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了解成长过程中经历疼痛是怎样的感受:一项诗性元民族志研究。

Understanding what it is like to experience pain as you grow up: a poetic meta-ethnography.

作者信息

Toye Francine, Hannink Erin, Woolverton Amy, Barker Karen L

机构信息

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.

Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.

出版信息

Pain. 2025 Jan 1;166(1):24-33. doi: 10.1097/j.pain.0000000000003420. Epub 2024 Oct 18.

Abstract

A recent Lancet Commission raised concerns about the management of child and adolescent pain. We aimed to undertake a comprehensive review of qualitative research to understand children and adolescent pain experiences across contexts. We used the 7 stages of meta-ethnography to synthesise findings. We combined the strengths of arts-based methods, translating themes into poems in a range of languages. We screened 7471 titles, 464 abstracts, and 302 full texts, including 189 reports (177 unique samples) incorporating 5875 young people. Age range across studies was 2 to 38 years, with 93% including those between the age of 11 and 20 years old. Studies spanned 30 years (1993-2023) with 121 (64%) published in the last 10 years. Almost all (93%) were set-in high-income countries. We report 6 themes focusing on transition to adulthood: (1) I want to stay within the safety of home; (2) don't exclude me from my own care; (3) it might hurt but it's for my own good; (4) I rely on others but I want some independence; (5) I am no longer a child but I am not an adult yet; and (6) I wasn't prepared for the transfer to adult health care. Our findings focus on the complex transition into adulthood and the importance of creating a genuine healthcare partnership with young people by acknowledging their perspectives, creating a safe and supportive environment, and preparing them for the transition to adult pain care. Arts-based methods have the potential to make findings from qualitative evidence syntheses accessible and impactful for compassionate health care.

摘要

近期,《柳叶刀》委员会对儿童和青少年疼痛管理表示担忧。我们旨在对定性研究进行全面综述,以了解不同背景下儿童和青少年的疼痛经历。我们运用元民族志的7个阶段来综合研究结果。我们结合了基于艺术方法的优势,将主题翻译成多种语言的诗歌。我们筛选了7471个标题、464篇摘要和302篇全文,其中包括189份报告(177个独特样本),涉及5875名年轻人。各研究的年龄范围为2至38岁,93%的研究对象为11至20岁的人群。研究跨度为30年(1993 - 2023年),其中121项(64%)在过去10年发表。几乎所有研究(93%)都在高收入国家开展。我们报告了6个关注向成年期过渡的主题:(1)我想待在安全的家中;(2)不要将我排除在自身护理之外;(3)这可能会疼,但这是为了我好;(4)我依赖他人,但我想要一些独立性;(5)我不再是孩子,但我还不是成年人;(6)我没有为转至成人医疗保健做好准备。我们的研究结果聚焦于向成年期的复杂过渡,以及通过认可年轻人的观点、营造安全支持性环境并帮助他们为向成人疼痛护理过渡做好准备,与年轻人建立真正医疗伙伴关系的重要性。基于艺术的方法有可能使定性证据综合的结果易于理解,并对富有同情心的医疗保健产生影响。

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