Parent‐reported pain in non‐verbal children and adolescents with cerebral palsy

Jayanath, Subhashini; Ong, Lai Choo; Marret, Mary J.; Fauzi, Aishah Ahmad

doi:10.1111/dmcn.12943

Cited by 26 publications

(50 citation statements)

References 26 publications

(45 reference statements)

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“…The children in this study had a high pain burden; they experienced frequent, intense pain from a variety of sources and the incidence is broadly like other studies of this population [5, 7, 8]. Parents were clearly challenged by their children's pain, regardless of the source or type of pain, and many of them talked in terms of pain management being a “struggle” although like parents in other studies they were able to articulate their child's pain responses [9].…”

Section: Discussionsupporting

confidence: 56%

“…This in turn can result in ambiguity and misinterpretation of pain-related behaviours [4]. The combination of these factors can result in a “perfect storm” whereby children with PCI experience frequent, persistent, significant, and sometimes daily pain [5–8] and are at high risk of their pain being underassessed and undertreated [4, 9, 10]. …”

Section: Introductionmentioning

confidence: 99%

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Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers’ Perspectives

Carter

Arnott

Simons

et al. 2017

Pain Research and Management

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Children with profound cognitive impairment (PCI) are a heterogenous group who often experience frequent and persistent pain. Those people closest to the child are key to assessing their pain. This mixed method study aimed to explore how parents acquire knowledge and skills in assessing and managing their child's pain. Eight mothers completed a weekly pain diary and were interviewed at weeks 1 and 8. Qualitative data were analysed using thematic analysis and the quantitative data using descriptive statistics. Mothers talked of learning through a system of trial and error (“learning to get on with it”); this was accomplished through “learning to know without a rule book or guide”; “learning to be a convincing advocate”; and “learning to endure and to get things right.” Experiential and reflective learning was evident in the way the mothers developed a “sense of knowing” their child's pain. They drew on embodied knowledge of how their child usually expressed and responded to pain to help make pain-related decisions. Health professionals need to support mothers/parents to develop their knowledge and skills and to gain confidence in pain assessment and they should recognise and act on the mothers' concerns.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers’ Perspectives

Carter

Arnott

Simons

et al. 2017

Pain Research and Management

View full text Add to dashboard Cite

show abstract

“…Pain in children with CP is a relatively new area of study, since it is common and difficult to recognize due to communication challenges of the children with CP. [5,6] Moreover, clinicians focus on the medical problems associated with CP, and their treatment, and the evaluation of pain is ignored.…”

mentioning

confidence: 99%

Pain evaluation in a sample of Turkish children with cerebral palsy and its association with dependency level, verbal abilities, and the quality of life of patients and sociodemographic status, depression, and quality of life of their caregivers

Giray

Şimşek

Aydoğduoğlu

et al. 2018

Turk J Phys Med Rehab

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The study results were submitted as oral presentation at the 16 th Marmara University Student Congress (MASCO) on May 2016, İstanbul, Turkey and was awarded the Best in Oral Presentation. Also the study was accepted for oral presentation at the 26 th National Physical Medicine and Rehabilitation Congress on April 2017, Antalya, Turkey. Cerebral palsy (CP) is a group of permanent impairments of movement and posture development that result in activity restrictions caused by nonprogressive disturbances that occurred in the developing fetal or infant brain. [1] The actual brain damage does not progress, which differentiates CP from similar conditions. The brain damage occurs in parts of the brain that affect muscle tone, gross and fine motor functions, balance, control, reflexes, and posture. These are mainly orthopedic in nature and are considered primary conditions of CP. Primary conditions which are a direct result of ABSTRACT Objectives: This study aims to evaluate pain in children with cerebral palsy (CP), to investigate its association with dependency level, verbal abilities, and the quality of life (QoL) of children and sociodemographic status, depression levels, and QoL of their caregivers.

