Advertisement

Bausteine des Schmerztherapieprogramms

Chapter

Zusammenfassung

Dieses Kapitel fokussiert auf die organisatorischen und strukturellen Voraussetzungen sowie die therapeutische Vorgehensweise einer Schmerztherapie bei Kindern, die an einer chronischen Schmerzstörung leiden. Insbesondere wird das wissenschaftlich evaluierte stationäre Schmerztherapieprogramm des Deutschen Kinderschmerzzentrums (DKSZ) vorgestellt, welches sowohl für Kinder geeignet ist, welche unter einer monosymptomatischen Schmerzstörung leiden, als auch für Kinder, welche neben der Schmerzstörung komorbid andere psychische oder schwere organischen Erkrankungen haben. Nach der Darstellung von Organisation und Struktur werden spezielle Aspekte der Edukation anhand von Fallbeispielen erläutert, bevor verschiedene Schmerzbewältigungstechniken, hilfreiche Strategien und Vorgehensweisen anschaulich vermittelt werden.

Literatur

  1. Asmundson GJ (2012) Do attentional biases for pain depend on threat value of pain and competing motivation toward non-pain goals? Pain [Epub ahead of print]Google Scholar
  2. Asmundson GJ, Norton PJ, Norton GR (1999) Beyond pain: the role of fear and avoidance in chronicity. Clin Psychol Rev 19(1): 97–119PubMedCrossRefGoogle Scholar
  3. Asmundson GJ, Coons MJ, Taylor S, Katz J (2002) PTSD and the experience of pain: research and clinical implications of shared vulnerability and mutual maintenance models. Can J Psychiatry 47(10): 930–937PubMedGoogle Scholar
  4. Ayling Campos A, Amaria K, Campbell F, McGrath PA (2011) Clinical impact and evidence base for physiotherapy in treating childhood chronic pain. Physiother Can 63(1): 21–33CrossRefGoogle Scholar
  5. Bailey KM, Carleton RN, Vlaeyen JW, Asmundson GJ (2010) Treatments addressing pain-related fear and anxiety in patients with chronic musculoskeletal pain: a preliminary review. Cogn Behav Ther 39(1): 46–63PubMedCrossRefGoogle Scholar
  6. Beck, A.T. et al. (1991) Kognitive Therapie der Depression. Beltz TaschenbuchGoogle Scholar
  7. Beck, J.S. (1999) Praxis der kognitiven Therapie. Beltz Psychologie Verlags UnionGoogle Scholar
  8. Boos A (2007) Traumatische Ereignisse bewältigen: Hilfen für Verhaltenstherapeuten und ihre Patienten. Hogrefe, GöttingenGoogle Scholar
  9. Bronfort G, Nilsson N, Haas M, Evans R, Goldsmith CH, Assendelft WJ et al. (2004) Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev (3): CD001878Google Scholar
  10. Bugdayci R, Ozge A, Sasmaz T, Kurt AO, Kaleagasi H, Karakelle A et al. (2005) Prevalence and factors affecting headache in Turkish schoolchildren. Pediatr Int 47(3): 316–322PubMedCrossRefGoogle Scholar
  11. Craske MG, Wolitzky-Taylor KB, Labus J, Wu S, Frese M, Mayer EA et al. (2011) A cognitive-behavioral treatment for irritable bowel syndrome using interoceptive exposure to visceral sensations. Behav Res Ther 49(6–7): 413–421PubMedCrossRefGoogle Scholar
  12. Crombez G, Bijttebier P, Eccleston C, Mascagni T, Mertens G, Goubert L et al. (2003) The child version of the pain catastrophizing scale (PCS-C): a preliminary validation. Pain 104(3): 639–646PubMedCrossRefGoogle Scholar
  13. Crombez G, Van Damme S, Eccleston C (2005) Hypervigilance to pain: an experimental and clinical analysis. Pain 116(1–2): 4–7PubMedCrossRefGoogle Scholar
