儿童临床检验采血中奖赏缓解疼痛和焦虑的性别差异性研究  

Gender Differences of Modulation of Pain and Anxiety by Cartoon Sticker Rewards in the Blood Collection of Children’s Clinical Examination

作　　者：张奕[1] 任锋[2] 黄彩玲 李飞 曹科[1] 杨方华[1] 陈洪谋 马东礼[1] 陈运生[1] ZHANG Yi;REN Feng;HUANG Cai-ling;LI Fei;CAO Ke;YANG Fang-hua;CHEN Hong-mou;MA Dong-li;CHEN Yun-sheng(Department of Clinical Laboratory,Shenzhen Children’s Hospital,Guangdong Shenzhen 518038,China;Department of General Surgery,Shenzhen Children’s Hospital,Guangdong Shenzhen 518038,China;Medical College of Jiaying University,Guangdong Meizhou 514031,China)

机构地区：[1]深圳市儿童医院检验科,广东深圳518038 [2]深圳市儿童医院普外一科,广东深圳518038 [3]嘉应医学院,广东梅州514031

出　　处：《现代检验医学杂志》2020年第5期151-153,共3页Journal of Modern Laboratory Medicine

基　　金：深圳市卫计委临床研究项目(NO.SZLY2017016)。

摘　　要：目的探讨在儿童临床检验末梢采血中奖赏缓解焦虑和疼痛的性别差异。方法选取160例在门诊检验科采血的患儿,随机分为男童对照组、女童对照组、男童奖赏组和女童奖赏组。对照组采用常规采血流程,无任何干预手段。奖赏组在采血前被告知进行采血可被奖励卡通贴纸。观察者使用儿童焦虑和疼痛评估量表(children’s anxiety and pain scales,CAPS)和面部疼痛修订评估量表(faces pain scale-revised,FPS)评估患儿采血前及采血时的焦虑水平以及采血时的疼痛水平。结果男童对照组采血前和采血时的CAPS评分高于女童对照组(2.475±1.28,95%CI=2.07~2.89 vs 1.93±1.12,95%CI=1.57~2.28;2.65±1.21,95%CI=2.26~3.04 vs 2.08±0.94,95%CI=1.77~2.38),差异具有统计学意义(P<0.05)。男童对照组采血时的FPS评分也高于女童对照组(7.18±1.95,95%CI=6.55~7.80 vs 6.28±1.64,95%CI=5.76~6.81),差异具有统计学意义(P<0.05)。与对照组相比,卡通贴纸的奖赏显著降低了男童采血时的CAPS评分(2.65±1.21,95%CI=2.26~3.04 vs 1.58±0.96,95%CI=1.27~1.88)和FPS评分(7.18±1.95,95%CI=6.55~7.80 vs 5.77±1.71,95%CI=5.22~6.32),差异具有统计学意义(P<0.05)。但是奖赏不能降低女童的CAPS评分(2.08±0.94,95%CI=1.77~2.38 vs 2.13±1.18,95%CI=1.75~2.50)和FPS评分(6.28±1.64,95%CI=5.76~6.81 vs 6.07±1.90,95%CI=5.46~6.68),差异无统计学意义(P>0.05)。结论卡通贴纸作为奖赏对缓解不同性别的儿童采血时的疼痛和焦虑的效果存在差异。Objective To study whether modulation of pain and anxiety by the cartoon sticker rewards after capillary blood collection depending on gender in children.Methods 160 children with blood sample in outpatient were selected from Department of Clinical Laboratory of Shenzhen Children’s Hospital.They were randomly divided into boy control group,girl control group,boy reward group and girl reward group.In the control group,routine blood sampling was used without any intervention.Before blood collection,the reward group was told that blood collection could be rewarded with cartoon stickers.Pre-procedural and procedural anxieties were evaluated using the Children’s Anxiety and Pain Scales(CAPS)by observers.Procedural pain level was assessed using Faces Pain Scale-Revised(FPS)by observers.Results Pre-procedural and procedural CAPS scores in male control group were higher than those in female control group(2.475±1.28,95%CI=2.07~2.89 vs 1.93±1.12,95%CI=1.57~2.28;2.65±1.21,95%CI=2.26~3.04 vs 2.08±0.94,95%CI=1.77~2.38),the difference were statistically significant(P<0.05).Also procedural FPS scores in male control group were higher than those in female control group(7.18±1.95,95%CI=6.55~7.80 vs 6.28±1.64,95%CI=5.76~6.81),the difference were statistically significant(P<0.05).Compared with male control group,the cartoon sticker rewards effectively decreased procedural CAPS and FPS scores among boys(2.65±1.21,95%CI=2.26~3.04 vs 1.58±0.96,95%CI=1.27~1.88;7.18±1.95,95%CI=6.55~7.80 vs 5.77±1.71,95%CI=5.22~6.32),the difference were statistically significant(P<0.05).But with or without rewards,there was no significant difference in the change in the anxiety and pain during the procedure among girls(2.08±0.94,95%CI=1.77~2.38 vs 2.13±1.18,95%CI=1.75~2.50;6.28±1.64,95%CI=5.76~6.81 vs 6.07±1.90,95%CI=5.46~6.68),the difference was not statistically significant(P>0.05).Conclusion As a reward,cartoon stickers had different effects on relieving pain and anxiety of children of different genders.

关 键 词：末梢采血 奖赏 疼痛 焦虑 性别差异 

分 类 号：R446.11[医药卫生—诊断学]