父母心理因素、感知的儿童疼痛与家庭阿片类药物给药在术后疼痛管理中的瞬时关联
Momentary associations of parent psychological factors, perceived child pain, and home opioid administration for postoperative pain management.
文献信息
| PMID | 42708319 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Amanda L Stone |
| 作者单位 | Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States. |
| 期刊 | Pain |
| SCI 分区 | Q1 |
| IF | 7.2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
表征父母在孩子手术后经历的情感过程，以及这些过程如何预测他们对儿童疼痛的感知和术后药物给药，对于改进干预措施以改善儿童疼痛管理至关重要。本研究在138名7至12岁青少年样本中，评估了扁桃体切除术后7天内父母情感（疼痛灾难化、负性情感和正性情感）、感知的儿童疼痛强度和阿片类药物给药之间的同时和滞后关联。潜在合格患者的父母在手术前被招募，并在手术后7天内每天通过智能手机应用程序完成3次电子日记。阿片类药物给药在常规临床护理背景下进行评估。患者通常被开具3天用量的液体羟考酮，供父母在对乙酰氨基酚和布洛芬无法控制疼痛时给药。在完成至少1次日记的138名父母中，90名父母报告在日记期间给予了阿片类药物（65.2%），并被纳入阿片类药物分析。在多水平模型中，父母情感的平均水平和瞬时水平均预测了父母对孩子疼痛强度的感知，而只有平均负性情感和瞬时父母情感水平预测了阿片类药物给药的几率。在滞后分析中，父母疼痛灾难化与感知的儿童疼痛存在双向关系，较高的父母疼痛灾难化预测随后时间点更高的感知疼痛强度，反之亦然。评估父母情感的瞬时水平可能对于捕捉预测儿童疼痛加剧和阿片类药物给药的动态变化尤为重要。
英文摘要
Characterizing the affective processes parents experience following a child's surgery and how these processes might predict their perceptions of children's pain and postoperative medication administration is critical for refining interventions to improve children's pain management. This study evaluated concurrent and lagged associations among parent affect (pain catastrophizing, negative affect, and positive affect), perceived child pain intensity, and opioid administration in the 7 days after tonsillectomy in a sample of youth ages 7 to 12 years (n = 138). Parents of potentially eligible patients were recruited before surgery and completed electronic diaries through a smartphone application 3 times daily for 7 days after surgery. Opioid administration was evaluated in the context of routine clinical care. Patients were generally prescribed a 3-day supply of liquid oxycodone for parents to administer if pain was uncontrolled by acetaminophen and ibuprofen. Of the 138 parents who completed ≥1 diary, 90 parents reported administering an opioid during the diary period (65.2%) and were included in opioid analyses. In multilevel models, both average and momentary levels of parent affect predicted parents' perceptions of their child's pain intensity, whereas only average negative affect and momentary levels of parent affect predicted odds of opioid administration. Parent pain catastrophizing had a bidirectional relation with perceived child pain in lagged analyses, with higher parent pain catastrophizing predicting higher perceived pain intensity at subsequent timepoints and vice versa. Assessing momentary levels of parent affect may be particularly important for capturing dynamic shifts that predict escalations in children's pain and opioid administration.