  14. De Peuter S, Van Diest I, Vansteenwegen D, Van den Bergh O, Vlaeyen JW (2011) Understanding fear of pain in chronic pain: interoceptive fear conditioning as a novel approach. Eur J Pain 15(9): 889–894PubMedCrossRefGoogle Scholar
  15. Disselhoff BC (2007) TENS – Transkutane Elektrische Nervenstimulation. In: Bernatzky G, Wendtner F, Wenzel G, Ausserwinkler M, Sittl R, Likar R (Hrsg) Nichtmedikamentöse Schmerztherapie. Springer, Heidelberg, S 243–267CrossRefGoogle Scholar
  16. Dobe M (2013) Den Schmerz bei Kindern verschlimmern! Die Methode der Schmerzprovokation als ein Verfahren der interozeptiven Reizexposition zur Behandlung von Kindern mit sowohl Schmerz als auch Anpassungs- oder Traumafolgestörung. Trauma und Gewalt 1 (im Druck)Google Scholar
  17. Dobe M, Zernikow B (2012) Rote Karte für den Schmerz. Wie Kinder und ihre Eltern aus dem Teufelskreislauf chronischer Schmerzen ausbrechen, 2. Aufl. Carl Auer, HeidelbergGoogle Scholar
  18. Dobe M, Hechler T, Zernikow B (2009) The pain provocation technique as an adjunctive treatment module for children and adolescents with chronic disabling pain: a case report. J Child Adolesc Trauma 2(4): 297–307CrossRefGoogle Scholar
  19. Dobe M, Hechler T, Behlert J, Kosfelder J, Zernikow B (2011) Chronisch schmerzkranke, schwer beeinträchtigte Kinder und Jugendliche: Langzeiterfolge einer dreiwöchigen stationären Schmerztherapie. Schmerz 25(4): 411–422PubMedCrossRefGoogle Scholar
  20. Eccleston C, Crombez G (2007) Worry and chronic pain: a misdirected problem solving model. Pain 132(3): 233–236PubMedCrossRefGoogle Scholar
  21. Eccleston C, Malleson P (2003) Managing chronic pain in children and adolescents. We need to address the embarrassing lack of data for this common problem. BMJ 326(7404): 1408–1409PubMedCrossRefGoogle Scholar
  22. Ellert U, Neuhauser H, Roth-Isigkeit A (2007) Schmerzen bei Kindern und Jugendlichen in Deutschland: Prävalenz und Inanspruchnahme medizinischer Leistungen. Bundesgesundheitsblatt 50: 711–717CrossRefGoogle Scholar
  23. Emrich O (2001) Die transkutane elektrische Nervenstimulation (TENS). In: Junker U, Nolte T (Hrsg) Grundlagen der speziellen Schmerztherapie. Urban & Vogel, MünchenGoogle Scholar
  24. Feinstein AB, Forman EM, Masuda A, Cohen LL, Herbert JD, Moorthy LN et al. (2011) Pain intensity, psychological inflexibility, and acceptance of pain as predictors of functioning in adolescents with juvenile idiopathic arthritis: a preliminary investigation. J Clin Psychol Med Settings 18(3): 291–298PubMedCrossRefGoogle Scholar
  25. Forgeron PA, McGrath P, Stevens B, Evans J, Dick B, Finley GA et al. (2011) Social information processing in adolescents with chronic pain: my friends don’t really understand me. Pain 152(12): 2773–2780PubMedCrossRefGoogle Scholar
  26. Fryszer A, Schwing R (2010) Systemisches Handwerk. Werkzeug für die Praxis, 4. Aufl. Vandenhoeck & Ruprecht, GöttingenGoogle Scholar
  27. Gonzalez A, Zvolensky MJ, Hogan J, McLeish AC, Weibust KS (2011) Anxiety sensitivity and pain-related anxiety in the prediction of fear responding to bodily sensations: a laboratory test. J Psychosom Res 70(3): 258–266PubMedCrossRefGoogle Scholar
  28. Goubert L, Eccleston C, Vervoort T, Jordan A, Crombez G (2006) Parental catastrophizing about their child’s pain. The parent version of the Pain Catastrophizing Scale (PCS-P): a preliminary validation. Pain 123(3): 254–263PubMedCrossRefGoogle Scholar
