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Children with cancer: the pain experience away from the health care setting
E A Bossert1, L Van Cleve, M C Savedra
1School of Nursing, Loma Linda University, CA 92350, USA.
Insights
Children with cancer experience significant pain outside the hospital. Common pain sites include the stomach, joints, legs, and back, often stemming from chemotherapy. Pain management strategies include rest, medication, and social support.
Area of Science:
- Pediatric Oncology
- Pain Management
- Childhood Cancer Survivorship
Background:
- Limited understanding of pediatric cancer pain experienced outside clinical settings.
- Need for comprehensive pain assessment in children with cancer, irrespective of location.
Purpose of the Study:
- To explore the nature and characteristics of pain in children with cancer in non-healthcare settings.
- To identify common pain locations, intensity, sources, and management strategies used by these children.
Main Methods:
- Pilot study utilizing a purposive sample of 20 children (ages 4-16) with cancer.
- Semistructured interviews incorporating validated pain assessment tools (Poker Chip Tool, Preschool Body Outline, Adolescent Pediatric Pain Tool).
- Supplemental parental input and longitudinal follow-up for a subset of participants.
Main Results:
- Children reported pain in various locations, most frequently the stomach, joints, legs, and back.
- Pain intensity demonstrated wide variability.
- Chemotherapy was the most frequently identified source of pain.
- Commonly reported management strategies included rest, analgesics, rubbing, distraction, social support, and heat.
Conclusions:
- Children with cancer experience pain even when away from healthcare settings.
- Pain assessment for pediatric cancer patients is crucial in all environments.
- Findings highlight the need for tailored pain management strategies considering non-clinical contexts.
Abstract:
Relatively little is known about the nature of pain in children with cancer away from the health care setting. Accordingly, this pilot study focused on the pain experience in this group. A purposive sample of 20 children, ages 4 through 16 years, with any type of cancer, was obtained. A semistructured interview including the Poker Chip Tool and Preschool Body Outline (ages 4 to 7 years) or the Adolescent Pediatric Pain Tool (age 8 to 16 years) was administered to all the children once during a clinic appointment. Supplemental parental input was sought during the interview. Two of the children also were contacted every 2 weeks for 3 months. Content analysis indicated that the children experienced pain in a number of locations, most frequently the "stomach", joints, legs, and back. Pain intensity varied widely. The source of pain identified most often was chemotherapy. The most common pain management strategies mentioned were rest/sleep, analgesics, rubbing, distraction, social support, and heat. Clearly, children with cancer away from the health care setting do have pain. Assessment of pain in children with cancer regardless of setting is a necessity.