Authors:
Hla TK, Hegarty M, Russell P, Drake-Brockman TF, Ramgolam A, Von Ungern-Sternberg BS
Authors notes:
Paediatric Anaesthesia. 2014;24(11):1127-31
Keywords:
Pain, Pediatric anesthesia, Postoperative, Faces Pain Scale, pain assessment
Abstract:
Pain is a subjective experience. In children with limited understanding and communication skills, reliable assessment of pain is challenging.
Self-reporting of pain is the gold standard of pain measurement.
For children who are unable to self-report their pain, assessments made by their parents are often used as a proxy measure.
The validity of this approach has not been conclusively determined.
Our aim was to investigate differences in the assessment of pediatric pain between children, parents, nurses, and independent observers in the acute postoperative setting.
For verbal children, scores reported by patients and their parents did not differ significantly.
Median scores by children, parents, nurses, and independent observers were, respectively, 2.0, 2.0, 0.0, and 1.0.
In nonverbal children, median scores by parents, nurses, and independent observers were 1.0, 0, and 0, respectively.
The agreement between the different scorers was statistically significant.
Children's pain self-reports should be used wherever possible to guide management, but in their absence, parental pain scores can be reliably used as a surrogate measure.
Nurses and independent observers produce lower pain scores than parents or children, which may result in inadequate treatment of pain.