Comparison of Adolescent, Parent, Nurse and Physician Pain Assessment in Pediatric Emergency Departments

The accurate and consistent assessment of pain in adolescents is very important for appropriate treatment and care. This study aimed to compare the pain assessment by parents, physicians, nurses, and adolescents in pediatric patients admitted to the emergency department for evaluation.

This cross-sectional study was conducted with 352 adolescents aged 11 to 18 years who complained of pain, their parents, and caring physicians and nurses. Data were collected between January 2023 and February 2024 using the Descriptive Information Form and the visual analog scale for adolescents, parents, physicians, and nurses.

The visual analog scale pain score was 6.79 (1.73) in adolescents' self-assessment of pain. Parents evaluated adolescents' pain as 6.73 (SD 1.87), physicians as 4.38 (SD 1.90), and nurses as 4.19 (SD 1.78). The overall adolescent-parent agreement was low (Cohen's weighted κ = 0.201), and there was a discrepancy between adolescent-nurse (κ = -0.008) and adolescent-physician agreement (κ = 0.005). Pain assessment reliability between adolescents and parents was good (intraclass correlation coefficient, 0.772; 95% CI, 0.719-0.815), whereas it was moderate between adolescents and nurses (intraclass correlation coefficient, 0.591; 95% CI, 0.496-0.669) and weak between adolescents and physicians (intraclass correlation coefficient, 0.353; 95% CI, -0.157 to 0.627).

The reliability of pain assessment between adolescents and parents was good. The pain assessment scores of physicians and nurses were lower than adolescents themselves and their parents. Parents' assessment of pain should be taken into account when adolescents' self-reports are unavailable.