探讨成骨不全症患儿的疼痛干扰和自我感知健康状况 - 一项横断面研究。
Exploring pain interference and self-perceived health status in children with osteogenesis imperfecta - a cross-sectional study.
机构信息
Department of Women's and Children's Health, Neuropediatric Unit, Karolinska Institutet, Karolinska vägen 37A7tr, 171 76, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
出版信息
BMC Musculoskelet Disord. 2022 Sep 21;23(1):876. doi: 10.1186/s12891-022-05825-5.
BACKGROUND
Chronic pain may affect and interfere in children's everyday life and can be present in children with Osteogenesis Imperfecta (OI). However, the knowledge is still sparse to what extent pain is present, how pain interfere in children's everyday life and affect their self-perceived health status. The purpose of the study was therefore to explore presence of chronic pain, pain interference in daily life, and self-perceived health status in children with OI.
METHODS
Children with OI, aged 6-18 years, were recruited consecutively to this cross-sectional study. Participants answered a standardised interview including five pre-structured questions, and the Numeric Pain Rating Scale (NPRS), the Pain Interference Index, and a questionnaire concerning self-perceived health status the Patient Reported Outcomes Measurement Information System Pediatric-25 Profile v1.1 (PROMIS-25).
RESULTS
Twenty-eight children (median: 11 years, IQR 6) with OI type I, III, or IV participated. Pain was present in 27 of 28 children and interfered in their everyday life regardless of OI-type, sex, and age. The median NPRS for average pain intensity was 4 (IQR 2), the median for pain frequency was 2-3 times/week, and the median frequency of school absence due to pain was 2-3 times per month. The most common pain locations were back and feet. Pain in the feet was more frequently reported in children with type I (p = 0.032), and pain in the hip was more often reported in children ≥13 years (p = 0.011). The children were asked what they thought to be the cause of pain and the most frequent response was "walking long distances". Self-perceived health status for mobility was lower than the general population, and lowest for children with type III (p = 0.016). Pain interference was associated with children's self-perceived health status (r = 0.84, p < 0.001).
CONCLUSION
Almost all children experienced pain, which interfered in children's everyday lives, affected participation in various activities and was associated with reduced self-perceived health status. If children avoid physical activities because of pain, it might cause a vicious circle of inactivity, which further decreases bone density and increase the risk of fractures. The results emphasize the importance to offer adequate pain reducing interventions.
背景
慢性疼痛可能会影响和干扰儿童的日常生活，并且可能存在于患有成骨不全症（OI）的儿童中。然而，目前对于疼痛的程度、疼痛对儿童日常生活的干扰以及对他们自我感知健康状况的影响程度知之甚少。因此，本研究旨在探讨患有 OI 的儿童中慢性疼痛的存在、疼痛对日常生活的干扰以及自我感知的健康状况。
方法
本研究为一项横断面研究，连续招募了年龄在 6-18 岁的 OI 儿童。参与者回答了一份标准化访谈，其中包括五个预先结构化的问题，以及数字疼痛评分量表（NPRS）、疼痛干扰指数和一份关于自我感知健康状况的问卷，即患者报告的结果测量信息系统儿科 25 项简表 v1.1（PROMIS-25）。
结果
28 名 I、III 或 IV 型 OI 儿童参与了本研究（中位数：11 岁，IQR 6）。28 名儿童中有 27 名存在疼痛，且无论 OI 类型、性别和年龄如何，疼痛均对其日常生活造成干扰。平均疼痛强度的中位数 NPRS 为 4（IQR 2），疼痛频率的中位数为 2-3 次/周，因疼痛而缺课的频率中位数为 2-3 次/月。最常见的疼痛部位是背部和脚部。I 型 OI 儿童更常报告脚部疼痛（p=0.032），而≥13 岁的儿童更常报告髋关节疼痛（p=0.011）。儿童被问及他们认为疼痛的原因是什么，最常见的回答是“走很长的路”。儿童对移动能力的自我感知健康状况低于一般人群，而 III 型 OI 儿童的自我感知健康状况最低（p=0.016）。疼痛干扰与儿童的自我感知健康状况相关（r=0.84，p<0.001）。
结论
几乎所有儿童都经历过疼痛，这种疼痛会干扰儿童的日常生活，影响他们参与各种活动的能力，并与自我感知的健康状况下降有关。如果儿童因疼痛而避免进行体育活动，这可能会导致活动减少的恶性循环，进一步降低骨密度并增加骨折的风险。研究结果强调了提供充分的止痛干预措施的重要性。
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