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Point prevalence study of pediatric inpatients who are unable to communicate effectively about pain
Douglas L Hill1, Karen W Carroll1, Susan Dougherty1
1The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Insights
Many pediatric inpatients struggle with communication, impacting their ability to report pain. While communication barriers didn't affect pain management effectiveness, they hindered specific pain communication and increased caregiver involvement needs.
Area of Science:
- Pediatric healthcare
- Patient communication
- Pain management
Background:
- Effective communication is crucial for adequate pain management in pediatric inpatients.
- Vulnerable populations, including children with age, cognitive, or physical limitations, may face communication barriers.
Purpose of the Study:
- To estimate the proportion of pediatric inpatients experiencing communication difficulties.
- To investigate the relationship between communication ability, pain experience, and pain management effectiveness.
Main Methods:
- A point prevalence study was conducted in a pediatric hospital.
- Nurse reports on patient communication ability were collected for inpatients aged 12 months and older.
Main Results:
- Forty percent of surveyed pediatric inpatients had communication difficulties.
- Communication challenges were not linked to pain experience or management effectiveness.
- Communication difficulties were associated with challenges in reporting pain and increased need for caregiver assistance.
Conclusions:
- A significant number of pediatric inpatients face communication barriers, potentially affecting their ability to express pain.
- While overall pain management effectiveness was not impacted, specific pain communication was hindered.
- Further research is needed to identify factors contributing to communication inability in pediatric patients.
Objective:
Pediatric inpatients may be at risk for inadequate pain management if they are unable to communicate effectively because of age, physical or cognitive impairment, or medical procedures. We conducted a point prevalence study to estimate the proportion of inpatients at a children's hospital who have difficulty communicating to hospital staff.
Methods:
We obtained nurse reports of ability to communicate for all inpatients aged ≥12 months in a pediatric hospital. Demographic information was obtained from the medical record.
Results:
Questionnaires were completed for 254 inpatients. Forty percent of inpatients had some difficulty communicating, and 69% had experienced pain during the hospitalization. Patient ability to communicate was not related to experiencing pain (χ(2) test, P = .30) or effectiveness of pain management (χ(2) test, P = .80) but was associated with difficulty communicating about pain and nurses needing help from the caretaker to communicate with the patient (χ(2) tests, Ps < .001).
Conclusions:
A substantial proportion of inpatients aged ≥12 months at a large children's hospital had difficulties communicating effectively and experienced pain during hospitalization. These communication difficulties were not associated with nurse reports of the effectiveness of pain management. However, patients who had difficulties communicating in general were also more likely to have difficulty communicating about pain specifically, and nurses were more likely to need help from the caregiver to understand these patients. Future directions include identifying which conditions, procedures, and medications are associated with inability to communicate.
