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青少年儿科疼痛工具用于诊断为成骨不全症的儿童和青少年疼痛多维测量的验证

Validation of the Adolescent Pediatric Pain Tool for the Multidimensional Measurement of Pain in Children and Adolescents Diagnosed with Osteogenesis Imperfecta.

作者信息

Boitor Madalina, Gélinas Céline, Rauch Frank, Jacob Eufemia, LeMay Sylvie, Carrier Jaimie Isabel, Bilodeau Claudette, Tsimicalis Argerie

机构信息

Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.

Centre for Nursing Research and Lady Davis Institute, CIUSSS Centre-Ouest-Ile-de-Montréal, Jewish General Hospital, Montréal, Québec, Canada.

出版信息

Can J Pain. 2019 Jul 18;3(1):148-156. doi: 10.1080/24740527.2019.1626705. eCollection 2019.

Abstract

: The Adolescent Pediatric Pain Tool (APPT) is a self-reported, multidimensional assessment of pain location, intensity, and quality in children and adolescents. Yet, it has not been validated for use in children and adolescents with osteogenesis imperfecta (OI). : This study aimed to validate and evaluate the feasibility of the APPT for pain assessment in children and adolescents with OI. : A prospective observational study was conducted at a university-affiliated pediatric hospital in Canada. Thirty-three children and adolescents with OI participated by completing the APPT pre-bisphosphonate intravenous infusion and 1 week post-bisphosphonate intravenous infusion. Main outcomes were internal consistency, convergent and discriminative validity, and feasibility. : The Kuder-Richardson test of internal consistency was 0.863, 0.661, and 0.729 for the Sensory, Affective, and Evaluative subscales, respectively. For the entire pain quality scale, the Cronbach's alpha was 0.835. Regarding convergent validity, a moderate correlation was observed between the ratings on the pain intensity scale and the Faces Pain Scale-Revised (Spearman's rho = 0.711). Patients for whom pain was a problem reported higher pain intensity (Mann Whitney U = 41.50, P = 0.032) and more pain quality descriptors (Mann Whitney U = 45.50, P = 0.020) and painful body areas (Mann-Whitney U = 25.50, P = 0.001) than those for whom it was not (Mann-Whitney U, P < 0.05). In terms of feasibility, completing the tool may require a considerable time commitment and assistance from a clinician or parent, especially if the patient is experiencing pain and provides detailed pain location and quality information by completing the APPT. : This study suggests that the APPT is valid for the multidimensional assessment of pain in children and adolescents with OI, but feasibility needs to be enhanced.

摘要

青少年儿科疼痛工具(APPT)是一种通过自我报告对儿童和青少年疼痛的部位、强度及性质进行的多维度评估。然而,它尚未在成骨不全症(OI)患儿及青少年中得到验证。

本研究旨在验证和评估APPT在OI患儿及青少年疼痛评估中的可行性。

在加拿大一家大学附属医院开展了一项前瞻性观察性研究。33名OI患儿及青少年参与研究,在静脉注射双膦酸盐前及注射后1周完成APPT。主要结果包括内部一致性、收敛效度和区分效度以及可行性。

感觉、情感和评估子量表的库德-理查森内部一致性检验分别为0.863、0.661和0.729。整个疼痛性质量表的克朗巴哈系数为0.835。关于收敛效度,疼痛强度量表评分与修订面部疼痛量表之间观察到中度相关性(斯皮尔曼等级相关系数=0.711)。报告疼痛的患者比未报告疼痛的患者疼痛强度更高(曼-惠特尼U=41.50,P=0.032),有更多的疼痛性质描述词(曼-惠特尼U=45.50,P=0.020)和疼痛身体部位(曼-惠特尼U=25.50,P=0.001)(曼-惠特尼U,P<0.05)。在可行性方面,完成该工具可能需要相当长的时间投入以及临床医生或家长的协助,特别是当患者正在经历疼痛并通过完成APPT提供详细的疼痛部位和性质信息时。

本研究表明,APPT在OI患儿及青少年疼痛的多维度评估中是有效的,但可行性有待提高。

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