  29. Greenwald HP (1991) Interethnic differences in pain perception. Pain 44(2): 157–163PubMedCrossRefGoogle Scholar
  30. Gregory RJ, Manring J, Berry SL (2000) Pain location and psychological characteristics of patients with chronic pain. Psychosomatics 41(3): 216–220PubMedCrossRefGoogle Scholar
  31. Hagenah U, Herpertz-Dahlmann B (2005) Somatisierungsstörungen bei Kindern und Jugendlichen. Dtsch Arztebl 8: 361–366Google Scholar
  32. Hechler T, Dobe M, Kosfelder J, Damschen U, Hübner B, Blankenburg M et al. (2009) Effectiveness of a three-week multimodal inpatient pain treatment for adolescents suffering from chronic pain: statistical and clinical significance. Clin J Pain 25(2): 156–166PubMedCrossRefGoogle Scholar
  33. Hechler T, Dobe M, Damschen U, Schroeder S, Kosfelder J, Zernikow B (2010) The pain provocation technique for adolescents with chronic pain: preliminary evidence for its effectiveness. Pain Med 11(6): 297–310CrossRefGoogle Scholar
  34. Hechler T, Baginski M, Wager J, Tietze AL, Vocks S, Zernikow B (2011) Beeinflusst der Migrationshintergrund den Therapieoutcome von schmerzkranken Kindern nach einer ambulanten multimodalen Schmerztherapie? – Eine Pilotstudie. Schmerz 25:Sonderheft 1Google Scholar
  35. Hermann C, Hohmeister J, Demirakça S, Zohsel K, Flor H (2006) Long-term alteration of pain sensitivity in school-aged children with early pain experiences. Pain 125(3): 278–285PubMedCrossRefGoogle Scholar
  36. Hinsch R, Pfingsten U (2007) Gruppentraining sozialer Kompetenzen GSK, 5. Aufl. Beltz Psychologische Verlags-Union, WeinheimGoogle Scholar
  37. Hohmeister J, Kroll A, Wollgarten-Hadamek I, Zohsel K, Demirakça S, Flor H et al. (2010) Cerebral processing of pain in school-aged children with neonatal nociceptive input: an exploratory fMRI study. Pain 150(2): 257–267PubMedCrossRefGoogle Scholar
  38. van der Kolk BA, Courtois CA (2005) Editorial comments: complex developmental trauma. J Trauma Stress 18(5): 385–358PubMedCrossRefGoogle Scholar
  39. Krüger A, Reddemann L (2009) Psychodynamisch Imaginative Traumatherapie für Kinder und Jugendliche. PITT-KID – Das Manual, 2. Aufl. Klett-Cotta, StuttgartGoogle Scholar
  40. Labbé EE (1995) Treatment of childhood migraine with autogenic training and skin temperature biofeedback: a component analysis. Headache 35(1): 10–13PubMedCrossRefGoogle Scholar
  41. Leeuw M, Goossens ME, van Breukelen GJ, de Jong JR, Heuts PH, Smeets RJ et al. (2008) Exposure in vivo versus operant graded activity in chronic low back pain patients: results of a randomized controlled trial. Pain 138(1): 192–207PubMedCrossRefGoogle Scholar
  42. Liedl A, Müller J, Morina N, Karl A, Denke C, Knaevelsrud C (2011) Physical activity within a CBT intervention improves coping with pain in traumatized refugees: results of a randomized controlled design. Pain Med 12: 234–245PubMedCrossRefGoogle Scholar
  43. Lipani TA, Walker LS (2006) Children’s appraisal and coping with pain: relation to maternal ratings of worry and restriction in family activities. J Pediatr Psychol 31(7): 667–673PubMedCrossRefGoogle Scholar
  44. Logan DE, Catanese SP, Coakley RM, Scharff L (2007) Chronic pain in the classroom: teachers’ attributions about the causes of chronic pain. J Sch Health 77(5): 248–256PubMedCrossRefGoogle Scholar
