Pain-sensitive temperament: Does it predict procedural distress and response to psychological treatment among children with cancer?
Pain-sensitive temperament: Does it predict procedural distress and response to psychological treatment among children with cancer?
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DOI：
10.1093/jpepsy/25.4.269
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发表时间：
2000-06-01
影响因子：
3.6
通讯作者：
Zeltzer, LK
中科院分区：
文献类型：
--
作者：
Chen, E;Craske, MG;Zeltzer, LK
目的：探讨儿童腰椎穿刺术中疼痛敏感性与疼痛反应的关系，以及疼痛敏感性是否能调节儿童对减轻腰椎疼痛心理干预的反应。方法：对55例3~18岁的急性淋巴细胞白血病患儿及其父母进行疼痛敏感性问卷调查。在研究基线LP期间收集了自我报告、生理和观察到的痛苦测量。然后，孩子们被随机分为心理干预组或注意力控制组。结果：无论是在LP之前还是在LP期间，疼痛敏感度越高，焦虑和疼痛越严重。初步分析表明，疼痛敏感度减缓了干预对痛苦的影响。疼痛敏感度较高且未接受任何干预的儿童，随着时间的推移，腰椎疼痛的增加幅度更大。相反，疼痛敏感度较高并接受干预的儿童随着时间的推移表现出更大的LP痛苦下降。结论：在儿科肿瘤学环境中，疼痛敏感度的测量可能有助于有效地针对疼痛易感儿童进行心理干预。初步分析表明，经验支持的程序性痛苦干预对那些对疼痛最敏感的儿童是有效的。
Objective: To evaluate the relationship between pain sensitivity and children's distress during lumbar punctures (LPs), and whether pain sensitivity functions as a moderator of children's responses to a psychological intervention aimed at reducing LP distress.Method: Fifty-five children with acute lymphoblastic leukemia (ages 3 to 18) and their parents completed a questionnaire measure of pain sensitivity. Self-report, physiological, and observed measures of distress were collected during the study baseline LP. Children were then randomized into a psychological intervention or an attention control group. Postintervention and follow-up LPs were observed.Results: Higher levels of pain sensitivity were associated with greater anxiety and pain, both prior to and during the LP. Preliminary analyses indicated that pain sensitivity moderated the effects of intervention on distress. Children who were more pain-sensitive and who received no intervention showed greater increases in LP distress over time. In contrast, children who were more pain-sensitive and who received intervention showed greater decreases in LP distress over time.Conclusions: A measurement of pain sensitivity may be useful in pediatric oncology settings for effectively targeting pain-vulnerable children for psychological intervention. Preliminary analyses indicate that an empirically-supported intervention for procedural distress is efficacious for those children who are most pain-sensitive.