Pain management for children with cerebral palsy in school settings in two cultures: action and reaction approaches

Adolfsson, Margareta; Johnson, Ensa; Nilsson, Stefan

doi:10.1080/09638288.2017.1327987

Cited by 6 publications

(20 citation statements)

References 62 publications

(79 reference statements)

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“…In recent studies, professionals (teachers and therapists) working with children with CP in school settings in South Africa and Sweden were asked about the intervention strategies they used to manage the children’s recurrent pain in school settings (Adolfsson et al 2018; Johnson et al 2015; Nilsson et al 2016). The professionals in the said studies reported on a variety of intervention strategies.…”

Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

“…The professionals in the said studies reported on a variety of intervention strategies. Subsequently, action-and-reaction approaches followed by healthcare professionals during pain management were identified (Adolfsson et al 2018). Action refers to strategies professionals use to prevent pain, while reaction refers to professionals’ strategies to intervene when a child is already experiencing pain.…”

Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

“…Action refers to strategies professionals use to prevent pain, while reaction refers to professionals’ strategies to intervene when a child is already experiencing pain. A difference was noted between strategies employed by South African and Swedish professionals, as a reaction approach was more commonly used in South Africa (Adolfsson et al 2018). Reasons for this finding could be that the Swedish health professionals (who are typically consultants in school settings) had access to interventions to prevent children’s pain.…”

Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

“…These drugs are mostly used for acute pain (Wren et al 2019). In the South African schools where the study was conducted, teachers or nurses sometimes only offered children a glass of water as an alternative to pain medication (Adolfsson et al 2018; Nilsson et al 2016). Possible explanations for strategies used by South Africa professionals working in school settings are (1) legislation stipulating that only doctors can prescribe pharmacological treatment, (2) caregivers (e.g.…”

Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

“…In school settings, pain management could contribute to children with CP’s optimal learning opportunities and participation in classroom activities. This study, which is part of a larger project that aims to facilitate discussions about best practices (Adolfsson, Johnson & Nilsson 2018; Johnson, Nilsson & Adolfsson 2015; Nilsson, Johnson & Adolfsson 2016), explores how professionals working in South African schools for children with special educational needs perceive pain management intervention for children with CP, and how their ideas about interventions comply with knowledge about evidence-based interventions as reported by Novak et al (2013).…”

Section: Introductionmentioning

confidence: 99%

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How pain management for children with cerebral palsy in South African schools complies with up-to-date knowledge

2019

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BackgroundPain in children with cerebral palsy (CP) has its sources in musculoskeletal problems that can influence learning in a school setting. Best pain management is essential for these children, but school staff may not keep up to date with the latest developments and interventions. Therefore, staff’s perceptions of beneficial strategies may not comply with contemporary scientific knowledge about effective evidence-based interventions.ObjectivesThis study investigated how pain management intervention for children with CP in South African schools complied with international scientific knowledge about evidence-based interventions. The intention was to provide support for an update of knowledge on both individual level (i.e. professionals) and system level (i.e. decision makers).MethodFive focus groups were conducted with staff members at five schools for children with special educational needs in South Africa. Manifest and latent content analyses of professional statements identified interventions reported as beneficial and related them to higher and lower levels of intervention evidence as reported at the time of data collection.ResultsMost treatment strategies concerned motor functioning that fell within the framework of physiotherapists and occupational therapists. Access to orthopaedic expertise was limited, waiting times were long and medication for spasticity treatment was not offered.ConclusionA discrepancy between published evidence and clinical practice for pain management in children with CP in South African school settings was noted. Suggestions for improved early intervention to identify children’s hips at risk through surveillance programmes; and orthopaedic management are proposed to prevent deformities and unnecessary suffering in South African children with CP.

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Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

Section: Intervention Strategies In South African School Settingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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How pain management for children with cerebral palsy in South African schools complies with up-to-date knowledge

2019

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Pain is frequent in children with cerebral palsy and negatively affects physical activity and participation

et al. 2020

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Cerebral palsy (CP) is the most common motor functional disability in childhood 1,2. Studies have reported that pain is one of the most frequent problems among children with CP, and lack of acknowledgement as well as a lack of acting on the pain negatively affects their quality of life 3-6. In regard to this, pain will, as the limiting factor for children with CP, affect their quality of life by being incapable or unable to participate in physical leisure activities such as soccer, swimming, gymnastics and other social contexts. Moreover, the pain in children with CP can vary considerably both in intensity and bodily location, depending on the gross motor functioning 7. Children with more severe gross motor impairments, Gross Motor Functioning Classification System (GMFCS) levels IV-V, often depend on adult assistance, walking aids or wheelchairs 8 , thus contributing to a limited opportunity for participation 9 .

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The Children's Action‐Reaction Assessment Tool (CARAT) as an observational technique for assessing symptom management: An initial validation study with children aged 3–7 years undergoing needle procedures

Karlsson

Johnson

Nilsson

2021

Specialist Pediatric Nursing

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Purpose: For many children, needle procedures are fearful events that are often painful. The first step in symptom management is to assess the child's pain and fear, and the next step is to use coping strategies to provide symptom relief for children who experience or feel pain and fear during procedures. The Children's Action-Reaction Assessment Tool (CARAT) is built on action-reaction strategies.This study aimed to determine the inter-rater reliability of the CARAT when used during needle procedures with 3-to 7-year-old children. Design and Methods:We used a quantitative approach in which 21 children were observed by two independent observers during needle procedures to evaluate the inter-rater reliability of the CARAT. Data were analysed with descriptive statistics, and the observation scores were calculated with an intraclass correlation coefficient (ICC) test on SPSS for Windows, version 25. Results:The completed CARAT indicated the use of action-reaction strategies.Neither action nor reaction strategies were frequently used. The parents were seldom involved in the procedure. The inter-rater reliability showed a sufficient correlation between the observers.Practice Implications: This study showed promising results for the inter-rater reliability of the CARAT, which can be used to facilitate care for children. The observational tool can be used to assess the use of action-reaction strategies in conjunction with needle procedures in children aged 3-7 years. K E Y W O R D S children, needle procedure, observational tool, symptom management This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Pain management for children with cerebral palsy in school settings in two cultures: action and reaction approaches

Cited by 6 publications

References 62 publications

How pain management for children with cerebral palsy in South African schools complies with up-to-date knowledge

How pain management for children with cerebral palsy in South African schools complies with up-to-date knowledge

Pain is frequent in children with cerebral palsy and negatively affects physical activity and participation

The Children's Action‐Reaction Assessment Tool (CARAT) as an observational technique for assessing symptom management: An initial validation study with children aged 3–7 years undergoing needle procedures

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