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The Prevalence, Intensity, Assessment, and Management of Acute Pain in Hospitalized Children in Botswana
Samuel T Matula1, Sharon Y Irving2, Janet A Deatrick3
1Faculty of Health Sciences, School of Nursing, University of Botswana, Gaborone, Botswana.
Insights
This study found low prevalence and intensity of acute pain in hospitalized children in Botswana. Pain management practices and demographic associations were also examined.
Area of Science:
- Pediatric Pain Management
- Global Health
- Clinical Nursing
Background:
- Limited data exists on acute pain in children in sub-Saharan Africa.
- Understanding pain prevalence and management is crucial for this population.
Purpose of the Study:
- To determine the prevalence and intensity of acute pain in hospitalized children in Botswana.
- To describe pain management practices and associated demographic factors.
Main Methods:
- Prospective observational study with repeated cross-sectional samples.
- Involved 308 children (2 months to 13 years) and 226 parents/guardians.
- Utilized validated pain scales (Faces Pain Scale-Revised, revised FLACC, NRS) and health record review.
Main Results:
- Pain prevalence was 50% for children under 7 and 54% for children 7 and older.
- Pain was documented in 54% of cases; acetaminophen was the most common analgesic.
- Significant associations found between pain intensity and factors like weight, diagnosis, residence, and surgery.
Conclusions:
- Acute pain prevalence and intensity among hospitalized children in Botswana appear to be low.
- Findings highlight the need for continued monitoring and tailored pain management strategies.
Background:
There is very limited clinical and observational data on acute pain experienced by children in sub-Saharan Africa.
Aims:
To report the prevalence and intensity of acute pain, pain management practices, and describe associations between acute pain outcomes, children's and parents or guardian's demographics in hospitalized children aged 2 months to 13 years in Botswana.
Design:
A descriptive correlational prospective observational study using five repeated cross-sectional samples.
Settings:
Two referral hospitals in Botswana.
Participants:
The sample size included 308 children and 226 parents or guardians. Data were collected between November 2018 and February 2019 from children, their parents or guardians (<7 years child), and the health record for pain documentation and treatment.
Measures:
Pain was measured using Faces Pain Scale-Revised for children ≥7 years, revised Face, Legs, Activity, Cry, Consolability scale for children <7 years and numeric rating scale for parents or guardians.
Results:
There are 1,290 data points for children of which 1,000 were children <7 years and 999 data points for parents or guardians of children <7 years were used in analysis. Fifty percent of children <7 years were in pain using the revised Face, Legs, Activity, Cry, Consolability scale, whereas parents indicated 46% to be in pain. The pain prevalence for children ≥7 years was estimated at 54%. Pain was documentated at a rate of 54 % on the health records. Acetaminophen was most common analgesic across all age groups. Univariate associations of child <7 years pain intensity was statistically significant (p ≤ .05) for weight, diagnosis, residence, and parent relationship. Parents reported pain intensity was statistically significant (p ≤ .05) for child sex, weight, diagnosis, residence, surgery, parent or guardian age and education. Only age and surgery were significant for children ≥7 years.
Conclusions:
Acute pain prevalence and intensity among hospitalized children in Botswana is low.
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