Craig Kenneth D, MacKenzie Nicole E
Department of Psychology University of British Columbia Vancouver BC Canada.
Department of Psychology and Neuroscience Dalhousie University Halifax NS Canada.
Paediatr Neonatal Pain. 2021 May 4;3(3):106-118. doi: 10.1002/pne2.12046. eCollection 2021 Sep.
Pain is a universal experience, but it has been challenging to adequately define. The revised definition of pain recently published by the International Association for the Study of Pain addressed important shortcomings of the previous version; however, it remains narrow in its focus on sensory and emotional features of pain, failing to capture the substantial roles of cognitive and social core components of the experience and their importance to advances in pain management. This paper reviews evidence and theoretical models for the significant role social and cognitive factors play in pain experience and we argue that without explicit recognition of these core components in the definition, significant nuances are lost at a cost to understanding and clinical management of pain. A focus on sensory and emotional features perpetuates biomedical interventions and research, whereas recognition of cognitive and social features supports a multidimensional model of pain, advances in interdisciplinary care, and the benefits of cognitive behavioral therapy and self-management interventions. We also explore the six Key Notes that accompany the new definition of pain, discuss their application to the understanding of pain in childhood, and, in doing so, further explore social and cognitive implications. Considerations are also described for assessment and treatment of pain in pediatric populations.
疼痛是一种普遍的体验，但要对其进行充分定义一直具有挑战性。国际疼痛研究协会最近发布的疼痛修订定义解决了先前版本的重要缺陷；然而，它仍然局限于关注疼痛的感觉和情感特征，未能涵盖该体验中认知和社会核心成分的重要作用及其对疼痛管理进展的重要性。本文回顾了社会和认知因素在疼痛体验中发挥重要作用的证据和理论模型，我们认为，如果在定义中没有明确认识到这些核心成分，就会在理解和临床管理疼痛方面失去重要的细微差别，代价高昂。对感觉和情感特征的关注使生物医学干预和研究长期存在，而对认知和社会特征的认识则支持疼痛的多维模型、跨学科护理的进展以及认知行为疗法和自我管理干预的益处。我们还探讨了伴随疼痛新定义的六个要点，讨论了它们在理解儿童疼痛方面的应用，并在此过程中进一步探讨社会和认知方面的影响。文中还描述了对儿科人群疼痛评估和治疗的考虑因素。
