Self-Reported Pain Intensity and Associated Distress in Children Aged 4-18 Years on Admission, Discharge, and One-Week Follow Up to Emergency Department

Johnston, Céleste; Bournaki, Marie-Christine; Gagnon, Anita J.; Pepler, Carolyn; Bourgault, Patricia

doi:10.1097/01.pec.0000159067.09573.f1

Cited by 39 publications

(27 citation statements)

References 24 publications

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“…A great disparity was observed in the literature review. The study by Kircher et al found similar results to those of our study and was conducted in patients with musculoskeletal pain (6%), 12 in contrast to the studies by Benini et al, 13 done in headache patients, and by C. Johnston et al, 14 in multiple diseases, where pain was assessed in more than a half of patients (57% and 71%, respectively). In our study, and contrary to what is recommended in the literature, pain was assessed without using validated scales.…”

Section: Discussioncontrasting

confidence: 56%

“…In our study, and contrary to what is recommended in the literature, pain was assessed without using validated scales. In relation to pain management in the PED, our results were observed to be somewhat better than in other studies 12,13,16 and similar to those observed by C. Johnston 14 and O'Donnell, 17 which included limb trauma cases and where only 39% and 49% of patients received analgesia during their stay in the emergency room. In our study, like in the ones by Rogovik 16 and Benini et al, 13 analgesia was prescribed at the time of discharge to most patients; whereas, in the studies by C. Johnston et al 14 and Kircher et al, 12 it was only prescribed to 9% and 24% of patients, respectively.…”

Section: Discussioncontrasting

confidence: 50%

“…In a study by Zisk et al that included fracture patients who were prescribed scheduled analgesia at the time of discharge and whose parents were instructed on how to assess children's pain, 19 more than a half of patients did not receive analgesia or received only one dose, and this differs from the results of this study. In addition, in the study by C. Johnston, 14 although the authors did not compare prescribed analgesia to that administered by parents, it was observed that, one week later, pain persisted in 5% of cases (it is worth remembering that analgesia was prescribed to only 9%). All these data reflect the importance of an adequate pain management by offering precise and concise guidelines to parents.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of orofacial pain management in a pediatric emergency department and at home after discharge

Red

Martín

Márquez

et al. 2018

Arch Argent Pediatr

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Section: Discussioncontrasting

confidence: 56%

Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of orofacial pain management in a pediatric emergency department and at home after discharge

Red

Martín

Márquez

et al. 2018

Arch Argent Pediatr

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“…Pain is a common reason for seeking health care [1][2][3] and adequate pain management is a basic human right 4,5 .…”

Section: Introductionmentioning

confidence: 99%

A Survey of Caregiver Perspectives on Children’s Pain Management in the Emergency Department

