健康与遗传心理学研究室知识库

儿童医疗辅导（Child Life Service），作为一个专业化的领域，近年来在医疗体系中逐渐占据了一席之地。它并不仅仅是一个简单的概念或者服务，而是一个涵盖了情感支持、教育引导以及应对技能培养的综合体系。其核心目的在于帮助儿童及其家庭更好地应对医疗过程中的种种压力、焦虑和恐惧，使他们在面临健康挑战时能够保持坚强和乐观。随着儿童在医疗过程中疼痛和焦虑问题的凸显，本研究专注于探讨儿童医疗辅导对 3-6 岁儿童疼痛缓解的有效性及个体差异。

研究一分别选取了来自北京一家高端私立医院的 102 名 3-6 岁儿童作为研究对象，旨在评估儿童医疗辅导对儿童疼痛缓解的效果，主要探讨儿童医疗辅导在指尖血采集和疫苗接种过程中发挥的至关重要的作用。儿童由于年龄小、心理承受能力有限，往往对医疗活动产生强烈的恐惧感，这种恐惧不仅会导致儿童产生抵触和哭闹的行为，还可能影响采集的效果，甚至给儿童留下心理阴影。

研究结果表明，辅导后医疗操作前，干预组儿童疼痛评分显著低于常规对照组和积极对照组，凸显儿童医疗辅导在减轻疼痛方面的积极作用；积极对照组疼痛评分低于常规对照组，说明宣传单有一定的效果。医疗操作后，三组疼痛评分无明显差异，干预组儿童行为表现虽优但疼痛评分上升，常规对照组儿童哭闹挣扎比例高。医疗操作后十分钟，干预组儿童与其他两组儿童疼痛评分有显著差异。

研究二从北京一家高端私立医院的就诊儿童中随机选取了 N=400 名 3-6 岁儿童作为研究样本，旨在评估儿童医疗辅导对儿童疼痛缓解效果的个体差异性。具体探究儿童医疗辅导对儿童疼痛缓解水平与情绪因素、基础属性及家庭属性的相关性，构建量化模型以精确刻画疼痛缓解水平的贡献度，挖掘疼痛缓解效果显著儿童的画像特征，为实践的个性化定制与效果优化提供实证依据和理论指导。

研究结果发现，儿童医疗辅导对儿童的疼痛缓解水平与负性情绪因素、语言发展水平、家庭和谐氛围、家长学历、家长协同辅导、家长主动控制感成正相关，与年龄成负相关，与性别显著相关。采用 CHAID 决策树模型，拟合准确度达

86.98%，可描绘出疼痛缓解水平较高儿童群体的画像特征为“负向情绪因素较高” “语言发展水平较高”“家长主动控制感较强”“家庭氛围较好”。其中，对疼 痛缓解水平影响最大的是儿童负向情绪因素，其次是语言发展水平，再次是家长主动控制感和家庭氛围。

两项研究结果的共同特征如下：

首先，两项研究都表明儿童医疗辅导对儿童疼痛缓解有一定作用。研究一中干预组在辅导后医疗操作前疼痛评分显著降低，体现了儿童医疗辅导的积极效果；研究二中通过相关性分析和决策树模型，进一步验证了儿童医疗辅导对疼痛缓解水平的影响。

其次，两项研究都揭示了儿童疼痛缓解水平存在差异性。研究一通过不同组别的对比显示出干预组与对照组在疼痛评分和行为表现上的效果差异；研究二明确指出疼痛缓解水平与负向情绪因素、语言发展水平、家庭和谐氛围、家长学历等多种因素相关，这些因素共同造成了儿童疼痛缓解的个体差异。

两项研究结果除了具有临床实践成效外，还具有重要的理论价值。首先，它验证了儿童医疗辅导在缓解儿童疼痛和提高医疗操作配合度方面的有效性，为儿童医疗辅导的推广和应用提供了科学依据。其次，本研究还探讨了儿童医疗辅导对疼痛缓解效果明显的儿童，是否可以给出可描述的画像特征。

通过深入研究和实践，儿童医疗辅导有望成为未来医疗服务的重要组成部分，为儿童的健康成长提供更全面的保障。

Child Life Service as a specialized field, has gradually gained a place in the medical system in recent years. It is not just a simple concept or service, but a comprehensive system that covers emotional support, educational guidance and coping skills development. Its core purpose is to help children and their families better cope with the stress, anxiety and fear of medical treatment, so that they can remain strong and optimistic in the face of health challenges.

Study 1, 102 children aged 3-6 years from a high-end private hospital in Beijing were selected as the subjects to evaluate the effect of child life service on pain relief and mainly examined the critical role of child life service in fingertip blood collection and vaccination. Because of their young age and limited psychological endurance, children often have a strong fear of medical activities, which not only leads to children's resistance and crying behavior, but also may affect the effect of collection, and even leave a psychological shadow on children.

The results showed that the pain scores of children in the intervention group were significantly lower than those in the conventional control group and the active control group after child life service and before medical operation, which highlighted the positive effect of child life service in reducing pain; the pain scores of the active control group were lower than those in the conventional control group, which indicated that the leaflet had a certain effect. After medical operation, there was no significant difference in pain scores among the three groups. Although the children in the intervention group had excellent behavior, their pain scores increased. The children in the conventional control group had a higher proportion of crying and struggling. Ten minutes after the medical procedure, children in the intervention group had significantly different pain scores from those in the other two groups.

In the second study, N = 400 children aged 3-6 years were randomly selected from a high-end private hospital in Beijing as the research sample, aiming to evaluate the individual differences of children's pain relief effect in child life service. Specifically, this paper explores the correlation between child life service and children's pain relief level, emotion, basic attributes and family attributes, constructs a quantitative model to accurately depict the contribution of pain relief level, excavates the portrait characteristics of children with significant pain relief effect, and provides empirical basis and theoretical guidance for personalized customization and effect optimization of practice.

The results showed that the pain relief level of children's medical counseling was positively correlated with negative emotional factors, language development level, family harmonious atmosphere, parents'educational background, parents' collaborative counseling and parents'sense of active control, negatively correlated with age, and significantly correlated with gender .Using CHAID decision tree model, the fitting accuracy was 86.98%, and the portrait characteristics of children with higher pain relief level were higher negative emotional factors, higher language development level, stronger sense of parental active control and better family atmosphere. Among them, the greatest impact on the level of pain relief is children's negative emotional factors, followed by the level of language development, followed by parents'sense of active control and family atmosphere.

The common features of the results of the two studies are as follows:

First, both studies have shown that child life service for children has some effect on pain relief in children. In the first study, the pain scores of the intervention group were significantly reduced after child life service and before medical operation, which reflected the positive effect of child life service; in the second study, the influence of child life service on pain relief level was further verified by correlation analysis and decision tree model.

Second, both studies revealed individual differences in the level of pain relief in children. The first study showed the differences in pain scores and behavior between the intervention group and the control group by comparing different groups; the second study clearly pointed out that the level of pain relief was related to negative emotional factors, language development level, family harmony atmosphere, parents' education and other factors, which together caused individual differences in children's pain relief.

The results of the two studies have important theoretical value in addition to clinical practice. First of all, it verifies the effectiveness of child life sevice in alleviating children's pain and improving the degree of medical operation cooperation, and provides a scientific basis for the promotion and application of child life service. Secondly, this study also explored whether child life service could give descriptive portrait characteristics to children who had obvious pain relief effect.

Through in-depth research and practice, child life service is expected to become an important part of future medical services, providing a more comprehensive guarantee for the healthy growth of children.