The Prevalence of Pain in Pediatric Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome as Reported by Participants in the Pediatric Late Outcomes Study (PACTG 219)

Gaughan, Denise M.; Hughes, Michael D.; Seage, George R.; Selwyn, Peter A.; Carey, Vincent J.; Gortmaker, Steven L.; Oleske, James M.

doi:10.1542/peds.109.6.1144

Cited by 39 publications

(23 citation statements)

References 40 publications

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“…In light of the metabolic complications of antiretroviral therapy, which include lipodystrophy, dyslipidemia, and osteonecrosis, it will be important to monitor the long-term effects of therapy. Gaughan et al 20 noted that, whereas painful diagnoses decreased from 1995 to 1999 among children with HIV infection, the prevalence of caregiver-reported pain remained constant at ϳ20%. Pain was associated with a number of factors, including age and gender.…”

Section: Discussionmentioning

confidence: 99%

“…15,20 This study used the GHAC for children 5 to 11 years of age and the version for children Ն12 years of age to examine QOL in the domains of health perceptions, physical functioning, psychologic functioning, social/school functioning, and HIV symptoms. In the health perceptions domain, caregivers rate the child's health in the past 3 months on a 10-point scale, from the very worst he/she ever felt to the very best he/she ever felt, in each of 4 areas, ie, overall, physically, emotionally, and schoolwork (age 5-11 years) or daily activities/schoolwork/job/housework (age Ն12 years).…”

Section: E174mentioning

confidence: 99%

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Protease Inhibitor Combination Therapy, Severity of Illness, and Quality of Life Among Children With Perinatally Acquired HIV-1 Infection

Storm¹,

Boland²,

Gortmaker

et al. 2005

Pediatrics

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ABSTRACT.Objectives. This study examines quality of life (QOL) among school-aged children with perinatally acquired HIV infection and compares QOL outcomes between treatment groups that differ according to the use of protease inhibitor (PI) combination therapy (PI therapy). To gain insights into how PI therapy might influence QOL, associations between severity of illness and QOL were also investigated.Methods. Cross-sectional data for 940 children, 5 to 18 years of age, who were enrolled in Pediatric AIDS Clinical Trials Group Late Outcomes Protocol 219 were used to examine domains of caregiver-reported QOL, as assessed with the General Health Assessment for Children, during 1999. The General Health Assessment for Children is an age-specific, modular, QOL assessment that was developed for the study with previously validated measures. QOL differences between treatment groups were estimated with linear and logistic regressions that controlled for sociodemographic characteristics (age, gender, race/ethnicity, maternal/caregiver education, and respondent) and severity-of-illness indicators related to receipt of PI therapy (AIDS status, log 10 CD4 ؉ cell counts, and height-for-age z scores).Results. The mean age of participants was 9.7 years. Most children were non-Hispanic black (54%) or Hispanic (31%), and 49% of the participants were female. At the 1999 study visit, ϳ14% of children had severe immune suppression (<15% CD4 ؉ cells), whereas 62% of children had >25% CD4 ؉ cells, ie, no immune suppression. Participants did exhibit some lag in growth, with mean height and weight z scores of ؊0.70 and ؊0.20, respectively. Twenty-eight percent of the children were reported to have met criteria for AIDS at study entry (1993)(1994)(1995)(1996)(1997)(1998)(1999). When treatment groups were compared, children receiving PI therapy (72%) were older, had lower CD4 ؉ cell percentages, and had lower height and weight z scores than did those receiving non-PI therapies. They were also more likely to have met criteria for AIDS at study entry. The most commonly used PIs were ritonavir (46%) and nelfinavir (63%). Health perceptions ratings for most children were at the upper end of the scale, whereas ratings for 25% of the children ranged over the lower 70% of scale scores. Almost one half of the children had at least some limitations in physical functioning, with more frequent limitations in energydemanding activities (46%) than in basic activities of daily living (32%). The Behavior Problems Index was used to assess psychologic functioning. The mean total Behavior Problems Index score (9.34) and the proportion of children with extreme scores (23%) were consistent with values reported for chronically ill children and those at social and economic risk. One or more limitations in social/school functioning were reported for 58% of children. More than one third of the children (38%) experienced >1 physical symptoms that were at least moderately distressing. Health perceptions, physical functioning, psychologic functioning, social/school...

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Section: Discussionmentioning

confidence: 99%

Section: E174mentioning

confidence: 99%

Protease Inhibitor Combination Therapy, Severity of Illness, and Quality of Life Among Children With Perinatally Acquired HIV-1 Infection

Storm¹,

Boland²,

Gortmaker

et al. 2005

Pediatrics

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“…Poorly relieved pain has been associated with negative outcomes including delayed recovery and increased likelihood of early death in HIV infected children [3]. Despite knowledge of these consequences, inadequate pain management in hospitalized children is widely documented [4] [5] [6] and [7].…”

Section: Introductionmentioning

confidence: 99%

Nurses’ Knowledge and Attitudes towards Pain Management in Children Admitted in the Paediatric Department of Queen Elizabeth Central Hospital, Blantyre, Malawi

Kholowa¹,

Chimwaza²,

Majamanda³

et al. 2017

JBM

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Background: Inadequate pain management is a problem in hospitalized children. Objectives: To explore knowledge and attitudes of nurses in management of pain in children. Methods: A descriptive design using qualitative methods was used to conduct the study. 17 nurses with prior pain management training were interviewed using a semi-structured interview guide. Ethical approval was obtained from College of Medicine Research and Ethics Committee. Data were analysed using thematic content analysis. Results: Nurses had some knowledge of pain assessment methods, treatment and use of morphine. Gaps, however, existed on how to use pain assessment scales, analgesics to use at each step of the WHO analgesic ladder, and how to effectively use morphine for pain relief. Although most nurses had positive attitudes towards children's pain and use of morphine, negative attitudes were evident in some nurses regarding administration of morphine to neonates or acutely ill children. Conclusion and Implications: The study has revealed knowledge and attitude gaps which may reflect deficiencies in the pain education nurses received, non-availability of pain scales and lack of support for nurses to link theory with practice. Nurse leaders are challenged to provide repeated comprehensive education for nurses on pain assessment and management. Furthermore, user friendly pain scales should be developed, and nurses educated and demonstrated on their use. In addition, opportunities for supportive supervision with nurses in the clinical setting should be created for linkage of theory and practice.

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“…Em 1995, 35 de nossos pacientes morreram após uma infância marcada por dor e sofrimento significativos 10 . Em 2005, nenhum de nossos pacientes morreu, apesar do aumento real no número de crianças e adolescentes acompanhados no FXB.…”

Section: Observações Pessoaisunclassified

When should we treat children with HIV?

Oleske¹

2006

J Pediatr (Rio J)

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The Prevalence of Pain in Pediatric Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome as Reported by Participants in the Pediatric Late Outcomes Study (PACTG 219)

Abstract: Pain is a frequently encountered symptom in children and youth with HIV disease and is also associated with increased mortality. These findings emphasize the importance of pain management in this population.

Cited by 39 publications

References 40 publications

Protease Inhibitor Combination Therapy, Severity of Illness, and Quality of Life Among Children With Perinatally Acquired HIV-1 Infection

Protease Inhibitor Combination Therapy, Severity of Illness, and Quality of Life Among Children With Perinatally Acquired HIV-1 Infection

Nurses’ Knowledge and Attitudes towards Pain Management in Children Admitted in the Paediatric Department of Queen Elizabeth Central Hospital, Blantyre, Malawi

When should we treat children with HIV?

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