什么是痛苦:认知和社交功能是核心组成部分吗?

K. Craig, Nicole E. MacKenzie
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引用次数: 9

摘要

疼痛是一种普遍的体验,但要对其进行充分的定义却颇具挑战性。国际疼痛研究协会最近发布的修订后的疼痛定义解决了之前版本的重要缺陷;然而,它仍然局限于疼痛的感觉和情感特征,未能捕捉到经验的认知和社会核心组成部分的实质性作用,以及它们对疼痛管理进展的重要性。本文回顾了社会和认知因素在疼痛体验中发挥重要作用的证据和理论模型,我们认为,如果在定义中没有明确认识到这些核心成分,就会失去对疼痛的理解和临床管理的重大细微差别。对感觉和情感特征的关注延续了生物医学干预和研究,而对认知和社会特征的认识支持了疼痛的多维模型,跨学科护理的进步,以及认知行为治疗和自我管理干预的益处。我们还探讨了伴随疼痛新定义的六个关键音符,讨论了它们在理解儿童疼痛中的应用,并在此过程中进一步探讨了社会和认知意义。还描述了评估和治疗儿科人群疼痛的考虑因素。
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What is pain: Are cognitive and social features core components?
Pain is a universal experience, but it has been challenging to adequately define. The revised definition of pain recently published by the International Association for the Study of Pain addressed important shortcomings of the previous version; however, it remains narrow in its focus on sensory and emotional features of pain, failing to capture the substantial roles of cognitive and social core components of the experience and their importance to advances in pain management. This paper reviews evidence and theoretical models for the significant role social and cognitive factors play in pain experience and we argue that without explicit recognition of these core components in the definition, significant nuances are lost at a cost to understanding and clinical management of pain. A focus on sensory and emotional features perpetuates biomedical interventions and research, whereas recognition of cognitive and social features supports a multidimensional model of pain, advances in interdisciplinary care, and the benefits of cognitive behavioral therapy and self‐management interventions. We also explore the six Key Notes that accompany the new definition of pain, discuss their application to the understanding of pain in childhood, and, in doing so, further explore social and cognitive implications. Considerations are also described for assessment and treatment of pain in pediatric populations.
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