Broome M E, Rehwaldt M, Fogg L
University of Wisconsin-Milwaukee 53211, USA.
J Pediatr Nurs. 1998 Feb;13(1):48-54. doi: 10.1016/S0882-5963(98)80068-7.
A limited number of studies have examined relationships between temperament and children's/adolescents' responses to painful procedures and have identified several different dimensions of temperament that are related to children's pain response. The focus of these studies was one-time, acute pain experiences, such as immunization and postoperative pain. In this study, children and adolescents' responses to a moderately painful procedure, lumbar puncture, were examined as they related to temperament. Nineteen children and adolescents, ages 4 to 18 years, who were receiving treatment for cancer, were participants in this study. Parents completed one of three age-appropriate temperament questionnaires at the beginning of the study and prior to the parent and child learning cognitive-behavioral techniques. Behavior during the procedure was videotaped at baseline, and for up to four visits after baseline and coded using the Observation Scale of Behavioral Distress (OSBD). Pain reports were collected after the procedure using the Oucher pain self-report scale. Improvement in the level of behavioral distress was determined by examining the differences between pre- and post-treatment OSBD scores and self-reported pain ratings. There was a significant improvement in pain reports over the 5-month period, but behavioral distress did not change significantly. At the baseline visit, the temperament dimensions of more positive mood, lower activity, less persistence, and lower distractibility were related to higher pain reports, but not behavioral distress. However, after 5 months, only the dimension of positive mood was significantly correlated with improvement in pain reports. The amount of time parents and children practiced the techniques, their comfort with the techniques and their perceived effectiveness also were correlated with positive mood.
少数研究考察了气质与儿童/青少年对疼痛程序的反应之间的关系，并确定了与儿童疼痛反应相关的几个不同气质维度。这些研究的重点是一次性的急性疼痛经历，如免疫接种和术后疼痛。在本研究中，考察了儿童和青少年对中等疼痛程序腰椎穿刺的反应与气质的关系。19名年龄在4至18岁、正在接受癌症治疗的儿童和青少年参与了本研究。在研究开始时以及家长和孩子学习认知行为技术之前，家长完成了三份适合年龄的气质问卷中的一份。程序进行期间的行为在基线时进行录像，并在基线后最多四次随访时录像，使用行为痛苦观察量表（OSBD）进行编码。程序结束后，使用奥ucher疼痛自评量表收集疼痛报告。通过检查治疗前和治疗后OSBD分数以及自我报告的疼痛评分之间的差异来确定行为痛苦水平的改善情况。在5个月的时间里，疼痛报告有显著改善，但行为痛苦没有显著变化。在基线访视时，更积极的情绪、较低的活动水平、较少的坚持性和较低的注意力分散性等气质维度与较高的疼痛报告相关，但与行为痛苦无关。然而，5个月后，只有积极情绪维度与疼痛报告的改善显著相关。家长和孩子练习这些技术的时间、他们对这些技术的舒适度以及他们认为的有效性也与积极情绪相关。
