Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington.
Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington; Department of Anesthesiology & Pain Medicine, Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington.
J Pain. 2023 Jul;24(7):1193-1202. doi: 10.1016/j.jpain.2023.02.001. Epub 2023 Feb 10.
Positive childhood experiences (PCEs) are associated with better mental and physical health outcomes and moderate the negative effects of adverse childhood experiences (ACEs). However, knowledge of the associations between PCEs and childhood chronic pain is limited. We conducted a cross-sectional analysis of 2019 to 2020 National Survey of Children's Health (NSCH) to evaluate associations between PCEs and childhood chronic pain. Parents of 47,514 children ages 6 to 17 years old reported on their child's exposure to 7 PCEs and 9 ACEs. Associations between PCEs and chronic pain were evaluated using weighted, multivariate logistic regression analyses adjusted for sociodemographic factors. We found that PCEs had dose-dependent associations with pediatric chronic pain; children exposed to higher numbers of PCEs (5-7 PCEs) had the lowest reported rate of chronic pain (7.1%), while children exposed to 2 or fewer PCEs had the highest rate of chronic pain (14.7%). The adjusted analysis confirmed that children experiencing 5 to 7 PCEs had significantly lower odds of chronic pain relative to children experiencing 0 to 2 PCEs (adjusted odds ratio (aOR): .47, 95% confidence interval (CI): .39-.61, P < .0001). PCEs moderated associations between ACEs and chronic pain: among children reporting 2 or more ACEs, those reporting 5 to 7 PCEs were significantly less likely to report chronic pain as compared to children only reporting 0 to 2 PCEs (aOR: .64, 95%CI: .45-.89, P = .009). In conclusion, children with greater PCEs exposure had lower prevalence rates of chronic pain. Furthermore, PCEs was associated with reduced prevalence of chronic pain among children exposed to ACEs. PERSPECTIVE: This article estimates associations between survey-measured PCEs and pediatric chronic pain among children in the United States. Promoting PCEs could improve pediatric pain outcomes.
积极的童年经历（PCEs）与更好的身心健康结果相关，并适度减轻不良童年经历（ACEs）的负面影响。然而，关于 PCEs 与儿童慢性疼痛之间的关联，我们的了解有限。我们对 2019 年至 2020 年全国儿童健康调查（NSCH）进行了横断面分析，以评估 PCEs 与儿童慢性疼痛之间的关联。47514 名 6 至 17 岁儿童的父母报告了他们孩子接触 7 种 PCEs 和 9 种 ACEs 的情况。使用加权、多变量逻辑回归分析调整了社会人口因素后，评估了 PCEs 与慢性疼痛之间的关联。我们发现，PCEs 与儿科慢性疼痛之间存在剂量依赖性关联；接触较多 PCEs（5-7 个 PCEs）的儿童报告的慢性疼痛发生率最低（7.1%），而接触较少 PCEs（2 个以下）的儿童慢性疼痛发生率最高（14.7%）。调整分析证实，与接触 0 至 2 个 PCEs 的儿童相比，经历 5 至 7 个 PCEs 的儿童慢性疼痛的可能性显著降低（调整后的优势比（aOR）：0.47，95%置信区间（CI）：0.39-0.61，P<0.0001）。PCEs 调节了 ACEs 与慢性疼痛之间的关联：在报告 2 个或更多 ACEs 的儿童中，与仅报告 0 至 2 个 PCEs 的儿童相比，报告 5 至 7 个 PCEs 的儿童报告慢性疼痛的可能性显著降低（aOR：0.64，95%CI：0.45-0.89，P=0.009）。总之，暴露于更多 PCEs 的儿童慢性疼痛患病率较低。此外，在暴露于 ACEs 的儿童中，PCEs 与慢性疼痛患病率降低有关。观点：本文估计了美国儿童中调查测量的 PCEs 与儿科慢性疼痛之间的关联。促进 PCEs 可以改善儿科疼痛结果。
