Author:
Kristin R.
Ostermueller
Master of Science in Nursing, Vanderbilt University, 1988
Assessment of pain in children has been a major dilemma for nurses. Recent research studies have shown that children of all ages indeed experience pain, but some children cannot verbally express their feelings. The fact that they are not neurologically defective to pain have been shown for years (Swafford and Allan, 1968).
It is important to consider developmental level in response to pain. School-aged children begin thinking at the concrete-operational level and are able to use logic and understand simple casual explanations.
Without a strong knowledge base and without reliable methods of measurement, nurses have a weak foundation on which to base assessment and intervention with analgesics ordered for the pediatric patient. The nurse must comprehend how the pain is perceived by the child in order to provide adequate relief.
The purpose of this research study is to examine postoperative children's perceptions of pain intensity. The goal is to determine if analgesia administration will influence the postoperative child's perception of pain at different times. Also, the researcher will try to identify if the child's behavioral/physiological responses correlate with the "face" selected. This pain study will attempt to support the notion that children do indeed experience pain, and are relieved by analgesia. Therefore, with more knowledge in this area, nurses may be able to manage children's pain more effectively.
One hundred percent of the subjects who were awake one hour after receiving pain medication chose a lower pain rating score, indicating they felt less pain than before the medication was given. The investigator believes that if a subject is asleep one hour after receiving pain medication, it does not necessarily indicate the patient is not experiencing pain. Analysis of the data revealed that the subject's sex made no significant difference in the way pain medication affects children's perception of their pain. The behavioral responses suggested that the subject's pain intensity had decreased in nature.
Pediatric nurses are urged to recognize that children (ages six to twelve years) are able to relate the intensity of their pain. Behavioral responses may be of assistance, but not adequate to assess pain. The Baker-Wong's Faces Rating Scale utilized in this study shows that children are able to tell us the degree of their pain. Therefore, it is recommended that pediatric nurses utilize this rating scale in order to determine the child's perception of the intensity of their pain.
An educational program, given as inservices for new as well as experienced nurses may be effective. This is a way to promote the types of behaviors necessary to better manage children's pain. The author recommends that under-medicating children should be avoided whenever possible. The investigator suggests to administer analgesics at regular intervals throughout the hospital stay and conduct a study measuring the effectiveness of pain relief.
March 15, 2002
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