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Children's pain: a mandate for change
1Memorial University of Newfoundland School of Nursing, Memorial University of Newfoundland, St John's, Canada. brennan@morgan.ucs.mun.ca
Insights
Despite advances in understanding children's pain, effective clinical management remains a challenge. This review highlights the gap between knowledge and practice, calling for improved pain assessment and treatment in pediatric patients.
Area of Science:
- Pediatric Pain Management
- Clinical Practice Gaps
- Evidence-Based Healthcare
Background:
- Significant research progress in pediatric pain knowledge and management strategies over the last 15 years.
- Persistent challenges in the clinical care of children in pain, leading to frequent underrecognition and ineffective treatment.
- Growing advocacy from healthcare professionals, children, and families demanding improved pain management for pediatric patients.
Purpose of the Study:
- To provide an overview of current knowledge regarding children's pain.
- To identify factors hindering effective pain assessment and management in pediatric populations.
- To present a call for change and mandate for improving the clinical care of children experiencing pain.
Main Methods:
- Conducted a comprehensive literature review using Medline search with keywords 'child* + pain'.
- Employed a snowball technique to gather relevant articles and resources on children's pain.
- Prioritized resources published after 1990 to reflect current knowledge and its practical application.
Main Results:
- Despite available information, there is a significant gap in the implementation of knowledge for effective pediatric pain management.
- Children's postoperative pain is presented as a key example illustrating the disparity between available pain expertise and clinical practice.
- The review underscores that current knowledge about children's pain is not consistently translated into effective clinical practice.
Conclusions:
- A critical need exists to bridge the gap between scientific knowledge and clinical practice in pediatric pain management.
- The principles and mandate for change discussed are applicable across all types of pain, conditions, and age groups in children.
- Urgent action is required to ensure that advances in understanding children's pain translate into improved patient outcomes and effective care.
Abstract:
There have been tremendous research advances in the past 15 years in knowledge about children's pain, and strategies for recognizing and managing that pain. However, the clinical care of children in pain remains a challenge. Children's pain continues to be frequently unrecognized, dismissed or ineffectively managed. A loud call for change is being voiced by physicians, nurses, children and their families. A review of the literature was conducted to document this issue. Starting with a Medline search of the key word 'child* + pain' and continuing with a snowball technique, articles and resources addressing children's pain were collected. Resources presented or published after 1990 were particularly sought because they theoretically reflect both current knowledge about children's pain and the implementation of this knowledge in practice. Unfortunately, although information on pain is available to help children, in many instances, it is not being used. The purpose of the present paper is twofold - to present an overview of current knowledge of children's pain, and factors that hinder its effective assessment and management; and to present a mandate for change. Children's postoperative pain is highlighted in this paper as an example of the gap between pain knowledge and clinical practice. Although treatment strategies differ across different types of pain, children's conditions and ages, the principles and mandate for change discussed in this paper are directly relevant to all categories of children's pain.