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Validation of three paediatric pain scores for use by parents
1Department of Anaesthesia, Royal Hospital for Sick Children, Edinburgh.
Insights
Parents
Area of Science:
- Pediatric Surgery
- Pain Management
- Clinical Assessment
Background:
- Accurate pain assessment in children is crucial for effective postoperative care.
- Parental involvement in pain scoring can enhance the reliability of assessments.
- Various pain scoring systems exist, but their concordance requires further investigation.
Purpose of the Study:
- To compare pain scores assigned by doctors and parents in children undergoing surgery.
- To evaluate the correlation between different pain scoring systems (Objective Pain Score, numerical rating scale, visual analogue scale) when used by parents and medical professionals.
- To determine the utility of parental pain scoring in pediatric surgical research and audit.
Main Methods:
- A study involving 40 children (20 general surgery, 20 otorhinolaryngological surgery).
- Simultaneous pain assessments by a doctor and a parent on two separate occasions using three distinct pain scoring systems.
- Statistical analysis to calculate correlation coefficients between doctor and parental pain scores.
Main Results:
- High correlations were observed between doctor and parental pain scores across all three systems (Objective Pain Score, numerical rating scale, visual analogue scale).
- Parents consistently reported slightly higher pain scores than doctors.
- Correlation coefficients remained high even one hour after recovery, indicating sustained agreement.
Conclusions:
- Parental pain scoring demonstrates high concordance with medical assessments in pediatric surgical patients.
- Parental pain scores are a valuable tool for future research and audit of pain management strategies, especially in day-case surgery.
- Incorporating parental input can improve the accuracy and comprehensiveness of pediatric pain assessment.
Abstract:
Twenty children undergoing general surgery and 20 children undergoing otorhinolaryngological surgery were simultaneously assessed on two occasions by a doctor and a parent using three pain scoring systems. The pain scoring systems used were the Objective Pain Score, a four point numerical score and a 100 mm visual analogue scale. There was a high correlation between the scores given by the doctor and by the parents for all three scoring systems with parents consistently giving slightly higher scores than the doctor. The correlation coefficients for parental and medical pain scores in recovery were 0.77 for the Objective Pain Score, 0.70 for the four point numerical score and 0.69 for the visual analogue scale (p < 0.01). At 1 h after leaving the recovery area the correlation coefficients were 0.81, 0.80 and 0.73 respectively (p < 0.01). These results suggest that parental scoring of pain in children will be useful in future audit and research of analgesic regimens, particularly in day-case surgery.