Brudvik et al

• Aims

  Explore the relationship between children's self reported pain and ratings of their pain intensity made by parent and doctors

  How age, medical condition and severity of pain affect pain intensity estimates

  Whether pain assessments affects administration of pain relief
• Methodology

  Field study conducted in Emergency Department in Norway

  Correlation used to analyse
• Sample

  243 paediatric patients

  Opportunity sampling

  51 doctors recruited as they entered the hospital department
• Procedure

  1. Doctors and parents completed a Numeric Rating Scale (NRS) where they rated child's pain 0-10. Parents answered demographic questions

  2. Doctors asked about own medical experience, specialisms and whether they were a parent themselves. Also asked whether they gave any pain relief during consultation and whether child's pain level matched diagnosis

  3. The patients that were 3-8 completed Faces Pain Scale-Revised and Wong Baker Faces Pain Rating Scale.

  4. The patients that were 9-15 completed Visual Analogue Scale with a coloured 100mm line. Green = no pain, Red = worst pain thinkable.

  5. Childs diagnosis was classified as infection, fracture, wound injury or soft tissue, ligament/muscle injury.

  6. Waiting time (from arrival to consultation) was recorded
• Results

  1. Pain ratings were highest for children reporting their own pain, then parents, then doctors

  2. Low level of aggreement between doctors and children

  3. Low level of aggreement between parents and doctors

  4. Pain intenisty was highest for fractures and disagreement between children and doctors was highest for this injury

  5. 42% of children in intense pain were given pain relief (as judged by doctors)

  6. Doctors underestimate pain of younger children more
• Conclusions

  Doctors should place a higher value on parental reports of their childrens pain.
• Strength

  Natural setting, high ecological validity
• Weakness

  Not generalisable, only looked at Norway
• Ethics

  Written consent

  Psychological harm

  Right to withdraw
• Application to Everyday Life

  Highlights importance of listening to children and parents
• Idiographic vs Nomothetic

  Idiographoc; collecting qualitative data which would allow researchers to learn about why some children expereince a higher pain than others