Children’s Pain: A Mandate for Change

Abstract

There have been tremendous research advances in the past 15 years in knowledge about children's pain, and strategies for recognizing and managing that pain. However, the clinical care of children in pain remains a challenge. Children's pain continues to be frequently unrecognized, dismissed or ineffectively managed. A loud call for change is being voiced by physicians, nurses, children and their families. A review of the literature was conducted to document this issue. Starting with a Medline search of the key word 'child* + pain' and continuing with a snowball technique, articles and resources addressing children's pain were collected. Resources presented or published after 1990 were particularly sought because they theoretically reflect both current knowledge about children's pain and the implementation of this knowledge in practice. Unfortunately, although information on pain is available to help children, in many instances, it is not being used. The purpose of the present paper is twofold - to present an overview of current knowledge of children's pain, and factors that hinder its effective assessment and management; and to present a mandate for change. Children's postoperative pain is highlighted in this paper as an example of the gap between pain knowledge and clinical practice. Although treatment strategies differ across different types of pain, children's conditions and ages, the principles and mandate for change discussed in this paper are directly relevant to all categories of children's pain.

Children's perceptions on the implementation of methods for their postoperative pain alleviation: An interview study

“…Despite the tremendous advances in researches in children's pain and pain management in past decades, the clinical care of children in pain remains a challenge 1 . Many studies revealed that children in different cultures still suffered from moderate or severe postoperative pain, 2–5 which indicates a need for more effective intervention.…”

Does Participation in a Pain Course Based on the International Association for the Study of Pain’s Curricula Guidelines Change Student Knowledge about Pain?

“…©2003 Pulsus Group Inc. All rights reserved ORIGINAL ARTICLE D espite the publication of the seminal gate control theory of pain (2) in 1965 and the escalation in pain research and knowledge since that time, the management of many people with pain by health professionals remains inadequate. Numerous surveys have found not only the continued occurrence of inadequate pain management for children, elderly persons, and people with cancer or postoperative pain (3,4), but also inadequate knowledge of pain management by various health professional groups such as nursing (5,6), occupational therapy (7-10), physiotherapy (11), pharmacy (12) and medicine (6,13,14).…”

Conscious Sedation: Off-Label Use of Rectal S(+)-Ketamine and Midazolam for Wound Dressing Changes in Paediatric Heat Injuries

“…However paediatric health care professionals have the moral obligation to sufficiently and adequately manage pain resulting from the procedures they perform. Several recent studies have documented that pain in children is still underappreciated and undertreated (6,27,29).…”