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Assessing procedural pain in children with cancer in Beirut, Lebanon
Lina Kurdahi Badr Zahr1, Houry Puzantian, Miguel Abboud
1School of Nursing, Azusa Pacific University, California 90095, USA. linakbadr@hotmail.com
Insights
Accurate pain assessment in pediatric cancer patients is possible using self-reports, behavioral observations, and physiological measures. The DOLLS scale is a valid and preferred tool for children undergoing invasive procedures.
Area of Science:
- Pediatric Oncology
- Pain Management
- Child Psychology
Background:
- Assessing pain in children with cancer during invasive procedures is challenging.
- Multiple pain indicators (self-report, behavioral, physiological) require validation.
Purpose of the Study:
- To examine the relationship between various pain indicators in pediatric cancer patients.
- To evaluate the validity and reliability of the DOLLS pain scale in a Lebanese population.
Main Methods:
- 45 children (4-10 years) with cancer undergoing Port-a-Cath access were studied.
- Pain was measured using Wong-Baker FACES, DOLLS, Observational Scale of Behavioral Distress-Revised, and physiological measures.
- Nurses and parents also assessed pain and distress.
Main Results:
- High consistency between self-reports and moderate-to-high correlations with behavioral and physiological measures.
- The DOLLS scale demonstrated adequate validity and reliability in the Lebanese population.
- Children preferred the DOLLS scale for pain assessment.
Conclusions:
- Accurate pain assessment in pediatric cancer patients is feasible using combined indicators.
- The DOLLS scale is a valid, reliable, and preferred tool for pain assessment in this population.
- Nurses and parents can effectively assess children's pain and distress.
Abstract:
This study describes the relationship between different indicators of pain, including self-reports, behavioral observations, and physiological measures, in children with cancer undergoing invasive procedures. Forty-five children between the ages of 4 and 10 years were evaluated while undergoing Port-a-Cath access. The study was conducted in the outpatient clinics of the Children's Cancer Center in Beirut, Lebanon. Children used 2 self-report measures of pain (the Wong-Baker FACES Pain Rating Scale and an adaptation of the FACES, the DOLLS). Parents and nurses assessed the child's pain on the FACES and the child's distress on the Observational Scale of Behavioral Distress-Revised. Nurses recoded behavioral observations as well as physiological responses to pain. There was a high degree of consistency between the self-reports and moderate to high correlations between self-reports, behavioral parameters, and physiological parameters, suggesting that accurate pain assessments can be made by both nurses and parents. The results also demonstrate adequate validity and reliability of the DOLLS scale in a Lebanese population, in addition to being the preferred assessment tool for all the children in the study.