Family and Parent Influences on Pediatric Chronic Pain A Developmental Perspective
Family and Parent Influences on Pediatric Chronic Pain A Developmental Perspective
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DOI：
10.1037/a0035216
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发表时间：
2014-02-01
影响因子：
16.4
通讯作者：
Karlson, Cynthia W.
中科院分区：
文献类型：
--
作者：
Palermo, Tonya M.;Valrie, Cecelia R.;Karlson, Cynthia W.
不幸的是，反复发作或持续的疼痛是儿童的常见经历。一个独特的考虑在儿童慢性疼痛管理是儿童疼痛经历和父母和家庭因素的双向影响。在这篇综述中，我们提出了从发育的角度来理解儿童慢性疼痛和残疾，强调了从婴儿期到青春期的相关因素，以及家庭和父母的影响。初步证据表明，发育过程受到影响，也可能形成儿童疼痛经验。父母的情绪、行为和健康也在儿童的疼痛经历中发挥作用，其中过度保护的父母行为、增加的痛苦和慢性疼痛史是父母层面的重要影响。关于家庭层面影响的研究表明，与健康儿童的家庭相比，患有慢性疼痛儿童的家庭的家庭功能较差（例如，冲突较多，凝聚力较弱）。这项研究中存在一些重要的空白，例如在理解慢性疼痛儿童的基本发育过程以及它们如何影响儿童对疼痛的感知和反应。此外，缺乏关于家庭关系和个人调整的纵向数据，以便了解在儿童慢性疼痛经历的过程中，养育方式是否发生了变化。虽然父母干预已经成功地纳入了许多慢性疼痛儿童的认知行为治疗，但很少有指导存在，以适应干预策略的发展。需要进一步的研究来检验父母干预在不同的发育阶段是否有效，以及将发育目标纳入治疗的最佳方式。
Pain that recurs or persists is unfortunately a common experience for children. One of the unique considerations in pediatric chronic pain management is the bidirectional influences of children's pain experiences and parental and family factors. In this review we present a developmental perspective on understanding pediatric chronic pain and disability, highlighting factors relevant from infancy to adolescence, and family and parent influences. Preliminary evidence indicates that developmental processes are influenced and may also shape the pediatric pain experience. Parent emotions, behaviors, and health also play a role in children's pain experiences, where overly protective parent behaviors, increased distress, and history of chronic pain are important parent-level influences. Research on family-level influences has revealed that families of children with chronic pain have poorer family functioning (e. g., more conflict, less cohesion) than families of healthy children. Several important gaps exist in this research, such as in understanding basic developmental processes in children with chronic pain and how they influence children's perception of and responses to pain. Also, there is a lack of longitudinal data on family relationships and individual adjustment to allow for understanding of whether changes occur in parenting over the course of the child's chronic pain experience. Although parent interventions have been successfully incorporated into many cognitive-behavioral treatments for children with chronic pain conditions, little guidance exists for adapting intervention strategies to be developmentally appropriate. Additional research is needed to examine whether parent interventions are effective at different developmental stages and the best way to incorporate developmental goals into treatment.