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）：每年在美国接受手术超过450万，其中大约一半的儿童经历了中度严重的术后疼痛。疼痛也可能持续到直接的术后时期，并过渡到某些儿童的慢性疼痛。但是，对于小儿手术人群中持续性术后疼痛的普遍性或疼痛对儿童身体功能，与健康相关的生活质量（HRQOL）和健康服务利用的影响知之甚少。了解可能预测儿童持续性术后疼痛和减少HRQOL的风险的生物心理社会因素将解决知识的差距，从而允许未来的预防干预措施发展。该应用的目的是记录手术后儿童疼痛和HRQOL的纵向轨迹，并确定使儿童处于急性和慢性术后疼痛和HRQOL恶化的风险的个体差异。这项研究的长期目标是制定有效的策略，以防止儿童持续性术后疼痛。 K23候选人是华盛顿大学麻醉与疼痛医学系的助理教授，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获得的大量资源。该候选人表现出对以患者为导向的研究职业的承诺，并提出了为期五年的培训计划，并在儿科疼痛，卫生服务结果研究，儿科研究伦理和生物统计学方面具有专业知识的教师导师的支持。通过研究培训计划，候选人将获得有关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的指导的专业教学。研究计划涉及两项研究。研究1将在院后出院第一个月的大型医院群体中前瞻性地监测手术前后的疼痛和HRQOL。研究2将使用最先进的测量工具（包括每日电子日记监测和卧床行动术），在较小的，良好的测量工具中进行大手术前和超过18个月的疼痛和功能变化，前瞻性地测量与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，并确保成功地进行拟议的研究。这项研究产生的数据将用于确定儿童处于慢性术后疼痛和生活质量受损的危险中，这将指导后来的研究以开发和测试对高危青年的医学和行为干预措施。拟议的研究和培训计划的完成将为候选人提供必要的数据和基本技能，以发展成成功的独立儿科疼痛研究者。