A qualitative study of the language of satisfaction in children with pain

Measures of satisfaction are essential to understanding patient experience, in general, and particularly with pain management.

(A) To identify the words children commonly use to communicate satisfaction, in general, and for pain management and (B) to determine if this vocabulary matches their caregivers.

A study of child-caregiver pairs seen at a paediatric emergency department (PED) from July to November 2014 was conducted. Children were interviewed using ten open-ended questions. Grounded theory was employed for data coding and analysis. Caregivers completed a written survey.

A total of 105 child interviews were completed (n=53 females, mean age 9.91, SD 3.71, age range 4 to 16); 105 caregiver surveys were completed (n=80 females). Children (n=99) most commonly used 'good', 'better' and 'happy' to express satisfaction with pain management (27%, 21% and 22%, respectively), with PED care (31%, 14% and 33%) and in general (13%, 5% and 49%). Children (n=99) used the words 'sad', 'bad' and 'not good' to communicate dissatisfaction with pain management (21%, 7% and 11%, respectively) and with PED care (21%, 13% and 12%). Only 56% of children (55/99) were familiar with the word 'satisfaction'. Children's word choices were similar to their caregivers' word choices, 14% (14/99) of the time.

Children use simpler words than their caregivers, including good, better and happy, when communicating satisfaction. A child's vocabulary is seldom the same as the vocabulary their caregiver uses, therefore caregiver vocabulary should not be used as a surrogate for paediatric patients. The word 'satisfaction' should be avoided, as most children lack understanding of the term.