Related Experiment Video
Updated: Jan 15, 2026
Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm
Published on: October 3, 2020
Underestimating Children's Self-reported Pain: Agree/Disagree?
Şefika Başoğlu1, Özlem Selvi Can1, Volkan Baytaş1
1Ankara University Faculty of Medicine, Department of Anaesthesiology and Intensive Care, Ankara, Türkiye.
Insights
Parents accurately assessed children's postoperative pain using the visual analogue scale (VAS) and numeric rating scale (NRS), while nurses tended to underestimate pain levels.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Surgical Outcomes
Background:
- Accurate postoperative pain assessment in children is crucial for effective management.
- Discrepancies in pain reporting can occur between patients, parents, and healthcare providers.
- The visual analogue scale (VAS) and numeric rating scale (NRS) are commonly used pain assessment tools.
Purpose of the Study:
- To compare postoperative pain scores in children across different surgical types and grades.
- To evaluate the agreement between patient, parent, and nurse pain assessments using VAS and NRS.
- To identify potential differences in pain perception and reporting among these groups.
Main Methods:
- A prospective, randomized study included 172 children aged 7-18 years undergoing elective surgery.
- Pain was assessed 2 hours postoperatively using VAS and NRS by the patient, parent, and nurse.
- Data were analyzed for agreement using intraclass correlation coefficients (ICC).
Main Results:
- Excellent agreement was found between child and parent pain ratings (ICC > 0.90 for both VAS and NRS).
- Good agreement was observed between child and nurse pain ratings (ICC > 0.84 for both VAS and NRS).
- Fathers demonstrated a better ability to predict their child's pain compared to mothers.
Conclusions:
- Parental pain assessments using VAS and NRS closely mirrored children's self-reported pain.
- Nurses tended to underestimate children's postoperative pain when using both VAS and NRS.
- Self-reported pain remains the gold standard, with parental reports serving as a reliable proxy.
Objective:
To compare postoperative pain after different surgical types and grades using the visual analogue scale (VAS) and numeric rating scale (NRS) evaluated by the patient, parent, and nurse.
Methods:
After approval from the local ethics committee and written informed consent from the patient and parent, a single-center, prospective, randomized study was designed. A total of 180 children with American Society of Anesthesiologists I-III physical status between the ages of 7-12 (n = 90) and 13-18 (n = 90) years were included in the study who underwent elective surgery at Ankara University Faculty of Medicine Hospitals between January and December 2022. Pain was assessed postoperatively at 2 hours using two pain scales. Patients who underwent mini-intermediate or major surgery were evaluated separately.
Results:
Four children from each age group were excluded from the study due to insufficient data recording, and data from 172 children were analyzed. Including all age groups and surgical grades, all children had excellent agreement with the parent [VAS/NRS: intraclass correlation coefficient (ICC)= 0.903/ICC= 0.900] and good agreement was found between the child and nurse (VAS/NRS: ICC= 0.852/ICC= 0.842). For the VAS and NRS, when parent and nurse compliance scores were compared, no significant difference was observed between the two scores. For VAS and NRS, fathers were found to be better at predicting pain for children than mothers.
Conclusion:
Self-reported pain is the gold standard for pain evaluation. The parents assessed pain scores that were similar to those of their children using NRS and VAS. Nurses underestimated a child's pain with both scores.
Related Concept Videos
01:20Social Foundations of Self II: The Generalized Other
02:34Empathy
01:25Analgesia and Pain Management
01:08The Availability Heuristic
02:05Self-Presentation: Self-Monitoring and Self-Handicapping