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

Abstract

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.