Children with unexplained chronic pain: substantial impairment in everyday life
Children with unexplained chronic pain: substantial impairment in everyday life
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DOI：
10.1136/adc.2004.056820
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发表时间：
2005-07-01
影响因子：
5.2
通讯作者：
Graeff-Meeder, ERD
中科院分区：
文献类型：
--
作者：
Konijnenberg, AY;Uiterwaal, CSPM;Graeff-Meeder, ERD
目的：描述和量化门诊不明原因慢性疼痛（UCP）儿童的损伤。方法：对149例患儿进行研究，这些患儿的疼痛持续时间至少为3个月，就诊时没有令人满意的解释。测定躯体主诉（儿童躯体化量表，CSI）、疼痛强度（VAS, 0-10 cm）、功能残疾（儿童健康问卷（CHQ- cf）和临床病史）和总体健康感知（CHQ）。结果：患儿平均年龄11.8岁；73%是女孩。总的来说，72%的人在体育活动中受到损害，51%的人缺课，40%的人社交功能受限，34%的人有睡眠问题。躯体症状的平均数量在男孩（8.4）和女孩（10.7）之间有显著差异。身体功能、角色/社会功能和总体健康感知的CHQ-CF得分分别为76.4、70.7和57.5，表明在所有领域都存在严重损害。目前的平均疼痛强度为4.7，最严重的疼痛强度为7.1。在转诊前由全科医生单独评估的儿童报告的损伤较少，但仍然很大。总体健康认知低、角色/社会功能受损、疼痛强度高、头痛或肌肉骨骼疼痛是存在显著损伤的独立预测因子。结论：转介的UCP患儿在日常生活的多个领域表现出实质性的损害。
Aims: To describe and quantify impairment in an outpatient population of children with chronic pain of unknown origin ( UCP).Methods: A total of 149 children who presented with pain of at least three months' duration and without a satisfactory explanation at presentation were studied. Number of somatic complaints ( Children's Somatisation Inventory, CSI), pain intensity (VAS, 0-10 cm), functional disability (Child Health Questionnaire (CHQ-CF) and clinical history), and general health perceptions (CHQ) were determined.Results: Mean age of the children was 11.8 years; 73% were girls. Overall, 72% suffered impairment in sports activities, 51% reported absence from school, 40% experienced limitations in social functioning, and 34% had problems with sleeping. Mean number of somatic symptoms differed significantly between boys ( 8.4) and girls (10.7). The CHQ-CF scores for physical functioning, role/social functioning, and general health perceptions were 76.4, 70.7, and 57.5, respectively, indicating substantial impairment on all domains. The mean pain intensity was 4.7 for current and 7.1 for worst pain. Children solely evaluated by a general practitioner prior to referral reported less, though still substantial, impairment. Low general health perceptions, impaired role/social functioning, high pain intensity, and having headache or musculoskeletal pain were independent predictors of having significant impairment.Conclusions: Referred children with UCP show substantial impairment on multiple domains in daily life.