Pain assessment in children

Brand, Katherine; Al-Rais, Andrew

doi:10.1016/j.mpaic.2019.03.003

Cited by 25 publications

(12 citation statements)

References 3 publications

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“…This scale was chosen as it is commonly used to clinically assess pain in the US health care setting and by pain researchers, so we felt subjects would be familiar with and more comfortable answering questions using this scale. It has also been shown to be a quick and appropriate measure for children in this age range [ 29 , 30 ]. Patients in the VR group were also asked to rate their happiness, fun, engagement, and realism of the game on a NRS of 0–10 (higher score means more helpful).…”

Section: Methodsmentioning

confidence: 99%

Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial

Armstrong

Lun

Groner

et al. 2022

Pilot Feasibility Stud

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Background Virtual reality (VR) gaming is considered a safe and effective alternative to standard pain alleviation in the hospital. This study addressed the potential effectiveness and feasibility of a VR game that was developed by our research team for repeated at-home burn dressing changes. Methods A randomized clinical trial was conducted among patients recruited from the outpatient burn clinic of a large American Burn Association–verified pediatric burn center between September 2019 and June 2021. We included English-speaking burn patients aged 5–17 years old requiring daily dressing changes for at least 1 week after first outpatient dressing change. One group played an interactive VR game during dressing changes, while the other utilized standard distraction techniques available in the home for up to a week. Both child and caretaker were asked to assess perceived pain on a numerical rating scale (NRS) of 0–10. For the VR group, patients were also asked to rate various aspects of the VR game on a NRS of 0–10 and caregivers were asked questions assessing ease of use. Results A total of 35 children were recruited for this study with 24 fully completing study measures. The majority of participants were male (n=19, 54.3%), White (n=29, 82.9%), and with second degree burns (n=32, 91.4%). Children and caregivers in the VR group reported less pain than the control group at the 4th dressing change. Participants in the VR group showed a clinically meaningful (≥30%) reduction in child-reported overall pain (33.3%) and caregiver-reported worst pain (31.6%) in comparison with subjects in the control group. Children’s satisfaction with the VR remained at a high level across dressing changes over the 1-week period, with reported realism and engagement increasing over time. Over half of the children (54.5%) enjoyed playing the game and did not report any challenges nor any side effects. Conclusions Subjects found the VR to be a useful distraction during home dressing changes and reported no challenges/side effects. VR should be considered as a nonpharmacologic companion for pain management during at-home burn dressing changes. Trial registration ClinicalTrials.gov Identifier: NCT04548635. Registered September 14, 2020—retrospectively registered

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Section: Methodsmentioning

confidence: 99%

Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial

Armstrong

Lun

Groner

et al. 2022

Pilot Feasibility Stud

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“…Evaluar el dolor en los niños con el propósito de reconocerlo y brindar un abordaje clínico es de gran importancia desde cualquier punto de vista, son conocidos los efectos adversos tanto psicológicos como fisiológicos que puede generar el dolor durante la fase aguda en los pacientes 11 . En relación con lo anterior, en el presente estudio el 78,1% de los pacientes y/o acudientes manifestaron que algún miembro del personal asistencial había indagado sobre dolor en el paciente en las 24 h previas y el 71,1% de los pacientes tenían registro sobre la presencia o no de dolor en ese mismo periodo de tiempo, si bien documentar la valoración del dolor no es obligatorio, hace parte del formato de historia clínica de la institución.…”

Section: Discussionunclassified

“…En el ámbito hospitalario, los pacientes pueden presentar padecimientos dolorosos o ser sometidos a procedimientos que generan dolor. Por lo que es común, que los clínicos se enfrenten de forma cotidiana a pacientes que requieren su manejo; en especial en pediatría, donde el dolor no tratado puede tener efectos fisiológicos adversos 11 , retrasar la recuperación e impactar negativamente tanto a corto como a largo plazo en la salud física y emocional de los pacientes, hasta el punto de modificar la forma en la que el sistema nervioso del niño percibirá el dolor en el futuro 12,13 . A su vez, diferentes consensos han llegado a la conclusión que aspectos como la variabilidad clínica y cognitiva deben entrar a ser considerados e instaurar estos tratamientos con la mínima demora posible, adaptándolos a las características individuales de cada paciente 14,15 .…”

