McIntosh N
University of Edinburgh, Department of Child Life and Health, UK.
Eur J Pediatr. 1997 Mar;156(3):173-7. doi: 10.1007/s004310050576.
Pain is not a subjective experience, it is, particularly in children, an emotional issue. The formation of the International Association for the Study of Pain (IASP) in 1973 injected some standards and objectivity into the subject which allowed investigators around the world to probe both the underlying scientific basis of pain and nociception (nociception being the noxious sensation per se with no regard to the emotional experience). At the same time therapeutic strategies for different clinical problems have been evaluated, putting pain management on a scientifically secure and more individually effective basis. Self report has been the 'gold standard' of pain measurement but even in co-operative adults this has inherent weaknesses/biases related to the person and their situation (both the feelings and the reporting of pain are context sensitive). In some clinical areas, subject report is clearly impossible e.g. the psychogeriatric population, the mentally retarded and in preverbal children. However, even in these groups, there are usually behavioural responses to acute pain that are reasonably interpretable by their caregivers.
疼痛并非一种主观体验，尤其是在儿童中，它是一个情感问题。1973年国际疼痛研究协会（IASP）的成立为该领域注入了一些标准和客观性，这使得世界各地的研究人员能够探究疼痛和伤害感受的潜在科学基础（伤害感受本身是有害的感觉，不考虑情感体验）。与此同时，针对不同临床问题的治疗策略也得到了评估，将疼痛管理建立在科学可靠且更具个体有效性的基础上。自我报告一直是疼痛测量的“金标准”，但即使在配合良好的成年人中，这也存在与个体及其情况相关的固有弱点/偏差（疼痛的感受和报告都受情境影响）。在一些临床领域，显然无法进行主观报告，例如老年精神病患者群体、智力迟钝者以及不会说话的儿童。然而，即使在这些群体中，通常也会有对急性疼痛的行为反应，其照顾者能够合理地解读这些反应。
