Locher Cosima, Wörner Andreas, Carlander Maria, Kossowsky Joe, Dratva Julia, Koechlin Helen
Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.
Faculty of Health, University of Plymouth, Plymouth, United Kingdom.
Pain Rep. 2023 Jan 16;8(1):e1060. doi: 10.1097/PR9.0000000000001060. eCollection 2023 Jan.
Chronic pain is a prevalent, yet underrecognized, condition in children and adolescents. A biopsychosocial framework has been widely adopted over the past decades and resulted in a new pain classification in the International Classification of Diseases, 11th revision (ICD-11). Nevertheless, little is known about pediatricians' pain concepts.
We explored pain concepts of Swiss pediatricians by means of a qualitative analysis.
A cross-sectional online survey was sent to clinically active Swiss pediatricians registered with the Swiss Society for Pediatrics. A case vignette of a girl with chronic musculoskeletal pain was presented and pediatricians were asked (1) what they think caused the pain, and (2) how they would explain the pain to the patient and their family. Structuring content analysis was applied to describe major themes within the answers.
The following main categories emerged: psychological factors, biological factors, unclear etiology, social context, disorder specific, and multifactorial. Most pediatricians reported the belief that psychological factors explained the pain. However, when explaining the pain to the patient, biological factors were reported most often.
There is a discrepancy between pediatricians' conviction that chronic pain is mostly explained by psychological factors and their exploratory model towards patients that focuses on biological factors. Promoting the biopsychosocial framework of chronic pain is key to ensure timely and effective treatment. The new pain classification in the ICD-11 has the potential to increase the use of the biopsychosocial model.
慢性疼痛在儿童和青少年中普遍存在，但却未得到充分认识。在过去几十年里，生物心理社会框架已被广泛采用，并在《国际疾病分类》第11版（ICD - 11）中产生了新的疼痛分类。然而，对于儿科医生的疼痛概念却知之甚少。
我们通过定性分析探讨了瑞士儿科医生的疼痛概念。
向在瑞士儿科学会注册的临床活跃的瑞士儿科医生发送了一份横断面在线调查问卷。呈现了一名患有慢性肌肉骨骼疼痛女孩的病例 vignette，并询问儿科医生（1）他们认为疼痛的原因是什么，以及（2）他们将如何向患者及其家人解释疼痛。应用结构化内容分析来描述答案中的主要主题。
出现了以下主要类别：心理因素、生物因素、病因不明、社会背景、特定疾病和多因素。大多数儿科医生报告认为心理因素可以解释疼痛。然而，在向患者解释疼痛时，最常提及的是生物因素。
儿科医生认为慢性疼痛大多由心理因素解释，但他们对患者的探索模型却侧重于生物因素，这两者之间存在差异。推广慢性疼痛的生物心理社会框架是确保及时有效治疗的关键。ICD - 11中的新疼痛分类有可能增加生物心理社会模型的应用。
