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Pediatric pain: prevalence, assessment, and management in a teaching hospital
M B M Linhares1, F N P Doca, F E Martinez
1Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil. linhares@fmrp.usp.br
Insights
Pediatric inpatients experience significant pain, yet health professionals often under-recognize it. This study highlights the need for improved pain assessment and management strategies in hospitals.
Area of Science:
- Pediatric Medicine
- Pain Management
- Healthcare Quality
Background:
- Pain is a common experience for hospitalized children, impacting recovery and well-being.
- Effective pain assessment and management are crucial components of quality pediatric care.
- Previous research indicates potential gaps in pediatric pain management within hospital settings.
Purpose of the Study:
- To investigate the prevalence, assessment methods, and management strategies for pediatric pain in a public teaching hospital.
- To identify discrepancies in pain recognition and reporting among pediatric inpatients, families, physicians, and nurses.
- To evaluate the utilization of pharmacological and non-pharmacological interventions for pediatric pain relief.
Main Methods:
- A cross-sectional study involving 121 pediatric inpatients (infants, children, adolescents), their families, physicians, and nurses.
- Interviews with participants using open-ended questions about pain symptoms, assessment, and management in the preceding 24 hours.
- Data collection from 100% of eligible inpatients, with caregiver or health professional reports for non-communicative children.
Main Results:
- A high prevalence of pain was observed in pediatric inpatients, with significant under-reporting by physicians (38%) compared to nurses (50%) and family caregivers (49%).
- Discrepancies noted in reported pain management, with physicians reporting 66% pharmacological intervention versus nurses reporting 78% pharmacological and/or non-pharmacological interventions.
- While 28% of communicative children/adolescents reported pain, a substantial percentage of those reporting pain received pharmacological intervention (68%).
Conclusions:
- Pediatric inpatients experience a high prevalence of pain, underscoring the need for vigilant assessment.
- A significant under-recognition of pain by health professionals was identified, highlighting a critical gap in care.
- Findings emphasize the necessity for enhanced pain management protocols and interprofessional communication in pediatric healthcare settings.
Abstract:
The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients' pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child's pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.
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