Pain Assessment in Infants and Children

Franck, Linda S.; Greenberg, Cindy Smith; Stevens, Bonnie

doi:10.1016/s0031-3955(05)70222-4

Cited by 323 publications

(226 citation statements)

References 91 publications

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“…The pain-assessment tool used should be multidimensional, including measurements for both physiologic and behavioral indicators of pain, because neonates cannot self-report. [25][26][27][28][29] Physiologic indicators of pain include changes in heart rate, respiratory rate, blood pressure, oxygen saturation, vagal tone, palmar sweating, and plasma cortisol or catecholamine concentrations. Behavioral indicators include changes in facial expressions, body movements, and crying, but these may be absent in some neonates who are neurologically impaired or pharmacologically paralyzed.…”

Section: Assessment Of Pain and Stress In The Neonatementioning

confidence: 99%

Prevention and Management of Pain in the Neonate: An Update

2006

Pediatrics

418

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The prevention of pain in neonates should be the goal of all caregivers, because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in our knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor yet painful procedures. Every health care facility caring for neonates should implement an effective pain-prevention program, which includes strategies for routinely assessing pain, minimizing the number of painful procedures performed, effectively using pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and eliminating pain associated with surgery and other major procedures. INTRODUCTION ObjectivesThis updated statement is intended for health care professionals who care for neonates (preterm to 1 month of age). The objectives are to:1. emphasize that despite increased awareness of the importance of pain prevention, neonates in the NICU continue to be exposed to numerous painful minor procedures daily as part of their routine care;2. present objective means of assessing neonatal pain by health care professionals;3. describe effective strategies to prevent and treat pain associated with routine minor procedures; and 4. review appropriate methods to prevent and treat pain associated with surgery and other major procedures. BackgroundThe prevention of pain in neonates is an expectation of parents. 1 However, there are major gaps in our knowledge regarding the most effective way to accomplish this. Although it may not be possible to completely eliminate pain in neonates, much can be done to reduce the amount and intensity of pain. The prevention of www.pediatrics.org/cgi

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Section: Assessment Of Pain and Stress In The Neonatementioning

confidence: 99%

Prevention and Management of Pain in the Neonate: An Update

2006

Pediatrics

418

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“…27,[29][30][31]36 Authors of these reviews suggest further research is needed for applicability of findings to meet the needs of children with cognitive impairments and physical disabilities. 35,92 Against these reviews, we sought to address this gap by systematically reviewing and critiquing pediatric assessment tools to be used to evaluate chronic pain interference in children with CP across a broad range of physical and developmental function.…”

Section: Discussionmentioning

confidence: 99%

“…[26][27][28][29][30] However, the heterogeneity of physical and cognitive impairments associated with CP makes it difficult to assess chronic pain using a single standardized tool. [26][27][28][29][30][31][32] Further, barriers to assessment stem from a lack of awareness among health professionals of psychometrically sound tools and/or a lack of standardization within organizations for routine chronic pain assessment. [32][33][34] Although previous reviews have identified measures to inform clinical practice, the application to children with disabilities is lacking.…”

mentioning

confidence: 99%

“…[32][33][34] Although previous reviews have identified measures to inform clinical practice, the application to children with disabilities is lacking. [27][28][29][30][31]35,36 Therefore, the primary aim of this review was to identify, describe, and critique pediatric chronic pain assessment tools currently available and make recommendations for clinical use for children with CP. To address the gap between research and practice, a secondary aim was to select relevant assessment tools for inclusion in a clinical practice toolbox to support health care professionals in their efforts to accurately identify and assess chronic pain in children with physical disabilities.…”

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confidence: 99%

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Chronic Pain Assessment Tools for Cerebral Palsy: A Systematic Review

et al. 2015

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BACKGROUND AND OBJECTIVE: Chronic pain in children with cerebral palsy (CP) is underrecognized, leading to detriments in their physical, social, and mental well-being. Our objective was to identify, describe, and critique pediatric chronic pain assessment tools and make recommendations for clinical use for children with CP. Secondly, develop an evidenceinformed toolbox to support clinicians in the assessment of chronic pain in children with disabilities.

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“…Nurses must understand that children of primary school age communicate pain in concrete terms (24) , like Barney and Valéria. These children understand the concepts of order and sorting, and are generally able to describe in detail the intensity, location and quality of pain (24) .…”

Section: Discussionmentioning

confidence: 99%

Living with pain: the experience of children and adolescents in palliative care

Borghi

Rossato

Damião

et al. 2014

Rev. esc. enferm. USP

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El estudio tuvo como objetivo conocer la experiencia de niños y adolescentes en cuidados paliativos en el manejo diario del dolor. La investigación cualitativa fue realizada con entrevistas semi-estructuradas con seis niños entre siete y 17 años. La teoría del Desarrollo cognitivo de Piaget fue utilizada como Marco teórico y la Historia Oral como Referencial Metodológico. Cuatro temas fueron encontrados: describiendo el dolor; buscando una vida más próxima de la normalidad, a pesar del dolor y la enfermedad; utilizando varias alternativas para el control del dolor y viviendo la autoimagen perjudicada. A pesar del dolor ser un agente limitante en la vida de los niños y adolescentes, verificamos que enfrentaban el dolor diariamente y, que así mismo, tenían vida además del dolor y la enfermedad. Adicionamos, aun, la importancia de los enfermeros comprender que el eficaz manejo del dolor es esencial para una vida mas próxima de la normalidad, reduciendo su sufrimiento. DESCRIPTORES ABSTRACTA qualitative study was conducted with semi-structured interviews with the aim of understanding the experience of children and adolescents under palliative care when managing pain daily and how they describe the intensity, quality and location of pain. We used Piaget's theory of cognitive development as a theoretical framework and oral history as a methodological framework. We found four themes: describing pain; seeking a life closer to normality, despite pain and disease; using a variety of alternatives for pain control; and living with damaged physical appearance. Although pain is a limiting factor in the lives of children and adolescents, we found that they faced their daily pain and still had a life beyond pain and illness. In addition, we highlight the relevance of nurses' understanding that effective management of pain in children is essential for a normal life and less suffering.

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Pain Assessment in Infants and Children

Cited by 323 publications

References 91 publications

Prevention and Management of Pain in the Neonate: An Update

Prevention and Management of Pain in the Neonate: An Update

Chronic Pain Assessment Tools for Cerebral Palsy: A Systematic Review

Living with pain: the experience of children and adolescents in palliative care

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