The Assessment of Pain in Children

Beyer, Judith; Wells, Nancy

doi:10.1016/s0031-3955(16)36724-4

Cited by 152 publications

(75 citation statements)

References 40 publications

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“…This is in concordance with the fact that there are no reliable subjective scales for children under this age (18,19). Pain is by definition a subjective experience (20).…”

Section: Pain Evaluationsupporting

confidence: 80%

Pain in Pediatric Oncology: Do the Experiences of Children and Parents Differ from Those of Nurses and Physicians?

Ljungman¹,

Kreuger²,

Gordh³

et al. 2006

Upsala Journal of Medical Sciences

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Diagnosis and treatment of pain are central components in the care of children with cancer. The aim of the present study was to compare the viewpoints of children and parents with those of professionals, on different aspects of pain in children with cancer. Information was collected through questionnaires and interviews. In particular, we focused on the extent and causes of pain, strategies to reduce procedural pain, pain evaluation, and attitudes to pain treatment.We found that both families and professionals shared the opinion that pain was a common symptom during different phases of cancer treatment but, surprisingly, professionals regarded it as more frequent than families. The groups agreed that treatment related pain is the most critical problem, followed by procedure and cancer related pain. Concerning strategies to decrease procedural pain, there was a high concordance in views between groups. Nurses and physicians more often claimed that failing pain treatment was associated with psychological factors such as high levels of anxiety in parents and children, loneliness, and lack of preparation. The self-report, according to both parents and professionals, is a feasible procedure even in young children from 4 years of age. Both groups asserted that parents were better in ascertaining the extent of their child's pain.In conclusion, although the families and professionals in this study have many comparable views concerning pain in children with cancer, divergences also exist. To acquire a more accurate picture of the situation we must focus on the views of the children first, and then those of parents and professionals. A tendency to overestimate the problems was observed in professionals. Hopefully this reflects a keen awareness of the current situation. 87

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“…This is in concordance with the fact that there are no reliable subjective scales for children under this age (18,19). Pain is by definition a subjective experience (20).…”

Section: Pain Evaluationsupporting

confidence: 80%

Pain in Pediatric Oncology: Do the Experiences of Children and Parents Differ from Those of Nurses and Physicians?

Ljungman¹,

Kreuger²,

Gordh³

et al. 2006

Upsala Journal of Medical Sciences

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“…The measurement of pain in children can be even more difficult and has been a frequent subject of discussion. 21,23 Studies have shown that children 3 years and older are capable of understanding the concept of hurt and its varying degrees of intensity, if provided with an appropriate device. This study used a combination between two common validated rating scales, an NRS and the Wong-Baker FPS, for a correct pain assessment in children.…”

Section: Discussionmentioning

confidence: 99%

Influence of activation protocol on perceived pain during rapid maxillary expansion

Baldini

Nota

Santariello

et al. 2015

The Angle Orthodontist

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Objective: To investigate the influence of two different activation protocols on the timing and intensity of pain during rapid maxillary expansion (RME). Materials and Methods: A total of 112 prepubertal patients (54 males and 58 females, mean age 11.00 6 1.80 years) with constricted maxillary arches underwent RME with two different activation protocols (group 1: one activation/day; group 2: two activations/day). Patients were provided with a numeric rating scale (NRS) and the Faces Pain Scale (FPS) to correctly assess their daily pain. Results: Subjects treated with RME at two activations/day reported statistically significantly greater amounts of pain than subjects treated with RME at one activation/day. Differences related to gender and skeletal maturity were found. Conclusion: The choice of activation protocol influences the perceived pain during RME, and less daily expansion is correlated to less pain. Pain reported during RME could be influenced by skeletal maturity and gender of the subjects under treatment. (Angle Orthod. 2015;85:1015-1020

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“…1,2 No single measure is useful for all children with all types of pain, which can be acute, chronic, or recurrent. However, it should be possible to have a practical, valid, and reliable measure to evaluate a child's pain for any particular setting.…”

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confidence: 99%

Validation of 2 Pain Scales for Use in the Pediatric Emergency Department

Bulloch

Tenenbein

2002

Pediatrics

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ABSTRACT. Objective. To determine the construct, content, and convergent validity of 2 self-report pain scales for use in the untrained child in the emergency department (ED).Methods. A prospective study was conducted of all children who presented to an urban ED between 5 and 16 years of age inclusive after written informed consent was obtained. Children were excluded if they were intoxicated, had altered sensorium, were clinically unstable, did not speak English, or had developmental delays. Children marked their current pain severity on a standardized Color Analog Scale (CAS) and a 7-point Faces Pain Scale (FPS). They were then asked whether their pain was mild, moderate, or severe. Children were then administered an analgesic at the discretion of the attending physician and asked to repeat these measurements. For assessing content validity, the scales were also administered to age-and gender-matched children in the ED for nonpainful conditions. Convergent validity was assessed by determining the Spearman correlation coefficient between the 2 pain scales.Results. A total of 60 children were enrolled, 30 with pain and 30 without, with a mean age of 9.3 ؎ 3. ABBREVIATIONS. ED, emergency department; CAS, Color Analog Scale; FPS, Faces Pain Scale; IQR, interquartile range; CI, confidence interval; ACCS, Analog Continuous Chromatic Scale. I n assessing a child's pain, a measuring tool must take into account a child's age, cognitive level, type of pain, and the situation in which the pain is occurring. 1,2 No single measure is useful for all children with all types of pain, which can be acute, chronic, or recurrent. However, it should be possible to have a practical, valid, and reliable measure to evaluate a child's pain for any particular setting.The most effective method of pain measurement is self-report. [1][2][3][4][5][6][7][8] Children as young as 3 years have been shown reliably to self-report pain intensity with the use of several assessment tools. 1,2 However, pain management has been inadequately studied in the acute setting. 9 Any assessment of pain management in children requires a valid tool. There are no published data regarding the validity of pediatric pain scales in the untrained child in the emergency department (ED). Agreement among measures in one context does not necessarily suggest agreement in another context. 10 The primary objective of this study was to determine the construct validity of 2 self-report pain scales in the untrained pediatric ED patient. The secondary objectives were to determine the content and convergent validity of these 2 tools. METHODSThis was a prospective, descriptive study conducted in an urban ED at a children's hospital, with an annual census of 36 000. All children who presented to the ED between 5 and 16 years of age inclusive were eligible for enrollment. The minimum age of 5 years was chosen, despite some original research showing that children aged 3 and 4 years also can use these measures, because self-report measures of pain severity have been widely used in t...

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The Assessment of Pain in Children

Cited by 152 publications

References 40 publications

Pain in Pediatric Oncology: Do the Experiences of Children and Parents Differ from Those of Nurses and Physicians?

Pain in Pediatric Oncology: Do the Experiences of Children and Parents Differ from Those of Nurses and Physicians?

Influence of activation protocol on perceived pain during rapid maxillary expansion

Validation of 2 Pain Scales for Use in the Pediatric Emergency Department

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