Ali

Weingarten

Kircher

et al. 2015

CJEM

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Objectives: We explored caregiver perspectives on their children's pain management in both a pediatric (PED) and general emergency department (GED). Study objectives were to: (1) measure caregiver estimates of children's pain scores and treatment; (2) determine caregiver level of satisfaction; and (3) determine factors associated with caregiver satisfaction. Methods: This prospective survey examined a convenience sample of 97 caregivers (n = 51 PED, n = 46 GED) with children aged <17 years. A paper-based survey was distributed by research assistants, from 2009-2011. Results: Most caregivers were female (n = 77, 79%) and were the child's mother (n = 69, 71%). Children were treated primarily for musculoskeletal pain (n = 41, 42%), headache (n = 16, 16%) and abdominal pain (n = 7, 7%). Using a 100 mm Visual Analog Scale, the maximum mean reported pain score was 75 mm (95% CI: 70-80) and mean score at discharge was 39 mm (95% CI: 32-46). Ninety percent of caregiver respondents were satisfied (80/89, 90%); three (3/50, 6%) were dissatisfied in the PED and six (6/39, 15%) in the GED. Caregivers who rated their child's pain at ED discharge as severe were less likely to be satisfied than those who rated their child's pain as mild or moderate (p = 0.034). Conclusions: Despite continued pain upon discharge, most caregivers report being satisfied with their child's pain management. Caregiver satisfaction is likely multifactorial, and physicians should be careful not to interpret satisfaction as equivalent to adequate provision of analgesia. The relationship between satisfaction and pain merits further exploration. RÉSUMÉObjectifs: L'étude a porté sur le point de vue des aidants quant à la prise en charge de la douleur chez les enfants dans un service des urgences pédiatriques (SUP) et dans un service des urgences générales (SUG). L'étude visait à: 1) mesurer l'intensité de la douleur chez les enfants, estimée par les aidants ainsi que le traitement appliqué; 2) déterminer le degré de satisfaction des aidants; et 3) déterminer les facteurs associés à la satisfaction des aidants. Méthode: Il s'agit d'une enquête prospective, menée dans un échantillon de commodité de 97 aidants (SUP: n = 51; SUG: n = 46) qui accompagnaient des enfants de moins de 17 ans. Des questionnaires d'enquête sur papier ont été distribués par des assistants de recherche, de 2009 à 2011. Résultats: La plupart des aidants étaient des femmes (n = 77; 79 %) et, bien souvent, la mère des enfants (n = 69; 71 %). Les enfants étaient traités surtout pour des douleurs musculosquelettiques (n = 41; 42 %), des céphalées (n = 16; 16 %) et des douleurs abdominales (n = 7; 7 %). Le score maximal moyen, indiqué sur une échelle visuelle analogue de 100 mm s'élevait à 75 mm (IC à 95 %: 70-80) et le score moyen au moment du congé était de 39 mm (IC à 95 %: 32-46). Quatrevingt-dix pour cent des aidants qui ont répondu à l'enquête se sont dits satisfaits (n = 80/89; 90 %); 3 (n = 3/50; 6 %) au SUP et 6 (n = 6/39; 15 %) au SUG ne l'étaient pas. Les aidants qui ont ...

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“…[1][2][3] Numerous studies indicate that inadequate pain management during medical care can have many detrimental short and long-term effects, [4][5][6][7] and the World Health Organization has advocated for optimal pain treatment for all. 8 Children's pain in the ED remains poorly managed despite an increase in pain research over the past decade.…”

Section: Introductionmentioning

confidence: 99%

Canadian Emergency Medicine Residents’ Perspectives on Pediatric Pain Management

Ali

Kircher

Meyers

et al. 2015

CJEM

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Background: Under-treatment of children's pain in the emergency department (ED) can have many detrimental effects. Emergency medicine (EM) residents often manage pediatric pain, but their educational needs and perspectives have not been studied. Methods: A novel online survey was administered from May to June 2013 to 122 EM residents at three Canadian universities using a modified Dillman methodology. The survey instrument captured information on training received in pediatric acute pain management, approach to common painful presentations, level of comfort, perceived facilitators, and barriers and attitudes towards pediatric pain. Results: 56 residents participated (46%), 25 of whom (45%) indicated they had not received any training in pediatric pain assessment. All levels of residents reported they were uncomfortable with pain assessment in 0-2 year olds (p = 0.07); level of comfort with assessment increased with years of training for patients aged 2-12 years (p = 0.02). When assessing children with disabilities, 83% of respondents (45/54) indicated they were 'extremely' or 'somewhat' uncomfortable. Sixty-nine percent (38/55) had received training on how to treat pediatric pain. All residents reported they were more comfortable using pain medication for a 9 year old, as compared to a 1 year old (oral oxycodone p < 0.001, oral morphine p < 0.001, IV morphine p = 0.004). The preferred methods to learn about children's pain management were role-modeling (61%) and lectures (57%). The top challenges in pain management were with non-verbal, younger, or developmentally delayed patients. Conclusion: Canadian EM residents report receiving inadequate training in pediatric pain management, and are particularly uneasy with younger or developmentally disabled children. Post-graduate curricula should be adjusted to correct these self-identified weaknesses in children's pain management.

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Self-Reported Pain Intensity and Associated Distress in Children Aged 4-18 Years on Admission, Discharge, and One-Week Follow Up to Emergency Department

Cited by 39 publications

References 24 publications

Assessment of orofacial pain management in a pediatric emergency department and at home after discharge

Assessment of orofacial pain management in a pediatric emergency department and at home after discharge

A Survey of Caregiver Perspectives on Children’s Pain Management in the Emergency Department

Canadian Emergency Medicine Residents’ Perspectives on Pediatric Pain Management

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