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Vol. 57. Núm. 1.
Páginas 34-44 (Julio 2002)
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Vol. 57. Núm. 1.
Páginas 34-44 (Julio 2002)
Acceso a texto completo
Evaluación de la ansiedad y el dolor asociados a procedimientos médicos dolorosos en oncología pediátrica
Assessment Of Pain And Anxiety Related To Painful Medical Procedures In Pediatric Oncology
Visitas
12154
M. Salas Arrambidea,
Autor para correspondencia
jsalas@euskalnet.net

Correspondencia: Salas Arrambide y Prof. I. Amayra Caro. Universidad de Deusto. Facultad FICE. Despacho 213-D. Apartado 1. 48080 Bilbao. España.
, O. Gabaldón Pocb, J.L. Mayoral Miraveteb, I. Amayra Caroa,*
a Departamento de Psicología. Universidad de Deusto. Bilbao.
b Hospital Donostia. San Sebastián. España.
Este artículo ha recibido
Información del artículo

En este artículo se revisan los instrumentos más utilizados en la práctica clínica y la investigación para la evaluación del dolor y la ansiedad que experimenta la población oncológica pediátrica ante los procedimientos médicos dolorosos. También se revisan aspectos como la prevalencia del dolor en el cáncer infantil y el impacto psicológico que tienen los procedimientos médicos en el niño, y el esfuerzo que están realizando ciertas instituciones para que se implemente la evaluación del dolor en niños, teniendo en cuenta que el dolor es una experiencia subjetiva y multidimensional. Se incluyen medidas conductuales, autoinformes, instrumentos de evaluación multidimensionales y medidas fisiológicas, y destacan la importancia de los autoinformes, considerados como patrón oro para la evaluación del dolor pediátrico. La revisión de la bibliografía indica la necesidad de investigación y educación de los profesionales en la evaluación del dolor pediátrico. Finalmente, se proporcionan algunas recomendaciones para la evaluación del dolor en niños.

Palabras clave:
Dolor pediátrico
Cáncer infantil
Procedimientos médicos
Psicooncología pediátrica

In this article we review the instruments most commonly used in clinical practice and research to assess the pain and anxiety experienced by children with cancer undergoing painful medical procedures. Issues such as the prevalence of pain in childhood cancer, the psychologic impact of medical procedures in children, and the efforts some institutions are making to implement pediatric pain assessment programs are also reviewed, bearing in mind that pain is a subjective and multidimensional experience. Behavioral measures, self-reports, multidimensional assessment tools and physiological measures are included, emphasizing the importance of self-reports, which are considered the gold standard in pediatric pain assessment. This literature review indicates the need for research and for the education of health care professionals in pediatric pain assessment. Finally, recommendations for pediatric pain assessment are suggested.

