4.4 Article

Multidimensional Self-report Assessment of Children's Acute Pain in an Inpatient Setting

Journal

CLINICAL JOURNAL OF PAIN
Volume 37, Issue 6, Pages 421-428

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AJP.0000000000000938

Keywords

child; pain assessment; multidimensional; affective; evaluative

Funding

  1. Sydney Children's Hospital Foundation, Randwick, NSW, Australia

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The study found that self-report tools can effectively assess the sensory, affective, and evaluative aspects of children's acute pain experience. Factors such as age, pain duration, and observed pain behavior play a role in children's pain experience.
Objective: This study assessed the feasibility of administering a multidimensional, self-report pain assessment protocol to children in an inpatient, acute pain context, and sought insight into the interrelationships between sensory, affective, and evaluative pain dimensions. Methods: A total of 132 children (5 to 16 y) experiencing acute pain were recruited from acute pain ward rounds or the short-stay surgical unit. A multidimensional self-report assessment protocol was administered, assessing pain intensity, pain-related affect, bother, perceived unfairness, and pain expectations (for tomorrow and in 1 wk). Duration of protocol administration was assessed and ease of administration was rated. Pain-related behaviors were rated using the Face, Legs, Activity, Cry, and Consolability (FLACC) Scale. Results: The duration of protocol administration was <2.5 minutes, on average, for all age groups. Median ease of protocol administration was 7/10 for 5- to 7-year-olds and 8/10 for older age groups. Pain-related bother was higher for 14- to 16-year-olds, relative to younger age groups, and significantly correlated with perceived unfairness (r=0.59, P<0.01), intensity (r=0.76, P<0.01), and affect (r=0.33, P<0.05). For younger age groups, bother was significantly positively correlated only with pain intensity (rs=0.59 to 0.79, Ps<0.01) and affect (rs=0.4 to 0.71, Ps <0.05). A stepwise multiple regression analysis found multidimensional self-reported information (especially pain intensity and perceived unfairness), accounted for significant additional amount of variance, beyond that explained by age, pain duration, and observed pain behavior. Discussion: Sensory, affective, and evaluative aspects of children's clinical, acute pain experience may be assessed using self-report tools, which provide unique and valuable information about their pain experience.

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