Author:
Lisa T. Wilstrup, RN,
MSN
The purpose of this study was to compare 3- to 7-year-old children's self-reports of pain with assessments by the child's parent and the child's nurse. Through the use of the Wong-Baker Faces Pain Rating Scale children provided preoperative and postoperative responses indicative of their pain level. The scale was also shown to the child's parent and nurse to obtain comparison perceptions of the child's postoperative pain. The three scores, from the child, the parent, and the nurse were obtained at a similar point in time between 24 and 48 hours after surgery.
Pearson correlation coefficients were used to measure the degree of relationship among the postoperative responses of the groups of participants. The correlation coefficient between the responses of the children and their parents was r = .30 and r= .24 for the responses of the children and their nurses. No statistically significant relationship was found to support the research hypotheses at the p =.05 level of significance.
Manipulation of the data from the parents' scores and the nurses' scores to include one number on either side of the numerical score selected by the children was supportive of a relationship between the nurses and the patients with r = .48 at the p =.O1 level of significance. For the parents the correlation was r= .34 at the o = .09 level.
All the patients received pain relief medications as prescribed by their physicians. When the recommended dosage was calculated by using two references (The Harriet Lane Handbook and The Residents' Handbook for Pediatrics) the following results were found:
Although the sample of nurses was too small to be significant, a trend was noted when looking at the administration of PRN medication by the nursing staff. If given a range of dosages of medications (Demeral 20-35mg IM or IV, Tylenol c codeine 5-10cc PO) was allowed by the physician's orders, the nurses in each case gave the pediatric patient the higher dose of the PO medication (if giving a PO) and the lower dose of the IM or IV medication (if giving an IM or IV).
While the Pearson correlation coefficients were not statistically significant between the nurses and the patients or between the parents and the patients, (using raw scores) there was a strong correlation between the nurses and the parents. This could possibly be due to adult experience with pain, the ability of adults to more clearly differentiate pain from other feelings common to hospital patients (fear, anger, loss of control, separation anxiety), or the fact that the adults who participated in the study were not in a potentially painful situation as the children were during the course of their hospitalization.
Larger sample
Compare "experienced" hospital patients with "inexperienced"
Specifically classify and compare types of surgical procedures
March 15, 2002
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