of pain is different; (2) When the pain is winning; (3) 'I know how to deal with it'. Pain contributors and locations varied between children. Pain intruded on school, physical activity, and psychosocial functioning. Children described personalized strategies used to deal with pain.

INTERPRETATION

In this study, children self-reported highly individualized pain experiences which interfered with their daily life and psychosocial well-being. There is a need for improvement in pain assessment and a personalized approach to pain management.

摘要

目的

探讨脑瘫(CP)儿童和青少年疼痛的生活体验。

方法

参与者从悉尼儿童医院网络和新南威尔士州/澳大利亚首都领地 CP 登记处招募。纳入标准如下:CP;年龄 9 至 17 岁;目前/过去有疼痛经历;英语流利;智力障碍不超过轻度。目的抽样确保在年龄、运动亚型和粗大运动功能分类系统(GMFCS)水平上有代表性。进行半结构化面对面访谈。采用解释现象学方法进行数据分析。

结果

纳入了 10 名参与者(3 名男性)(平均年龄 14 岁 5 个月,标准差 2 岁),GMFCS 水平分别为 I(n=4)、II(n=3)、III(n=2)和 IV(n=1)。分析得出三个上位主题:(1)每个人的疼痛体验都不同;(2)当疼痛占上风时;(3)“我知道如何应对”。儿童的疼痛诱因和部位各不相同。疼痛会干扰他们的学校、体育活动和社会心理功能。孩子们描述了用于应对疼痛的个性化策略。

解释

在这项研究中,儿童自我报告了高度个性化的疼痛体验,这些体验干扰了他们的日常生活和社会心理幸福感。需要改进疼痛评估和个性化疼痛管理方法。

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