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A greater proportion of children report high intensity of distress from pain than of pain intensity itself when in the ED. Only a small proportion of children received analgesics during the visit to the ED and only slightly more on discharge. Although pain seems to resolve by 1 week, distress is less likely to have resolved. More attention needs to be paid both to pain children are experiencing in the ED and equally to the accompanying distress.

Guided by the Roy Adaptation Model of Nursing, the relationship of children's age, gender, exposure to past painful experiences, temperament, fears, and child-rearing practices to their pain responses to a venipuncture was examined. A sample of 94 children aged 8 to 12 years and their female caregivers were recruited from three outpatient clinics. During the venipuncture, children's behavioral and heart rate responses were monitored; immediately after, their subjective responses were recorded. Canonical correlation revealed two variates. In the first, age and threshold (temperamental dimension) correlated with pain quality, behavioral responses, and heart rate responses, explaining 12% of the variance. In the second, age, the temperamental dimensions of distractibility and threshold, and medical fears explained only 5.7% of the variance in pain quality and heart rate magnitude. Significant correlations between pain intensity, quality, behavioral responses, and heart rate responses support the multidimensionality of pain.

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