PDF(Pubmed)
Abstract：
Adverse childhood experiences (ACEs) affect over half of the adults in the United States and are known to contribute to the development of a wide variety of negative health and behavioral outcomes. The consequences of ACE exposure have been studied in patient populations that include individuals with gynecologic, orthopedic, metabolic, autoimmune, cardiovascular, and gastrointestinal conditions among others. Findings indicate that ACEs not only increase risks for chronic pain but also influence emotional responses to pain in many of these individuals. A growing body of research suggests that these effects may be the result of long-lasting changes induced by ACEs in neurobiological systems during early development. However, one area that is still largely unexplored concerns the effects of ACEs on burn patients, who account for almost 450,000 hospitalizations in the United States annually. Patients with severe burns frequently suffer from persistent pain that affects their well-being long after the acute injury, but considerable variability has been observed in the experience of pain across individuals. A literature search was conducted in CINAHL and PubMed to evaluate the possibility that previously documented ACE-induced changes in biological, psychological, and social processes might contribute to these differences. Findings suggest that better understanding of the role that ACEs play in burn outcomes could lead to improved treatment strategies, but further empirical research is needed to identify the predictors and mechanisms that dictate individual differences in pain outcomes in patients with ACE exposure and to clarify the role that ACE-related alterations play in early healing and recovery from burn injuries.
摘要：
不良儿童经历（ACE）影响美国一半以上的成年人，并且已知有助于各种负面健康和行为结果的发展。ACE暴露的后果已经在患者人群中进行了研究，包括妇科患者，骨科,新陈代谢，自身免疫，心血管,和胃肠道条件等等。研究结果表明，ACE不仅会增加慢性疼痛的风险，还会影响许多此类个体对疼痛的情绪反应。越来越多的研究表明，这些影响可能是早期发育过程中ACEs在神经生物学系统中引起的持久变化的结果。然而,一个仍未探索的领域涉及ACEs对烧伤患者的影响，每年在美国有近450,000人住院。严重烧伤患者经常遭受持续性疼痛，在急性损伤后很久影响他们的健康。但是在个体的疼痛经历中观察到相当大的差异。在CINAHL和PubMed中进行了文献检索，以评估先前记录的ACE诱导的生物学变化的可能性，心理,社会过程可能会导致这些差异。研究结果表明，更好地了解ACEs在烧伤结局中的作用可以改善治疗策略。但需要进一步的实证研究来确定决定ACE暴露患者疼痛结局个体差异的预测因素和机制,并阐明ACE相关改变在烧伤早期愈合和恢复中的作用.