Key words:
Pediatric pain
Childhood cancer
Medical procedures
Pediatric psycho-oncology
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BibliografÍa
[1.]
M.C. Benedito.
Intervención psicológica en la adhesión al tratamiento de enfermedades crónicas pediátricas.
An Esp Pediatr, 55 (2001), pp. 329-334
[2.]
P. Jacobsen, S. Manne, K. Gorfinkle, O. Schorr, B. Rapkin, W. Redd.
Analysis of child and parent activity during painful medical procedures.
Health Psychol, 9 (1990), pp. 559-576
[3.]
A.W. Miser, J. McCalla, J.A. Dothage, M. Wesley, J.S. Miser.
Pain as a presenting symptom in children and young adults with newly diagnosed malignancy.
Pain, 29 (1987), pp. 85-90
[4.]
A.W. Miser, J.A. Dothage, R.A. Wesley, J.S. Miser.
The prevalence of pain in a pediatric and young adult cancer population.
Pain, 29 (1987), pp. 73-83
[5.]
P.J. McGrath, E. Hsu, M. Cappelli, B. Luke.
Pain from pediatric cancer: A survey of an outpatient oncology clinic.
J Psychol Oncol, 8 (1990), pp. 109-124
[6.]
S.C. Elliott, A.W. Miser, A.M. Dose, D.L. Betcher, J.R. O'Fallon, R.S. Dukos.
Epidemiologic features of pain in pediatric cancer patients: A co-operative community-based study.
Clin J Pain, 7 (1991), pp. 263-268
[7.]
G. Ljungman, A. Kreuger, T. Gordh, T. Berg, S. Souml;rensen, R. Narinder.
Treatment of pain in pediatric oncology: A Swedish nationwide survey.
Pain, 68 (1996), pp. 385-394
[8.]
G. Ljungman, T. Gordh, S. Sörensen, A. Kruger.
Pain in pediatric oncology: Interviews with children, adolescents and their parents.
Acta Paediatrica, 88 (1999), pp. 623-630
[9.]
WHO, (1998),
[10.]
N.L. Schechter, A. Altman, S. Weisman.
Report of the consensus conference on the management of pain in childhood cancer.
Pediatrics, 86 (1990), pp. 814-834
[11.]
L. Zeltzer.
Pain and symptom management.
Pediatric psychooncology. Psychological perspectives on children with cancer, pp. 61-83
[12.]
B.S. Shapiro.
Pain in children.
A practical approach to pain management, pp. 191-203
[13.]
American Academy of Pediatrics y American Pain Society. The assessment and management of acute pain in infants, children and adolescents.
Pediatrics, 108 (2001), pp. 793-797
[14.]
M. Hockenberry-Eaton, P. Barrera, M. Brown, S.J. Bottomley, J.B. O'Neill.
Texas Cancer Council, (1999),
[15.]
C. Harbeck, L. Peterson.
Elephants dancing in my head: A developmental approach to children's concepts of specific pains.
Child Development, 63 (1992), pp. 138-149
[16.]
L. Peterson, K.K. Oliver, L. Saldana.
Children's coping with stressfulmedical procedures.
Handbook of children's coping: Linking theory and intervention, pp. 333-360
[17.]
RCN Publishing Company, (1999),
[18.]
R.L. Blount, A.J. Smith, N.C. Frank.
Preparation to Undergo Medical Procedures.
Handbook of pediatric and adolescent health psychology, pp. 305-326
[19.]
AHCPR, (1993),
[20.]
E.R. Katz, J. Kellerman, S.E. Siegel.
Distress behavior in children with cancer undergoing medical procedures: Developmental considerations.
J Consult Clin Psychol, 48 (1980), pp. 356-365
[21.]
E.R. Katz, J. Kellerman, S.E. Siegel.
Annual meeting of the Society of Behavioral Medicine, (1982),
[22.]
S.M. Jay, M. Ozolins, C.H. Elliot, S. Caldwell.
Assessment of children's distress during painful medical procedures.
Health Psychol, 2 (1983), pp. 133-147
[23.]
S.M. Jay, C. Elliott.
Behavioral observation scales for measuring children's distress: The effects of increased methodological rigor.
J Consult Clin Psychol, 52 (1984), pp. 1106-1107
[24.]
C.H. Elliott, S.M. Jay, P. Woody.
An observation scale for measuring children's distress during medical procedures.
J Pediatr Psychol, 12 (1987), pp. 543-551
[25.]
R.L. Blount, S.M. Corbin, J.W. Sturges, V.V. Wolfe, J.M. Prater, L.D. James.
The relationship between adults' behavior and child coping and distress during BMA/LP procedures: A sequential analysis.
Behav Ther, 20 (1989), pp. 585-601
[26.]
R.L. Blount, J.W. Sturges, S.W. Powers.
Analysis of Child and adult behavioral variations by phase of medical procedures.
Behav Ther, 21 (1990), pp. 33-48
[27.]
R.L. Blount, L.L. Cohen, N.C. Frank.
The child-adult medical procedure interaction scale-revised: An assessment of validity.
J Pediatr Psychol, 22 (1997), pp. 73-88
[28]
S.L. Manne, R. Bakeman, P.B. Jacobsen, K. Gorfinkle, W.H. Redd.
An analysis of a behavioral intervention for children undergoing venipuncture.
Health Psychol, 13 (1994), pp. 556
[29.]
L.M. Dahlquist, T.G. Power, L. Carlson.
Physician and parent behavior during invasive pediatric cancer procedures: Relationships to child behavioral distress.
J Pediatr Psychol, 20 (1995), pp. 477-490
[30.]
N.C. Frank, R.L. Blount, A.J. Smith, M.R. Manimala, J.K. Martin.
