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Updated: Aug 9, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
[Postoperative pain in children. A comparison between ratings of children and nurses]
J Rømsing1, S A Hertel, J Møller-Sonnergaard
1Ore-naese-hals-afdelingen, Amtssygehuset Roskilde.
Insights
Nurses in Denmark, like those in North America, often underestimate children's postoperative pain. This study found nurses significantly lowered pain ratings after analgesics, more than children did, indicating a potential gap in pain management for pediatric patients.
Area of Science:
- Pediatric Nursing
- Pain Management
- Clinical Assessment
Background:
- Studies indicate nurses underestimate pediatric postoperative pain.
- This underestimation impacts analgesic treatment effectiveness.
- Understanding nurse-patient pain rating discrepancies is crucial.
Purpose of the Study:
- To investigate the relationship between children's and nurses' pain ratings in Danish pediatric patients.
- To compare pain assessments before and after analgesic administration.
- To identify factors influencing nurses' pain estimations.
Main Methods:
- A comparative study involving 100 children aged 3-15 undergoing tonsillectomy.
- Utilized the Poker Chip Tool and a 10-cm Visual Analogue Scale for pain assessment.
- Collected pain ratings from both children and attending nurses.
Main Results:
- Significant discrepancies noted between children's and nurses' pain ratings, particularly post-analgesic administration (p < 0.001).
- Children reported a 17% decrease in pain post-analgesics, while nurses reported a 53-58% decrease.
- Nurses tended to overestimate analgesic effects and adjust ratings based on activity levels.
Conclusions:
- Danish nurses, similar to international findings, generally underestimate children's postoperative pain.
- Nurses' overestimation of analgesic efficacy may contribute to underestimation.
- Pain assessment in pediatric care requires careful consideration of both patient self-report and objective measures.
Abstract:
Several predominantly North American studies indicate that postoperative pain experienced by children is underestimated by the nurses, who are in charge of the analgesic treatment of the children's pain. The purpose of this investigation was to examine, in Danish children, the relationship between the children's ratings of their pain and the nurses' ratings of the children's pain. The issue was examined by comparing the pain ratings of 100 children three to 15 years of age following tonsillectomy. The ratings were obtained by using the Poker Chip Tool and a 10-cm Visual analogue scale. The differences between the children's and the nurses' pain ratings were most pronounced after administration of analgesics (p < 0.001). After analgesics, the children's mean pain score was 17% lower than before analgesics, while the nurses' mean pain scores of the children's pain were 53-58% lower than before analgesics. Consistent with results from foreign studies, this Danish study found that, in general, the nurses underestimated the children's pain. The nurses tended to overestimate the effect of analgesics and tended to modify their pain ratings according to the children's level of activity.
