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慢性疼痛的儿童和青少年如何描述他们的疼痛经历:一项定性系统综述。

How children and adolescents with chronic pain describe their pain experiences: A qualitative systematic review.

作者信息

Coventry Jessica, Pacey Verity, Smith Mitchell, Williams Cylie M, Ta Binh, Sturgiss Elizabeth

机构信息

School of Primary and Allied Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia.

School of Primary and Allied Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia; Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, 75 Talavera Rd, Macquarie Park, New South Wales, Australia.

出版信息

Patient Educ Couns. 2025 May;134:108634. doi: 10.1016/j.pec.2025.108634. Epub 2025 Jan 3.

Abstract

PURPOSE

To explore how children and adolescents with chronic pain describe their pain experiences.

METHOD

A systematic search of OVID Medline, CINAHL Complete, OVID Embase and APA PsycINFO (database inception to 19th August 2024) was conducted for qualitative or mixed-method studies investigating children's chronic pain experiences. Studies were excluded if focused on post-surgical or acute pain. Two independent reviewers screened studies, and disagreements resolved by a third reviewer. Methodological quality was assessed with the CASP checklist. Data from included studies were extracted and analysed using qualitative analysis.

RESULTS

Forty studies were included, and 4 main themes were identified: 1. 'I'm missing out because of my pain'; in which children described frustration and isolation due to missing activities. 2. 'Things that help me to get by with my pain'; described a variety of children's coping mechanisms. 3. 'It hurts and no one else understands my pain'; where children felt frequently disbelieved about their pain severity, and 4. 'I keep trying to make sense of my pain'; in which children identified ways they seek to understand the cause and possible outcomes of their pain, including accessing health care services.

CONCLUSIONS

This review highlights how children describe their pain challenges in managing their day to day while emphasising the necessity of understanding and incorporating children's perspectives into research and practice.

PRACTICE IMPLICATIONS

This review found that children were primarily concerned by how their pain affects their day-to-day activities and highlights the need to equip children with multiple strategies and promote autonomy in managing their pain. Additionally, further research is warranted into the ways that children understand their pain experience and seek information about their pain.

摘要

目的

探讨患有慢性疼痛的儿童和青少年如何描述他们的疼痛经历。

方法

对OVID Medline、CINAHL Complete、OVID Embase和APA PsycINFO(数据库创建至2024年8月19日)进行系统检索,以查找调查儿童慢性疼痛经历的定性或混合方法研究。如果研究聚焦于术后疼痛或急性疼痛,则将其排除。两名独立评审员筛选研究,分歧由第三名评审员解决。使用CASP清单评估方法学质量。对纳入研究的数据进行提取,并采用定性分析方法进行分析。

结果

纳入了40项研究,确定了4个主要主题:1. “因为疼痛,我正在失去机会”;在这一主题中,儿童描述了因错过活动而感到沮丧和孤立。2. “帮助我应对疼痛的事情”;描述了儿童的各种应对机制。3. “疼痛难忍,却无人理解我的痛苦”;在这一主题中,儿童经常感到自己的疼痛严重程度不被相信,以及4. “我一直在努力理解我的疼痛”;在这一主题中,儿童确定了他们试图理解疼痛原因和可能结果的方式,包括寻求医疗服务。

结论

本综述强调了儿童如何描述他们在日常生活中应对疼痛的挑战,同时强调了理解并将儿童的观点纳入研究和实践的必要性。

实践意义

本综述发现,儿童主要关心的是他们的疼痛如何影响日常活动,并强调需要为儿童提供多种策略,促进他们在管理疼痛方面的自主性。此外,有必要进一步研究儿童理解自己疼痛经历和寻求疼痛信息的方式。

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