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Pain assessment in children

Pain assessment in children
Pain assessment in children
The challenges of pain assessment in infants, children and young people are well recognised. As pain is known to be a complex and subjective phenomenon that is influenced by many factors, it is clear that both the intensity and unpleasantness or suffering due to pain can only be expressed accurately by the individual who experiences it. Therefore, self-report of pain is, and is likely to always remain, the ‘gold standard’ of assessment. Nevertheless, as self-report of pain is impractical in many clinical situations, a number of proxy measures of pain, including facial expressions, behaviours and ‘biomarkers’, i.e. changes in physiological or biological parameters, have been investigated and incorporated, where appropriate, into clinical practice. To date, no measure has emerged as superior to others in all situations and consequently they are often combined or included in composite pain measurement scales that require validation for particular groups of patients in specific clinical circumstances.

Biomarkers, such as heart rate, skin conductance, plasma levels of cortisol and stress hormones, inflammatory and genetic markers and neuroimaging have the advantage that they are relatively easy to measure and generally respond rapidly and in conjunction with the autonomic arousal that occurs in response to certain types of pain. Although they tend to broadly correlate with each other and with other pain measures including behaviours and self-reported pain, their clinical usefulness has generally been limited by their lack of specificity, low to moderate sensitivity, and tendency to ‘habituate’ over time due to homeostatic mechanisms.
0003-9888
1123-1124
Howard, R.
a9c7f87f-c5d4-4b32-a86a-a3264a516abe
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558
Howard, R.
a9c7f87f-c5d4-4b32-a86a-a3264a516abe
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558

Howard, R. and Liossi, Christina (2014) Pain assessment in children. Archives of Disease in Childhood, 99, 1123-1124. (doi:10.1136/archdischild-2014-306432).

Record type: Article

Abstract

The challenges of pain assessment in infants, children and young people are well recognised. As pain is known to be a complex and subjective phenomenon that is influenced by many factors, it is clear that both the intensity and unpleasantness or suffering due to pain can only be expressed accurately by the individual who experiences it. Therefore, self-report of pain is, and is likely to always remain, the ‘gold standard’ of assessment. Nevertheless, as self-report of pain is impractical in many clinical situations, a number of proxy measures of pain, including facial expressions, behaviours and ‘biomarkers’, i.e. changes in physiological or biological parameters, have been investigated and incorporated, where appropriate, into clinical practice. To date, no measure has emerged as superior to others in all situations and consequently they are often combined or included in composite pain measurement scales that require validation for particular groups of patients in specific clinical circumstances.

Biomarkers, such as heart rate, skin conductance, plasma levels of cortisol and stress hormones, inflammatory and genetic markers and neuroimaging have the advantage that they are relatively easy to measure and generally respond rapidly and in conjunction with the autonomic arousal that occurs in response to certain types of pain. Although they tend to broadly correlate with each other and with other pain measures including behaviours and self-reported pain, their clinical usefulness has generally been limited by their lack of specificity, low to moderate sensitivity, and tendency to ‘habituate’ over time due to homeostatic mechanisms.

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More information

e-pub ahead of print date: 8 September 2014
Published date: December 2014
Organisations: Psychology

Identifiers

Local EPrints ID: 372033
URI: https://eprints.soton.ac.uk/id/eprint/372033
ISSN: 0003-9888
PURE UUID: 7d37e6a3-5c8e-4efa-b807-38a029f7f27d
ORCID for Christina Liossi: ORCID iD orcid.org/0000-0003-0627-6377

Catalogue record

Date deposited: 26 Nov 2014 12:44
Last modified: 15 Aug 2019 00:43

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