Beveridge Jaimie K, Noel Melanie, Soltani Sabine, Neville Alexandra, Orr Serena L, Madigan Sheri, Birnie Kathryn A
Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
Pain. 2024 May 1;165(5):997-1012. doi: 10.1097/j.pain.0000000000003125. Epub 2023 Dec 6.
Mental health problems are common among parents of children with chronic pain and associated with worse outcomes for the child with chronic pain. However, the effect sizes of these associations between parent mental health and pediatric chronic pain vary widely across studies. The aim of this systematic review and meta-analysis was to generate pooled estimates of the (1) prevalence of mental health problems among parents of children with chronic pain and (2) associations between parent mental health and the (2a) presence of child chronic pain and (2b) functioning of children with chronic pain. Embase, MEDLINE, PsycINFO, Web of Science, and CINAHL were searched up to November 2022. Observational studies that examined symptoms or diagnoses of parent anxiety, depression, or general distress and the presence of child chronic pain and/or related functioning were included. From 32,848 records, 2 coders identified 49 studies to include in random-effects meta-analyses. The results revealed that mental health problems among parents of children with chronic pain were common (anxiety: 28.8% [95% CI 20.3-39.1]; depression: 20.0% [15.7-25.2]; general distress: 32.4% [22.7-44.0]). Poorer parent mental health was significantly associated with the presence of chronic pain (anxiety: OR = 1.91 [1.51-2.41]; depression: OR = 1.90 [1.51-2.38]; general distress: OR = 1.74 [1.47-2.05]) and worse related functioning (ie, pain intensity, physical functioning, anxiety and depression symptoms; r s = 0.10-0.25, all P s < 0.05) in children. Moderator analyses were generally nonsignificant or could not be conducted because of insufficient data. Findings support the importance of addressing parent mental health in the prevention and treatment of pediatric chronic pain.
心理健康问题在患有慢性疼痛儿童的父母中很常见，并且与患有慢性疼痛的儿童的更差预后相关。然而，这些父母心理健康与儿童慢性疼痛之间关联的效应大小在不同研究中差异很大。本系统评价和荟萃分析的目的是生成以下方面的合并估计值：（1）患有慢性疼痛儿童的父母中心理健康问题的患病率；（2）父母心理健康与（2a）儿童慢性疼痛的存在以及（2b）患有慢性疼痛儿童的功能之间的关联。截至2022年11月，对Embase、MEDLINE、PsycINFO、Web of Science和CINAHL进行了检索。纳入了检查父母焦虑、抑郁或一般困扰的症状或诊断以及儿童慢性疼痛的存在和/或相关功能的观察性研究。从32,848条记录中，2名编码员确定了49项研究纳入随机效应荟萃分析。结果显示，患有慢性疼痛儿童的父母中心理健康问题很常见（焦虑：28.8%[95%CI 20.3 - 39.1]；抑郁：20.0%[15.7 - 25.2]；一般困扰：32.4%[22.7 - 44.0]）。父母心理健康状况较差与慢性疼痛的存在显著相关（焦虑：OR = 1.91[1.51 - 2.41]；抑郁：OR = 1.90[1.51 - 2.38]；一般困扰：OR = 1.74[1.47 - 2.05]），并且与儿童更差的相关功能（即疼痛强度、身体功能、焦虑和抑郁症状；r s = 0.10 - 0.25，所有P值<0.05）相关。由于数据不足，调节因素分析通常无统计学意义或无法进行。研究结果支持在儿童慢性疼痛的预防和治疗中关注父母心理健康的重要性。
