Characterization of chronic pain, pain interference, and daily pain experiences in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

IF 5.9 1区 医学 Q1 ANESTHESIOLOGY
PAIN® Pub Date : 2024-11-01 Epub Date: 2024-07-09 DOI:10.1097/j.pain.0000000000003284
Nicole M Alberts, Wendy Leisenring, Jillian Whitton, Kayla Stratton, Lindsay Jibb, Jessica Flynn, Alex Pizzo, Tara M Brinkman, Kathryn Birnie, Todd M Gibson, Aaron McDonald, James Ford, Jeffrey E Olgin, Paul C Nathan, Jennifer N Stinson, Gregory T Armstrong
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引用次数: 0

Abstract

Abstract: Although survivors of childhood cancer are at an increased risk, little is known about the prevalence of chronic pain, associated interference, and daily pain experiences. Survivors (N = 233; mean age = 40.8 years, range 22-64 years; mean time since diagnosis = 32.7 years) from the Childhood Cancer Survivor Study completed pain and psychosocial measures. Survivors with chronic pain completed 2-week, daily measures assessing pain and psychological symptoms using mHealth-based ecological momentary assessment. Multivariable-modified Poisson and linear regression models estimated prevalence ratio estimates (PR) and mean effects with 95% confidence intervals (CI) for associations of key risk factors with chronic pain and pain interference, respectively. Multilevel mixed models examined outcomes of daily pain and pain interference with prior day symptoms. Ninety-six survivors (41%) reported chronic pain, of whom 23 (24%) had severe interference. Chronic pain was associated with previous intravenous methotrexate treatment (PR = 1.6, 95% CI 1.1-2.3), respiratory (PR = 1.8, 95% CI 1.2-2.5), gastrointestinal (PR = 1.6, 95% CI 11.0-2.3), and neurological (PR = 1.5, 95% CI 1.0-2.1) chronic health conditions, unemployment (PR = 1.4, 95% CI 1.0-1.9) and clinically significant depression and anxiety (PR = 2.9, 95% CI 2.0-4.2), as well as a diagnosis of childhood Ewing sarcoma or osteosarcoma (PR = 1.9, 95% CI 1.0-3.5). Higher pain interference was associated with cardiovascular and neurological conditions, unemployment and clinical levels of depression and/or anxiety, and fear of cancer recurrence. For male, but not female survivors, low sleep quality, elevated anxiety, and elevated depression predicted high pain intensity and interference the next day. A substantial proportion of childhood cancer survivors experience chronic pain and significant associated interference. Chronic pain should be routinely evaluated, and interventions are needed.

儿童癌症成年幸存者的慢性疼痛、疼痛干扰和日常疼痛体验特征:儿童癌症幸存者研究报告。
摘要:尽管儿童癌症幸存者的风险增加,但人们对其慢性疼痛的发生率、相关干扰和日常疼痛体验却知之甚少。儿童癌症幸存者研究》的幸存者(人数 = 233;平均年龄 = 40.8 岁,22-64 岁不等;平均确诊时间 = 32.7 年)完成了疼痛和社会心理测量。患有慢性疼痛的幸存者利用基于移动医疗的生态瞬间评估完成了为期两周的疼痛和心理症状日常评估。多变量修正泊松和线性回归模型分别估算了主要风险因素与慢性疼痛和疼痛干扰相关的患病率比值估计值 (PR) 和平均效应及 95% 置信区间 (CI)。多层次混合模型检验了日常疼痛和疼痛干扰与前一天症状的关系。96名幸存者(41%)报告了慢性疼痛,其中23人(24%)有严重的疼痛干扰。慢性疼痛与之前的甲氨蝶呤静脉注射治疗(PR = 1.6,95% CI 1.1-2.3)、呼吸系统(PR = 1.8,95% CI 1.2-2.5)、胃肠道(PR = 1.6,95% CI 11.0-2.3)和神经系统(PR = 1.5,95% CI 1.0-2.1)等慢性健康状况有关。1)慢性健康状况、失业(PR = 1.4,95% CI 1.0-1.9)和临床上显著的抑郁和焦虑(PR = 2.9,95% CI 2.0-4.2),以及儿童尤文肉瘤或骨肉瘤诊断(PR = 1.9,95% CI 1.0-3.5)。较高的疼痛干扰与心血管和神经系统疾病、失业、抑郁和/或焦虑的临床水平以及对癌症复发的恐惧有关。对于男性(而非女性)幸存者来说,睡眠质量低、焦虑和抑郁程度升高可预测第二天的疼痛强度和干扰程度。很大一部分儿童癌症幸存者都经历过慢性疼痛和严重的相关干扰。应当对慢性疼痛进行常规评估,并需要采取干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
PAIN®
PAIN® 医学-临床神经学
CiteScore
12.50
自引率
8.10%
发文量
242
审稿时长
9 months
期刊介绍: PAIN® is the official publication of the International Association for the Study of Pain and publishes original research on the nature,mechanisms and treatment of pain.PAIN® provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest.
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