The Longitudinal Impact of Parent Distress and Behavior on Functional Outcomes Among Youth With Chronic Pain
The Longitudinal Impact of Parent Distress and Behavior on Functional Outcomes Among Youth With Chronic Pain
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DOI：
10.1016/j.jpain.2016.02.014
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发表时间：
2016-06-01
期刊：
影响因子：
4
通讯作者：
Simons, Laura E.
中科院分区：
文献类型：
--
作者：
Chow, Erika T.;Otis, John D.;Simons, Laura E.
越来越多的证据支持在慢性疼痛的背景下，父母的痛苦和行为与儿童的功能之间的并行关联，现有的纵向研究仅限于儿科手术的背景下，确定父母的灾难性影响。在这项研究中，我们研究了在多学科儿科疼痛临床评估中评估的父母因素如何随着时间的推移影响儿童的心理和功能结局。一组195名慢性疼痛患者（年龄8-17岁）及其父母参加了多学科评估，在基线和4个月随访时完成了测量。患者完成了疼痛灾难化，疼痛相关的恐惧和回避，广泛性焦虑，抑郁症状和功能障碍的措施。父母完成了疼痛灾难化，疼痛相关的恐惧和回避，以及对儿童疼痛的保护性反应的措施。还收集了家长报告的儿童学校运作情况。父母的痛苦和行为同时与儿童的痛苦和功能评估。在控制基线儿童功能后，基线父母回避和保护行为成为4个月随访时儿童功能的重要预测因素。父母的痛苦和行为影响孩子的痛苦和功能随着时间的推移，这些研究结果确定关键的父母域的目标在一个孩子的疼痛treatment.Perspective的背景下：父母的行为，特别是回避和保护性反应，影响孩子的痛苦和功能随着时间的推移。儿童疼痛治疗干预措施应包括有影响力的父母因素，以确保成功的结果。(C)2016年美国疼痛协会American Pain Society
Accumulating evidence supports the concurrent association between parent distress and behavior and child functioning in the context of chronic pain, with existing longitudinal studies limited to a pediatric surgical context that identify parent catastrophizing as influential. In this study, we examined how parent factors assessed at a multidisciplinary pediatric pain clinic evaluation affect child psychological and functional outcomes over time. A cohort of 195 patients with chronic pain (ages 8-17 years) and their parents who presented for a multidisciplinary evaluation completed measures at baseline and at 4-month follow-up. Patients completed measures of pain catastrophizing, pain-related fear and avoidance, generalized anxiety, depressive symptoms, and functional disability. Parents completed measures of pain catastrophizing, pain-related fear and avoidance, and protective responses to child pain. Parent-reported child school functioning was also collected. Parent distress and behavior was concurrently associated with child distress and functioning at evaluation. After controlling for baseline child functioning, baseline parent avoidance and protective behavior emerged as significant predictors of child functioning at 4-month follow-up. Parent distress and behavior influence child distress and functioning over time and these findings identify key parent domains to target in the context of a child's pain treatment.Perspective: Parent behavior, specifically avoidance and protective responses, influence child distress and functioning over time. Child pain treatment interventions should include influential parent factors to ensure successful outcomes. (C) 2016 by the American Pain Society