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Do abused young children feel less pain?
Marie-Hélène Drouineau1, Elise Guenego1, Véronique Sebille-Rivain2
1Pediatric department, University Hospital of Nantes, France.
Child Abuse & Neglect
|February 15, 2017
Summary
Acute pain in abused children is often under-recognized by healthcare professionals compared to children with accidental injuries. This under-recognition may stem from abused children exhibiting reduced pain expression following trauma.
Area of Science:
- Pediatrics
- Child Abuse
- Pain Management
Background:
- Under-recognition of acute pain in abused children is a significant clinical challenge.
- Pain perception and expression in abused children may differ from those with accidental injuries.
Purpose of the Study:
- To investigate the recognition of acute pain in abused children versus children with accidental injuries.
- To determine if pain under-recognition is a symptom of child abuse.
Main Methods:
- Observational prospective case-control study in an emergency department.
- Inclusion criteria: children <6 years, trauma within 7 days, bone injury or burn, able to express pain.
- Case group: confirmed abuse; Control group: plausible injury cause, no abuse signs. Matched by age and trauma type.
Main Results:
- Pain was significantly less recognized in abused children (relative risk=0.63, p=0.04).
- Discrepancy noted between nurses' and doctors' pain assessment scores (Kappa=0.59).
- Abused children may exhibit reduced pain expression post-trauma.
Conclusions:
- Medical staff under-recognize pain expression in abused children.
- Abused children might display diminished pain responses after traumatic events.
- Focused attention on abused children's pain can optimize analgesic treatment.