Chronic Pain in Children: A Look at the Referral Process to a Pediatric Pain Clinic.
Chronic Pain in Children: A Look at the Referral Process to a Pediatric Pain Clinic.
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DOI：
10.1155/2017/8769402
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发表时间：
2017
影响因子：
2.1
通讯作者：
Ornelas B
中科院分区：
文献类型：
--
作者：
Cucchiaro G;Schwartz J;Hutchason A;Ornelas B
我们回顾了儿童的转诊模式与慢性疼痛专科儿科疼痛诊所。数据来自转诊医生和医疗记录，以及医生和一名心理学家对患者及其父母的访谈。我们分析了以下内容：转诊诊断、人口统计学、症状持续时间、以前咨询过的医生数量、上学出勤、体育活动、心理障碍的存在、最终团队诊断和结果。患儿持续疼痛34±55个月。除了儿科医生外，患者平均还咨询了3位医生。32%的患者在一年中至少缺课10天，47%的患者停止了体育运动。15%的人因为疼痛而手术失败。最常见的漏诊是焦虑（25%）和抑郁（13%）。69%的患者在我们首次咨询后的4个月内回到学校和/或参加体育运动。32%的患者在随访期间无任何进展。未能改善的最常见原因是不遵守推荐的治疗方法和控制不良的主要情绪障碍。将患有慢性疼痛的儿童转介到专门护理的时间可能非常长，造成重大的社会和心理后果。
We reviewed the referral pattern of children with chronic pain to a specialized pediatric pain clinic. Data were obtained from referring physicians and medical records and during an interview with patients and their parents by physicians and a psychologist. We analyzed the following: referral diagnosis, demographics, duration of symptoms, number of physicians previously consulted, school attendance, sports activities, presence of psychological disorders, final team diagnosis, and outcomes. Children had been experiencing pain for 34 ± 55 months. Patients had consulted on average 3 physicians in addition to their pediatrician. 32% of the patients had missed at least 10 days of school in a calendar year, and 47% had stopped playing sports. 15% had an operation because of pain that had been unsuccessful. The most common missed diagnosis was anxiety (25%) and depression (13%). 69% of the patients were back to school and/or playing sports within 4 months from our initial consultation. 32% of the patients did not make any progress during the follow-up period. The most common reasons for failure to improve were no compliance with the recommended treatments and poorly controlled major mood disorder. The time to refer children with chronic pain for specialized care could be extremely long causing significant social and psychological consequence.