Ratings of Pain From Postoperative Children and Their Nurses

Abstract

Concern has been expressed by many health professionals regarding the short- and long-term effects of unrelieved acute pain experienced by children following surgical procedures. Stoddard (1982) suggested that failure to cope with acute or chronic pain may shape a child's ego development, self-esteem and personal relationships. Some researchers have suggested that the reason for the occurrence of unrelieved postoperative pain in children may be that nurses are not able to assess the pain that children experience accurately. Nurses may be relying on assumptions and intuitions as the basis for their pain assessments (Beyer & Byers, 1985). It seemed possible that disparity between nurses' assessments of the intensity of pain experienced by children and the children's reports of their own pain intensity may account for unnecessary pain in the postoperative period. This study was designed to determine if such disparity existed, and in addition, what factors are taken into consideration in the nursing assessment and management of children's pain. Literature Review Recent research studies support the premise that children do experience unnecessary pain in the postoperative period (Lukens, 1982; Mather & Mackie, 1983). It has been reported that children have been given fewer analgesic medications when compared to adults who have undergone similar surgical procedures (Beyer, DeGood, Ashley & Russell, 1983; Eland & Anderson, 1977). One study that examined the relationship between children's reported pain and nurses' assessment of that pain showed no significant correlation between nurses' and children's reports of pain (Lukens, 1982). Over half of the nurses (53.8%) assessed the children as having less pain than the children themselves indicated, when using a pain rating instrument based on colour. Luken's (1982) study supported the idea that