Parent and staff behavior, previous child medical experience, and maternal anxiety as they relate to child procedural distress and coping.
J Pediatr Psychol, 20 (1995), pp. 277-289
[31]
G.D. Champion, B. Goodenough, C.L. Von Baeyer, W. Thomas.
Measurement of pain by self-report.
Management of pain in infants and children, Progress in Pain Research and Management, vol. 10, pp. 123-160
[32.]
P.A. McGrath, C.E. Seifert, K.N. Speechley, J.C. Booth, L. Stitt, M.C. Gibson.
A new analogue scale for assessing children's pain: An initial validation study.
Pain, 64 (1996), pp. 435-443
[33.]
E.C. Huskisson.
Measurement of pain.
Lancet, 2 (1974), pp. 1127-1134
[34.]
J. Scott, E.C. Huskisson.
Measurement of functional capacity with.
Ann Rheum Dis, 16 (1978), pp. 257-259
[35.]
J. Scott, E.C. Huskisson.
Graphic representation of pain.
Pain, 2 (1979), pp. 175-184
[36]
E.R. Katz, B. Sharp, J. Kellerman, A.R. Marston, J.M. Hershman, S.E. Siegel.
b-endorphin immunoreactivity and acute behavioral distress in children with leukemia.
J Nerv Mental Dis, 170 (1982), pp. 72-77
[37.]
J.M. Eland.
Minimizing pain associated with prekindergarten intramuscular injections.
Issues Compr Pediatr Nurs, 5 (1981), pp. 361-372
[38.]
J. Beyer, N. Wells.
The assessment of pain in children.
Pediatr Clin North Am, 36 (1989), pp. 837-854
[39.]
N. Hester.
The preoperational child's reaction to immunizations.
Nurs Res, 28 (1979), pp. 250-254
[40.]
C.T. Chambers, K.D. Craig.
An intrusive impact of anchors in children's faces pain escales.
Pain, 78 (1998), pp. 27-37
[41.]
Beyer JE. The oucher: A user's manual and technical report.Evanston: Hospital Play Equipment, 1984
[42.]
J.E. Beyer, C.R. Aradine.
Content validity of an instrument to measure young children's perception of the intensity of their pain.
J Pediatr Nurs, 1 (1986), pp. 386-395
[43.]
J.E. Beyer, C.R. Aradine.
Patterns of pediatric pain intensity: A methodological investigation of a self-report scale.
Clin J Pain, 3 (1987), pp. 130-134
[44.]
C. Knott, J. Beyer, A. Villarruel, M. Denyes, V. Erickson, G. Willard.
Using the Oucher developmental approach to pain assessment in children.
Am J Matern Child Nurs, 19 (1994), pp. 314-320
[45.]
D. Bieri, R.A. Reeve, G.D. Champion, L. Addicoat, J.B. Ziegler.
The faces pain scale for the self-assessment of the severity of pain experience by children: Development, initial validation, and preliminary investigation for ratio scale properties.
Pain, 41 (1990), pp. 139-150
[46.]
J.L. Douthit.
Psychosocial assessment and management of pediatric pain.
J Emerg Nurs, 16 (1990), pp. 168-170
[47.]
J.M. Goddard, S.E. Pickup.
Postoperative pain in children: Combining audit and a clinical nurse specialist to improve management.
Anaesthesia, 51 (1996), pp. 586-590
[48.]
P.A. McGrath, L.L. De Veber, M.J. Hearn.
Multidimensional pain assessment in children.
Proceedings of the Fourth World Congress on Pain Advances in Pain Research and Therapy, Vol. 9,
[49.]
R. Pothmann.
Comparison of the visual analogue scale (VAS) and a smiley analogue scale (SAS) for the evaluation of pain in children.
Advances in Pain Research and Therapy, 15, pp. 95-99
[50.]
D.L. Wong, C.M. Baker.
Pain in children: Comparison of assessment scales.
Pediatr Nurs, 14 (1988), pp. 9-17
[51.]
L. Kuttner, T. LePage.
Faces scales for the assessment of pediatric pain: A critical review.
Can J Behav Sci, 21 (1989), pp. 191-209
[52.]
E.L. Maunuksela, K.T. Olkkala, R. Korpela.
Measurement of pain in children with self-reporting and behavioral assessment.
Clin Pharmacol Therapy, 42 (1987), pp. 137-141
[53.]
Varni JW, Thompson KL. The Varni/Thompson Pediatric Pain Questionnaire. Sin publicar, 1985.
[54.]
S.D. Sweet, P.J. McGrath.
Physiological measures of pain.
Measurement of pain in infants and children. Progress in Pain Research and Management, Vol 10. Seattle, pp. 59-81
[55.]
S.M. Jay, C.H. Elliott, E.R. Katz, S. Siegel.
Cognitive-behavioral and pharmacologic interventions for children's distress during painful medical procedures.
J Consult Clin Psychol, 55 (1987), pp. 860-865
[56.]
S.M. Jay, C.H. Elliott.
A stress inoculation program for parents whose children are undergoing painful medical procedures.
J Consult Clin Psychol, 58 (1990), pp. 799-804
[57.]
J.C. Gonzalez, D.K. Routh, P.G. Saab, F.D. Armstrong, L. Shifman, E. Guerra, et al.
Effects of parent presence on children's reactions to injections: Behavioral, physiological, and subjective aspects.
J Pediatr Psychol, 14 (1989), pp. 449-462

Este trabajo ha sido realizado con la ayuda del Gobierno Vasco, a través de una beca del Programa de Formación de Investigadores del Departamento de Educación, Universidades e Investigación (BFI01.16 Mod. AE).

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