  45. Lommel K, Bandyopadhyay A, Martin C, Kapoor S, Crofford L (2011) A pilot study of a combined intervention for management of juvenile primary fibromyalgia symptoms in adolescents in an inpatient psychiatric unit. Int J Adolesc Med Health 23(3): 193–197PubMedCrossRefGoogle Scholar
  46. Martin AL, McGrath PA, Brown SC, Katz J (2007) Anxiety sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain. Pain Res Manag 12(4): 267–272PubMedGoogle Scholar
  47. Nakao M, Barsky AJ, Nishikitani M, Yano E, Murata K (2007) Somatosensory amplification and its relationship to somatosensory, auditory, and visual evoked and event-related potentials (P300). Neurosci Lett 415(2): 185–189PubMedCrossRefGoogle Scholar
  48. Palermo TM, Eccleston C, Lewandowski AS, Williams AC, Morley S (2010) Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: an updated meta-analytic review. Pain 148(3): 387–397PubMedCrossRefGoogle Scholar
  49. Pinquart M, Shen Y (2011) Depressive symptoms in children and adolescents with chronic physical illness: an updated meta-analysis. J Pediatr Psychol 2011 36(4): 375–384Google Scholar
  50. Reddemann L (2005) Imagination als heilsame Kraft. Klett-Cotta, StuttgartGoogle Scholar
  51. Reinecke H, Sorgatz H (2009) German Society for the Study of Pain (DGSS). AWMF S3- Leitlinie. Langzeitanwendung von Opioiden bei nicht tumorbedingten Schmerzen (LONTS). Schmerz 23(5): 440–447PubMedCrossRefGoogle Scholar
  52. Rief W, Barsky AJ (2005) Psychobiological perspectives on somatoform disorders. Psychoneuroendocrinology 30(10): 996–1002PubMedCrossRefGoogle Scholar
  53. Rief W, Broadbent E (2007) Explaining medically unexplained symptoms-models and mechanisms. Clin Psychol Rev 27(7): 821–841PubMedCrossRefGoogle Scholar
  54. Sansone RA, Pole M, Dakroub H, Butler M (2006) Childhood trauma, borderline personality symptomatology, and psychophysiological and pain disorders in adulthood. Psychosomatics 47(2): 158–162PubMedCrossRefGoogle Scholar
  55. Schlarb AA, Stavemann HH (2011) Einführung in die KVT mit Kindern und Jugendlichen: Grundlagen und Methodik. Beltz Psychologische Verlags-Union, WeinheimGoogle Scholar
  56. Seemann H, Schultis J, Englert B (2002) Kopfschmerzkinder. Hypnotherapeutische Gruppen- und Einzelbehandlung bei Migräne und Spannungskopfschmerz. Klett-Cotta, StuttgartGoogle Scholar
  57. Seng JS, Graham-Bermann SA, Clark MK, McCarthy AM, Ronis DL (2005) Posttraumatic stress disorder and physical comorbidity among female children and adolescents: results from service-use data. Pediatrics 116(6): e767–776PubMedCrossRefGoogle Scholar
  58. Sherry DD, Wallace CA, Kelley C, Kidder M, Sapp L (1999) Short- and long-term outcomes of children with complex regional pain syndrome type I treated with exercise therapy. Clin J Pain 15(3): 218–223PubMedCrossRefGoogle Scholar
  59. Simons LE, Claar RL, Logan DL (2008) Chronic pain in adolescence: parental responses, adolescent coping, and their impact on adolescent’s pain behaviors. J Pediatr Psychol 33(8): 894–904PubMedCrossRefGoogle Scholar
  60. Simons LE, Sieberg CB, Kaczynski KJ (2011) Measuring parent beliefs about child acceptance of pain: a preliminary validation of the Chronic Pain Acceptance Questionnaire, parent report. Pain 152(10): 2294–3000PubMedCrossRefGoogle Scholar
  61. Singer T, Seymour B, O‘Doherty J, Kaube H, Dolan RJ, Frith CD (2004) Empathy for pain involves the affective but not sensory components of pain. Science 303(5661): 1157–1162PubMedCrossRefGoogle Scholar
