Pain assessment in the paediatric Emergency Department: whose view counts?
OBJECTIVE
To compare patient, guardian and professional assessment of acute pain in children presenting to an Emergency Department, and to examine whether there was a correlation between the scores obtained using the Faces and linear scales for each group.


METHODS
A prospective, observational cohort study of 73 children aged 4-14 years attending a paediatric hospital Emergency Department between March and April 2002 with pain caused by an acute injury. The child's pain on admission, as estimated by the child, their guardian and a healthcare professional (nurse/doctor/emergency nurse practitioner) was recorded using a Faces scale and a linear scale.


RESULTS
Professionals consistently score pain lower [median linear scale score 3.1; interquartile range (IQR) 1.6-5.3] than do patients (6.6; 4.9-7.4) or guardians (6.0; 3.9-7.1) using both linear and Faces scales. There is a significant correlation between pain scores obtained using the two scales for professionals [Spearman R value 0.88; 95% confidence interval (CI) 0.82-0.93], guardians (0.83; 0.74-0.89) and patients (0.42; 0.21-0.59).


CONCLUSIONS
Professionals score pain lower than do children or guardians. Similar pain scores are obtained using both a Faces and a linear scale. This study offers no support for the introduction of a uniform pain assessment tool in a paediatric Emergency Department setting.
Maciocia
Paul M
PM
The Faculty of Medicine, University of Edinburgh, Edinburgh, UK.
Strachan
Elizabeth M
EM
Akram
Ahsan R
AR
Hendrie
Rachel E
RE
Kelly
Diane N
DN
Kemp
Alison
A
McLuckie
Alison M
AM
Smith
Laura M
LM
Beattie
Thomas F
TF
D000208:Acute Disease; D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D012044:Regression Analysis; D012606:Scotland