Pain management in hospitalized children: A cross-sectional study

Abstract

Objective: To characterize pain management in hospitalized children. Method: This is an observational, cross-sectional, retrospective and descriptive study of quantitative approach, carried out in a secondary hospital in the city of São Paulo, through analysis of 1,251 medical records of children admitted to the pediatric department. Data were tabulated and analyzed through descriptive statistics. Results: A total of 88.8% of children were assessed for pain with standardized instruments and 86% had analgesia prescribed. Among the assessments, 37.8% of the children had pain; of these, 26% had severe pain, greater in orthopedic conditions; 18.3% were not medicated, even with the presence of pain and prescribed analgesia; 4.3% had no analgesics prescribed; only 0.4% received non-pharmacological measures, and 40.3% had a report of reassessment. Professionals provided greater analgesia to children with surgical and orthopedic conditions compared to clinical conditions (p < 0.05). Conclusion: Pain management in hospitalized children is ineffective, from initial assessments to reassessments after interventions, with prioritization of medication actions guided by professional judgment in the face of pain complaints.

From theory to practice: the inclusion of hospitalized children’s families in painful procedures

“…However, as long as FCC is likely to occur, priority should be given to establishing this partnership ( 3 ) . Still, in cases of absence, professionals can spend non-pharmacological interventions and recognition of children as an active member in the procedure ( 22 ) , as listed in Figure 1 .…”

Pain therapy in the pediatric population

“…Pomimo dużej świadomości w ocenie i radzeniu sobie z bólem nadal bardzo duża część pacjentów pediatrycznych nie otrzymuje odpowiedniej pomocy. [13] Dodatkową barierą w radzeniu sobie bólem są obawy personelu medycznego przy stosowaniu leków przeciwbólowych, a szczególnie zastosowaniu leków opioidowych, co skutkować może stosowaniem dawek niższych niż jest to konieczne. [6] Każda grupa wiekowa, od noworodków do młodzieży, ma swoje unikalne wyzwania zarówno w odczytywaniu sygnałów mogących świadczyć o bólu i dyskomforcie a także w sposobach radzenia sobie z tymi objawami.…”

Pain management in hospitalized children: unveiling barriers from the nursing perspective

“…However, integrating pain management into goals, rights and policies does not guarantee that it will occur, with pain still being a research phenomenon in nursing. Here, pain management is understood as the cyclical stages of assessment, intervention (with pharmacological and non-pharmacological interventions, jointly) and reassessment (7) .…”

“…Along this path, nursing team professionals, with an emphasis on nurses, have an active role in managing pain management, being responsible for the assessment, implementation of pharmacological intervention, autonomy in the use of non-pharmacological interventions, reassessment and inclusion of the family in this process (7) . However, recent studies demonstrate that these steps are undervalued and remain below ideal standards (7,11,12) .…”

“…In Brazil, in a cross-sectional, retrospective study conducted with the medical records of 1,251 hospitalized children, it was noted that 11.2% were not assessed for pain; 481 had pain validated by scales, but the absence of analgesia occurred in 18.3%, even with prescription; 99.6% had no documentation of non-pharmacological interventions; and 59.7% required reassessment (7) . Furthermore, in a qualitative investigation conducted with nursing team professionals in Brazil, it was reported that in clinical practice there is no family inclusion in painful procedures, mainly due to professional beliefs and attitudes (11) .…”