O'Sullivan Grace, McGuire Brian, Roche Michelle, Caes Line
Centre for Pain Research, National University of Ireland Galway, Galway, Ireland.
School of Psychology, NUI Galway, Galway, Ireland.
Front Psychol. 2021 Nov 4;12:741963. doi: 10.3389/fpsyg.2021.741963. eCollection 2021.
Parental influence during children's "everyday" pain events is under-explored, compared to clinical or experimental pains. We trialed two digital reporting methods for parents to record the real-world context surrounding their child's everyday pain events within the family home. Parents ( = 21) completed a structured e-diary for 14 days, reporting on one pain event experienced by their child (aged 2.5-6 years) each day, and describing child pain responses, parental supervision, parental estimates of pain severity and intensity, and parental catastrophizing, distress, and behavioral responses. During the same 2-week period, a subsample of parent-child pairs ( = 9) completed digital ecological momentary assessments (EMA), immediately after any chosen pain event. Children reported their current pain while parents estimated the child's pain and indicated their own distress. "Everyday" pain events frequently featured minor injuries to the child's head, hands or knees, and child responses included crying and non-verbal comments (e.g., "Ouch!"). Pain events occurred less frequently when parents had been supervising their child, and supervising parents reported lower levels of worry and anxiety than non-supervising parents. Child sex was significantly associated with parental estimates of pain intensity, with parents of girls giving higher estimates than parents of boys. Child age was significantly associated with both the number of pain events and with parental estimates of pain intensity and child distress: the youngest children (2-3 years) experienced the fewest pain events but received higher pain and distress estimates from parents than older children. Hierarchal Linear Modeling revealed that parental estimates of pain severity were significant positive predictors of parental distress and catastrophizing in response to a specific pain event. Furthermore, higher levels of parental catastrophic thinking in response to a specific pain event resulted in increased distress, solicitousness, and coping-promoting behaviors in parents. The EMA data revealed that children reported significantly higher pain intensity than their parents. The electronic pain diary provided a key insight into the nature of "everyday" pain experiences around the family home. Digital daily reporting of how the family copes with "everyday" events represents a viable means to explore a child's everyday pains without disrupting their home environment.
与临床疼痛或实验性疼痛相比,父母在孩子“日常”疼痛事件中的影响尚未得到充分研究。我们试验了两种数字报告方法,让父母记录家庭环境中孩子日常疼痛事件的真实背景。21名父母连续14天完成了一份结构化电子日记,每天报告他们孩子(年龄在2.5至6岁之间)经历的一次疼痛事件,并描述孩子的疼痛反应、父母的监督情况、父母对疼痛严重程度和强度的估计,以及父母的灾难化思维、痛苦和行为反应。在同一两周期间,9对亲子组成的子样本在任何选定的疼痛事件发生后立即完成了数字生态瞬时评估(EMA)。孩子报告他们当前的疼痛,而父母估计孩子的疼痛并表明自己的痛苦程度。“日常”疼痛事件通常表现为孩子头部、手部或膝盖的轻伤,孩子的反应包括哭泣和非言语评论(如“哎哟!”)。当父母一直在监督孩子时,疼痛事件发生的频率较低,而且进行监督的父母报告的担忧和焦虑程度低于未进行监督的父母(。孩子的性别与父母对疼痛强度的估计显著相关,女孩的父母给出的估计高于男孩的父母。孩子的年龄与疼痛事件的数量以及父母对疼痛强度和孩子痛苦的估计均显著相关:最小的孩子(2至3岁)经历的疼痛事件最少,但父母对他们疼痛和痛苦的估计高于年龄较大的孩子。分层线性模型显示,父母对疼痛严重程度的估计是父母在特定疼痛事件发生时痛苦和灾难化思维的显著正向预测因素。此外,父母在特定疼痛事件发生时更高水平的灾难化思维导致父母的痛苦、关切和促进应对行为增加。EMA数据显示,孩子报告的疼痛强度明显高于他们的父母。电子疼痛日记为家庭周围“日常”疼痛经历的性质提供了关键见解。以数字方式每日报告家庭应对“日常”事件的方式,是在不干扰孩子家庭环境的情况下探索孩子日常疼痛的一种可行手段。