Abstract
Objective: Accurate assessment of patients' pain is an essential part of adequate analgesic treatment. Although reporting pain is a complex task, limited-to-no instructions are provided to pediatric patients regarding this process. Our goal in this randomized parallel-group clinical trial (Clinicaltrial.gov study protocol number NCT04306679) was to evaluate if a training program designed to improve children's ability to understand and use pain scales in a post-surgical setting would affect their pain scores.Methods: Eligible children (aged 8–17), hospitalized for elective surgery and their parents were randomized into two groups. Pre-surgery the intervention group underwent a multi-media program aimed to teach and train how to report pain. The control group received standard pre-surgical instructions. Post-surgery, the children reported their pain on 4 pain scales. The primary outcome was the concordance between children's pain intensity scores reported on four pain scales, both in terms of within-child standard deviation and absolute difference.Results: Ninety-six children met inclusion criteria and completed the study. The trained subjects' pain reports had significantly (p = 0.002) lower within-subject standard deviation (0.41 ± 0.31) than the control group (0.67 ± 0.46). In line, regarding absolute difference, the concordance of children's pain reports was twice better in the trained group (mean difference of 0.43 ± 0.40) than in the control group (0.88 ± 0.70) (p < 0.001).Discussion: Our results suggests that children's ability to report pain is a skill that can be improved. Future studies should test the potential clinical impacts of educational interventions aimed to improve pain assessment in children and adults.
Highlights
Evidence-based practice [1] surrounding pediatric perioperative care has continued to progress, improvements are still warranted [2, 3], with moderate to severe pain experienced by up to 40% of hospitalized children [4] and about 90 and 56% suffering some level of pain one- and 2-weeks following surgery [5]
We chose to focus our intervention on children ages 8–17 because it has previously been suggested that due to cognitive development children under the age of eight may have a different understanding of pain scales and introduce additional bias [15, 35]
Among 233 children who were admitted to the pediatric surgery departments between June and November 2019, 203 were eligible to participate
Summary
Evidence-based practice [1] surrounding pediatric perioperative care has continued to progress, improvements are still warranted [2, 3], with moderate to severe pain experienced by up to 40% of hospitalized children [4] and about 90 and 56% suffering some level of pain one- and 2-weeks following surgery (respectively) [5]. This is concerning as there is evidence that early life pain and surgery can produce longterm changes both in sensory processing, as well as in future pain response [6, 7]. Like in adult pain management, self-reporting of pain remains the gold standard for children’s pain measurement whenever feasible [19]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
