Pain and Health-Related Quality of Life in Children after Surgery

手术后儿童的疼痛和与健康相关的生活质量

• 批准号: 8765636
• 负责人: Jennifer Rabbitts
• 金额: $ 12.97万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-25 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8765636
• 关键词: Acute; Acute Pain; Address; Ambulatory Monitoring; Anesthesiology; Anxiety; Behavior Therapy; Biometry; Budgets; Child; Childhood; Chronic; Clinical; Data; Deterioration; Development; Early identification; Economic Burden; Electronics; Ensure; Event; Faculty; Family; Future; Glean; Goals; Health; Health Services Research; Healthcare; Hospitals; Impairment; Individual Differences; Inpatients; Instruction; Interdisciplinary Study; Intervention; Intervention Studies; Knowledge; Lead; Life; Measurement; Measures; Medical; Medicine; Mentors; Mentorship; Methodology; Methods; Minor; Monitor; Morbidity - disease rate; Operative Surgical Procedures; Outcome; Outcome Assessment; Outcomes and Health Services Research; Pain; Pain intensity; Pain management; Pain quality; Pattern; Pediatric Hospitals; Pediatric Research; Pediatric Surgical Procedures; Perioperative; Persistent pain; Physical Function; Physicians; Population; Postoperative Pain; Postoperative Period; Prevalence; Prevention; Prevention strategy; Preventive; Preventive Intervention; Problem behavior; Procedures; Quality of life; Recovery; Recovery of Function; Research; Research Ethics; Research Institute; Research Personnel; Research Training; Resources; Risk; Risk Factors; Sampling; Sleep; Testing; Time; Training; Universities; Washington; Youth; actigraphy; adverse outcome; base; biopsychosocial; career; career development; chronic pain; clinical care; clinical risk; cohort; diaries; experience; functional outcomes; health care service utilization; health related quality of life; improved; innovation; medical schools; patient oriented research; prevent; professor; programs; public health relevance; skills; success; tool

DESCRIPTION (provided by applicant): Over 4.5 million children undergo surgery in the U.S. each year and about half of them experience moderate- severe postsurgical pain. Pain may also persist beyond the immediate postsurgical period and transition into chronic pain for some children. However, little is known about the prevalence of persistent postsurgical pain in the pediatric surgery population or of the impact of pain on children's physical functioning, health-related quality of life (HRQOL) and health service utilization. Understanding of the biopsychosocial factors that may predict a child's risk for experiencing persistent postsurgical pain and reduced HRQOL would address gaps in knowledge to allow for the future development of preventive interventions. The objective of this application is to document longitudinal trajectories of pain and HRQOL in children following surgery, and to identify individual differences that place children at risk for both acute and chronic postsurgical pain and deteriorations in HRQOL. The long-term goal of this research is to develop effective strategies to prevent persistent postsurgical pain in children. The K23 candidate is an assistant professor in the Department of Anesthesiology and Pain Medicine at the University of Washington and a pediatric anesthesiologist and pain physician at Seattle Children's Hospital. Her K23 proposal will capitalize on the wealth of resources available at the University of Washington School of Medicine and Seattle Children's Research Institute. The candidate has demonstrated commitment to a patient-oriented research career and proposes a five-year training plan with the support of faculty mentors who have expertise in pediatric pain, health services outcomes research, pediatric research ethics, and biostatistics. Through the research training plan the candidate will obtain specialized instruction in state-of-the-art pain and functional outcomes assessment tools, intervention research methodology, preventive research and mentorship in research career development. The research plan involves two studies. Study 1 will prospectively monitor pain and HRQOL before and after surgery in a large hospital-based cohort of children undergoing minor and major surgical procedures over the first month post-hospital discharge. Study 2 will prospectively measure individual differences (clinical and biopsychosocial factors) associated with change in pain and function before and over 18 months following major surgery in a smaller, well-characterized sample using state-of-the art measurement tools including daily electronic diary monitoring and ambulatory actigraphy. Preliminary data demonstrate the feasibility of the multi-method assessment plan in the perioperative and postoperative periods and ensure success in carrying out the proposed studies. Data generated from this research will be used to identify children at-risk for chronic postsurgical pain and impaired quality of life, an will guide later research to develop and test medical and behavioral interventions for at-risk youth. Completion of the proposed research and training plan will provide the candidate with necessary data and essential skills to develop into a successful independent pediatric pain researcher.

描述（由申请人提供）：在美国，每年有超过450万儿童接受手术，其中约一半经历中度至重度术后疼痛。疼痛也可能持续超过术后即刻，并对某些儿童转变为慢性疼痛。然而，很少有人知道持续性术后疼痛的患病率在儿科手术人群或疼痛对儿童的身体功能，健康相关的生活质量（HRQOL）和卫生服务利用的影响。了解可能预测儿童术后持续疼痛和HRQOL降低的风险的生物心理社会因素，将解决知识差距，以便将来制定预防性干预措施。本申请的目的是记录术后儿童疼痛和HRQOL的纵向轨迹，并确定将儿童置于急性和慢性术后疼痛风险和HRQOL恶化的个体差异。这项研究的长期目标是制定有效的策略来预防儿童术后持续疼痛。K23候选人是华盛顿大学麻醉学和疼痛医学系的助理教授，也是西雅图儿童医院的儿科麻醉师和疼痛医生。她的K23提案将利用华盛顿大学医学院和西雅图儿童研究所的丰富资源。候选人已经证明了对以患者为导向的研究事业的承诺，并在具有儿科疼痛，卫生服务成果研究，儿科研究伦理和生物统计学专业知识的教师导师的支持下提出了一个为期五年的培训计划。通过研究培训计划，候选人将获得最先进的疼痛和功能结果评估工具，干预研究方法，预防性研究和研究职业发展导师的专业指导。研究计划包括两项研究。研究1将前瞻性监测出院后第一个月内接受小手术和大手术的大型医院队列儿童手术前后的疼痛和HRQOL。研究2将使用最先进的测量工具（包括每日电子日志监测和动态活动记录仪），前瞻性测量与大手术前和术后18个月内疼痛和功能变化相关的个体差异（临床和生物心理社会因素）。初步数据证明了围手术期和术后多方法评估计划的可行性，并确保成功开展拟议的研究。这项研究产生的数据将用于识别患有慢性术后疼痛和生活质量受损的儿童，并将指导后续研究开发和测试针对高危青少年的医疗和行为干预措施。完成拟议的研究和培训计划将为候选人提供必要的数据和基本技能，以发展成为一名成功的独立儿科疼痛研究人员。