  62. Statistisches Bundesamt (2010) Statistisches Jahrbuch 2010. Für die Bundesrepublik Deutschland mit „internationalen Übersichten“. Statistisches Bundesamt, WiebadenGoogle Scholar
  63. Sullivan MJ, Martel MO, Tripp DA, Savard A, Crombez G (2006) Catastrophic thinking and heightened perception of pain in others. Pain 123(1–2): 37–44PubMedCrossRefGoogle Scholar
  64. Trautmann E, Lackschewitz H, Kroner-Herwig B (2006) Psychological treatment of recurrent headache in children and adolescents – a meta-analysis. Cephalalgia 26(12): 1411–1426PubMedCrossRefGoogle Scholar
  65. Vlaeyen JW, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85(3): 317–332PubMedCrossRefGoogle Scholar
  66. Walker LS, Smith CA, Garber J, Claar RL (2007) Appraisal and coping with daily stressors by pediatric patients with chronic abdominal pain. J Pediatr Psychol 32(2): 206–216PubMedCrossRefGoogle Scholar
  67. Wallace DP, Harbeck-Weber C, Whiteside SP, Harrison TE (2011) Adolescent acceptance of pain: confirmatory factor analysis and further validation of the chronic pain acceptance questionnaire, adolescent version. J Pain 12(5): 591–599PubMedCrossRefGoogle Scholar
  68. Weydert JA, Ball TM, Davis MF (2003) Systematic review of treatments for recurrent abdominal pain. Pediatrics 111(1): e1–11PubMedCrossRefGoogle Scholar
  69. Wicksell RK, Melin L, Olsson GL (2007) Exposure and acceptance in the rehabilitation of adolescents with idiopathic chronic pain – a pilot study. Eur J Pain 11(3): 267–274PubMedCrossRefGoogle Scholar
  70. Wicksell RK, Melin L, Lekander M, Olsson GL (2009) Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain – a randomized controlled trial. Pain 141(3): 248–257PubMedCrossRefGoogle Scholar
  71. Wicksell RK, Olsson GL, Hayes SC (2011) Mediators of change in Acceptance and Commitment Therapy for pediatric chronic pain. Pain 152(12): 2792–2801PubMedCrossRefGoogle Scholar
  72. Wilken, Beate (2003) Methoden der kognitiven Umstrukturierung, 2. Auflage, Verlag W. KohlhammerGoogle Scholar
  73. Witthöft M, Basfeld C, Steinhoff M, Gerlach AL (2011) Can’t suppress this feeling: automatic negative evaluations of somatosensory stimuli are related to the experience of somatic symptom distress. Emotion [Epub ahead of print]Google Scholar
  74. Young Casey C, Greenberg MA, Nicassio PM, Harpin RE, Hubbard D (2008) Transition from acute to chronic pain and disability: a model including cognitive, affective, and trauma factors. Pain 134(1–2): 69–79PubMedCrossRefGoogle Scholar
  75. Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland (1989) Die EVaS-Studie – Eine Erhebung über die ambulante medizinische Versorgung in der Bundesrepublik Deutschland. Wissenschaftliche Reihe des Zentralinstituts, Bd 39.1. Deutscher Ärzte-Verlag, KölnGoogle Scholar
  76. Zernikow B (2009) Schmerztherapie bei Kindern, Jugendlichen und jungen Erwachsenen, 4. Aufl. Springer, HeidelbergCrossRefGoogle Scholar
  77. Zernikow B, Wager J, Hechler T, Hasan C, Rohr U, Dobe M et al. (2012) Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2.249 pediatric pain patients. BMC Pediatr 12(1): 54Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Deutsches Kinderschmerzzentrum, Vestische Kinder- u. JugendklinikUniversität Witten/HerdeckeDattelnDeutschland

Personalised recommendations