Fanurik Debra, Zeltzer Lonnie K, Roberts Michael C, Blount Ronald L
Department of Pediatrics, Pediatrie Pain Program, University of California School of Medicine, Los Angeles, CAUSA Department of Psychology and Human Development, University of Kansas Lawrence, KSUSA Department of Psychology, University of Georgia Athens, GAUSA.
Pain. 1993 May;53(2):213-222. doi: 10.1016/0304-3959(93)90083-2.
This study examined the hypothesis that matching pain management interventions to children's preferred coping methods would increase pain tolerance and decrease self-reported pain during the cold pressor pain paradigm. Children aged 8-10 years were classified as 'attenders' (focusing on the stimulus) or 'distractors' (focusing away from the stimulus) based upon their spontaneous coping responses during a baseline exposure to the cold pressor. Children were then randomly assigned to 1 of 3 intervention conditions (sensory focusing, imagery, or no intervention) and completed the cold pressor procedure again 2 weeks later. A significant interaction was found between coping style and intervention. Children who were classified as distractors demonstrated greater tolerance when taught to use imagery techniques (a 'matched' intervention). Although pain ratings tended to be lower for distractors using imagery, the significant interaction resulted from an increase in ratings for the distractors using sensory focusing (i.e., a 'mismatched' intervention). Results suggest that, for distractors, interventions that are consistent with natural coping methods are most effective in enhancing abilities to cope with pain, while a mismatched intervention reduces coping abilities. The findings also suggest further study regarding how to provide effective pain intervention with attenders, since neither intervention enhanced coping in this group.
在冷加压疼痛范式中，使疼痛管理干预措施与儿童偏爱的应对方式相匹配，将提高疼痛耐受性并降低自我报告的疼痛程度。根据8至10岁儿童在基线冷加压暴露期间的自发应对反应，将其分为“关注者”（关注刺激）或“分散注意力者”（不关注刺激）。然后，将儿童随机分配到三种干预条件之一（感觉聚焦、意象或无干预），并在两周后再次完成冷加压程序。结果发现应对方式与干预之间存在显著交互作用。被归类为分散注意力者的儿童在学会使用意象技术（一种“匹配”干预）时表现出更高的耐受性。尽管使用意象的分散注意力者的疼痛评分往往较低，但显著的交互作用是由于使用感觉聚焦的分散注意力者（即“不匹配”干预）的评分增加所致。结果表明，对于分散注意力者而言，与自然应对方式一致的干预措施在增强应对疼痛能力方面最为有效，而不匹配的干预会降低应对能力。研究结果还表明，需要进一步研究如何为关注者提供有效的疼痛干预，因为这两种干预措施均未增强该组的应对能力。