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“…For this, it was necessary to initially identify the presence of pain in patients with spastic cerebral palsy before the administration of botulinum toxin type A [18][19][20] , and also one week and one month after this application 21 , all using the FLACC scale, which is an interval scale that measures pain in patients between 2 and 7 years old, quantifying it in behaviors with values ? ?from 0 (painless behaviors) to 10 (behaviors most likely related to pain); there are five categories included in the scale:…”

Section: Objectivementioning

confidence: 99%

Effectiveness of botulinum toxin type A for pain control in children with spastic cerebral palsy

Palacios

Valencia

2018

Rev Col Med Fis Reh

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RESUMENSe realizó un estudio analítico longitudinal prospectivo de antes y después de 12 pacientes pediátricos entre los 2 y los 18 años con parálisis cerebral espástica con limitación para la comunicación, valorándose la presencia de dolor mediante el uso de la escala FLACC; los participantes tenían indicación de aplicación de toxina botulínica tipo A para el control de espasticidad. Posterior a esto se realizó nuevamente la evaluación de la presencia de dolor a la semana y al mes, esto con el objetivo de determinar si hay cambios objetivos en los pacientes que puedan favorecer una mejor calidad de vida. Materiales y métodos: Estudio analítico no experimental longitudinal prospectivo de antes y después para muestras relacionadas de una cohorte de niños entre 0 y 18 años con diagnóstico de parálisis cerebral espástica y presencia de dolor reportado por los padres. Se realizó el test estadístico T-student para muestras relacionadas (emparejadas o apareadas) analizando los resultados de la escala FLACC del dolor. Resultados: Se reunieron 15 pacientes de los cuales por falta en los controles y falta de datos proporcionados por los padres se perdieron 3 casos obteniéndose un total de 12 pacientes incluidos en el estudio, en el cual se encontraron, mediante el uso de la escala FLACC en la primera valoración (FLACC1) siete pacientes (58,3%) con dolor moderado, cuatro (33,3%) con dolor severo y uno (8,3%) con dolor leve; en la segunda valoración, una semana después de la aplicación de material miorelajante (FLACC2) los resultados evidenciaron que cuatro (33.3%) presentaban dolor moderado y ocho (66,7%) dolor leve. Posteriormente, en la tercera valoración al mes del procedimiento (FLACC3) tres (25%) de los pacientes presentaban dolor moderado, ocho (66,7%) dolor leve y uno (8,3%) de ellos ya no presentaba manifestaciones de dolor. Esto demostró que existen diferencias significativas entre los valores de dolor antes y después de la aplicación del material miorelajante, sugiriendo la efectividad del control del dolor con la aplicación de toxina botulínica tipo A. Conclusiones: La aplicación de la escala FLACC a pacientes con parálisis cerebral espástica permite una valoración objetiva del nivel de dolor en los pacientes con limitación para la comunicación y la aplicación de toxina botulínica como material miorelajante tiene un efecto benéfico significativo en la disminución del dolor en este grupo poblacional. Palabras clave: Toxina botulínica tipo A, escala FLACC, dolor en niños, espasticidad, lesión cerebral. indication for the administration of Botulinum Toxin type A for the control of spasticity. After this, the evaluation of the presence of pain was performed a week and a month after de administration of the myorelaxant material, in order to determine if there were any objective changes that may favor a better quality of life. Materials and methods: A Prospective longitudinal non-experimental analytical before and after for related samples study was performed in children between 0 and 18 years of age with a diagnosis...

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Parent‐reported pain in non‐verbal children and adolescents with cerebral palsy

Abstract: Caregivers of non-verbal children with CP report a high frequency of pain. Pain intensity is associated with patient factors but not parental psychosocial factors.

Cited by 26 publications

References 26 publications

Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers’ Perspectives

Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers’ Perspectives

Pain evaluation in a sample of Turkish children with cerebral palsy and its association with dependency level, verbal abilities, and the quality of life of patients and sociodemographic status, depression, and quality of life of their caregivers

Effectiveness of botulinum toxin type A for pain control in children with spastic cerebral palsy

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