Section: Introductionunclassified

Dolor en pacientes pediátricos hospitalizados en una institución de salud de tercer nivel

Zúñiga-Espitia

2021

Andes pediatr

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En el ámbito hospitalario, los pacientes pediátricos pueden presentar cuadros clínicos dolorosos o ser sometidos a procedimientos que generan dolor, por lo tanto, reconocer su existencia y realizar un abordaje clínico de este debe ser una prioridad en los equipos de salud.Objetivo: Caracterizar el dolor y su abordaje clínico-terapéutico en pacientes hospitalizados en la sala general de una institución pediátrica de tercer nivel de atención.Pacientes y Método: Estudio de tipo observacional, transversal, realizado entre agosto y octubre de 2019. Se incluyeron 187 pacientes. Variables de estudio: sexo, motivo de hospitalización, especialidad tratante, dolor crónico, actual y en las 24 horas previas, intensidad, causa máxima de dolor, prescripción analgésica. Se utilizó en niños entre los dos meses y tres años de edad la escala FLACC (Face, Legs, Activity, Cry, Consolability), en niños entre cuatro y ocho años la escala de caras revisada y a partir de los nueve años la escala visual analógica de autoevaluación del dolor. Posterior al análisis de los datos con estadísticos descriptivos, se calcularon las diferencias entre grupos con prueba c2 para variables cualitativas, pruebas no paramétricas para comparación de grupos con variable ordinal.Resultados: el 10,7% de los pacientes presentaban dolor crónico, sin diferencias según el sexo (p = 0,713). La prevalencia de dolor al momento de la evaluación fue del 38,5%, sin diferencias según el sexo (p = 0,419). Pacientes que ingresaron por cirugía y trauma presentaron mayor prevalencia de dolor (p = 0,034) y el 53,5% de los menores tenían prescripción analgésica.Conclusión: La prevalencia del dolor en el paciente pediátrico hospitalizado es alta. Adicionalmente se reporta alto uso de analgesia no opioide y baja prescripción de analgésicos opioides en el entorno pediátrico para el manejo habitual del dolor de intensidad moderada y severa.

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“…Pain is an urgent problem for patients and can trigger complications [1][2][3][4][5]. The Joint Commission on Accreditation of Health Care Organizations advocates that pain be considered a vital sign that should be recorded and monitored [6].…”

Section: Introductionmentioning

confidence: 99%

Pain Monitoring Using Heart Rate Variability and Photoplethysmograph-Derived Parameters by Binary Logistic Regression

et al. 2021

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Purpose To construct a pain classification model using binary logistic regression to calculate pain probability and monitor pain based on heart rate variability (HRV) and photoplethysmography (PPG) parameters. Methods Heat stimulation was used to simulate pain for modeling the pain generation process, and electrocardiography and PPG signals were recorded simultaneously. After signal analysis, statistical analysis was performed using SPSS to determine the parameters that were significant for pain. Thereafter, a pain classification model with HRV and PPG parameters was established using binary logistic regression. Results The sensitivity and specificity of the pain classification model were 60.0% and 72.0%, respectively. When pain occurred, the probability calculated using the pain classification model increased from < 50% to > 50%. When the pain was relieved, the probability decreased to < 50%. The probability of pain was consistent with the numeric rating scale value, which indicated that the model can correctly determine the presence of pain. Conclusion This pain classification model has sufficient robustness and adaptability to be applied to different healthy people for classification and monitoring. This model is helpful in establishing a real-time pain monitoring system to improve pain management for patients in the postoperative intensive care unit and patient-controlled analgesia and provide a reference for doctors regarding medication.

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Pain assessment in children

Cited by 25 publications

References 3 publications

Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial

Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial

Dolor en pacientes pediátricos hospitalizados en una institución de salud de tercer nivel

Pain Monitoring Using Heart Rate Variability and Photoplethysmograph-Derived Parameters by Binary Logistic Regression

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