Accuracy of parental-global-impression of children's acute pain

The primary purpose of this study is to compare parental-global-impression of children's level of acute pain at home with parental assessment of children's pain using a structured instrument and with children's self-reports of pain. We recruited 32 parents of children aged 5 to 10 years who were diagnosed with a fractured limb and treated in a tertiary emergency department. After discharge, parents were asked to complete three home-based assessments relating to their child's acute pain: the parental-global-impression of pain, child's reported pain, and structured Parental Postoperative Pain Measure. Data analysis included odds ratios, sensitivity, specificity, positive and negative predictive values, and repeated-measures analysis of variance. When compared with child report of pain, the sensitivity of parental-global-impression was 76% on day 1 and 93% on day 2, whereas specificity was 91% on day 1 and 83% on day 2. When compared with child report of pain, the sensitivity of Parental Postoperative Pain Measure was 71% on day 1 and 66% on day 2, whereas specificity was 82% on day 1 and 83% on day 2. On the basis of acceptable statistical criteria, parental-global-impression has good sensitivity and specificity compared with the child self-report measure. We do not suggest, however, that parental-global-impression can or should replace child report, but rather suggest that it can be used as an adjunct assessment measure as needed. (c) 2007 by the American Society for Pain Management Nursing.