Perception of venipuncture pain in children suffering from chronic diseases.
Perception of venipuncture pain in children suffering from chronic diseases.
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DOI：
10.1186/1756-0500-7-735
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发表时间：
2014-10-18
影响因子：
1.8
通讯作者：
Festini F
中科院分区：
文献类型：
--
作者：
Bisogni S;Dini C;Olivini N;Ciofi D;Giusti F;Caprilli S;Gonzalez Lopez JR;Festini F
儿童静脉穿刺疼痛是由多种共同因素引起的，这些因素增加了伤害性刺激的强度。其中，预期焦虑起着重要的作用。患有慢性疾病的儿童比其他儿童更常接受侵入性手术和静脉穿刺。一些保健专业人员仍然认为，反复经历痛苦手术的儿童，如患有慢性病的儿童，其疼痛耐受力逐渐增加，因此，他们的疼痛阈值高于没有慢性病的儿童。本研究的目的是评估患有慢性疾病的儿童和以前没有健康问题或没有静脉穿刺经验的儿童对静脉穿刺疼痛的感知是否存在差异。采用Wong疼痛量表和数字疼痛量表以及行为困扰观察量表（OSBD）进行横断面研究，评估行为困扰。一组患有慢性疾病的儿童和一组以前没有健康问题也没有静脉穿刺经验的儿童，年龄在4至12岁之间，包括男孩和女孩，在标准化静脉穿刺过程中进行观察。该研究共纳入230名儿童：其中82名患有慢性疾病且至少经历过一次静脉穿刺，而其余148名儿童以前没有静脉穿刺经历。患有慢性疾病的儿童比非慢性儿童报告更多的疼痛（Wong/数字量表疼痛中位数得分为8分），并表现出更多的行为困扰迹象（OSBD中位数得分为27分）（Wong/数字量表疼痛中位数得分为2分，p = 0.00001； OSBD中位数得分为5分，p = 0.00001）。我们的研究表明，患有慢性疾病的儿童比第一次经历静脉穿刺的同性别和年龄的儿童有更低的疼痛阈值。
Venipuncture pain in children results from a variety of co-factors which increase the intensity of the nociceptive stimulus. Among them, anticipatory anxiety plays an important role. Children with chronic diseases undergo invasive procedures and venipuncture more often than other children. Some healthcare professionals still believe that children who are repeatedly exposed to painful procedures, such as children with chronic diseases, gradually increase their pain tolerance and that, as a result, they have a higher pain threshold than children with no chronic diseases. The purpose of this study was to assess whether a difference exists in the perception of venipuncture pain between children with chronic diseases and children with no previous health problems nor experience of venipuncture. A cross-sectional study was carried out using the Wong and numeric pain scales and the Observational Scale of Behavioral Distress (OSBD) for the assessment of behavioral distress. A group of children with chronic diseases and a group of children with no previous health problems nor experience of venipuncture, aged 4 to 12 years, both boys and girls, were observed during a standardized venipuncture procedure. The study included 230 children in total: 82 of them suffered from chronic diseases and had already experienced venipuncture at least once, while the remaining 148 children had no previous experience of venipuncture. The children with chronic diseases reported more pain (median pain score of 8 on the Wong or numeric scales,) and showed more signs of behavioral distress (median score of 27 on the OSBD) than non-chronic children (median pain score of 2 on the Wong/numeric scales, p = 0.00001; median OSBD score 5, p = 0.00001). Our study suggests that children with chronic diseases have a lower pain threshold than children of the same sex and age who experience venipuncture for the first time.