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How Much Does It Hurt to Be a Hospitalized Child or Adolescent in a Latin American Country?
Maria I Cuervo-Suarez1,2, Karen Molina-Gomez1,3, Natalia Duque-Nieto1
1Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia.
Insights
Hospitalized children frequently experience pain, particularly during procedures. Children with cancer suffer more, highlighting the need for tailored pain management strategies.
Area of Science:
- Pediatric Medicine
- Pain Management
- Oncology
Background:
- Pain assessment and management in hospitalized children require optimized approaches.
- Understanding pain prevalence, assessment tools, and treatment modalities is crucial for improving pediatric care.
Purpose of the Study:
- To investigate the prevalence, intensity, and causes of pain in hospitalized children.
- To evaluate the assessment scales and treatment strategies employed for pediatric pain.
- To explore patient satisfaction with pain management outcomes.
Main Methods:
- A cross-sectional study was conducted from January 2022 to January 2023.
- Involved 300 pediatric patients (ages 3-17) hospitalized for over 24 hours.
- Data collected via an 8-item survey and electronic health records.
Main Results:
- 82.3% of children experienced pain, with 89% reporting procedural pain.
- Children with cancer (87 patients) reported 100% procedural pain, significantly higher than others.
- Multimodal strategies were common; 83.6% achieved pain relief, though severe pain was linked to less relief.
Conclusions:
- Pain, especially procedural pain, is highly prevalent in hospitalized children, with those having cancer experiencing increased suffering.
- Multimodal pain management strategies demonstrate improved outcomes for mild to moderate pain.
- A tailored, comprehensive approach to pain assessment and treatment is essential for hospitalized children.
Objective:
Adopting an optimized approach to pain assessment and treatment in hospitalized children is crucial. This study aims to explore the prevalence, assessment scales, and treatment of pain in hospitalized children.
Methods:
We conducted a cross-sectional study (January 2022-January 2023) of pediatric patients (ages 3-17, hospitalized >24 hours). Pain prevalence, intensity, causes, and satisfaction with management were assessed using an 8-item survey complemented by data from electronic health records.
Results:
The study included 300 children, among whom 247 (82.3%) experienced pain during hospitalization, and 269 (89%) patients reported procedural pain. Eighty-nine (29.7%) patients rated the pain as mild. Patients mainly received nonpharmacological therapy (distraction activities: 239 [79.6%]). One-hundred percent of children with cancer diagnosis (87 patients) reported pain due to procedures compared with patients without cancer (182 [85.8%] of 213 patients) (P < .016). Patients with cancer diagnosis received significantly more occupational therapy (44 [51%]), physical therapy (69 [79%]), psychotherapy (53 [61%]), and opioids (24 [27.6%]) (P < .001) compared with patients not receiving oncological care. Older children received nonpharmacological and pharmacological strategies for pain management more frequently, with significant differences across treatment categories. Two-hundred fifty-one (83.6%) achieved pain relief; severe pain was associated with less relief (17 [74%], P = .029).
Conclusions:
It hurts to be a hospitalized child or adolescent. In hospitalized children, pain, especially procedural pain, is common; children with cancer experience greater suffering due to this cause. Multimodal strategies improve outcomes for mild/moderate pain. It is important to take an approach that focuses on assessment and comprehensive pain treatment tailored to the needs of the child.
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