Pain in pediatric oncology: do the experiences of children and parents differ from those of nurses and physicians?
Diagnosis and treatment of pain are central components in the care of children with cancer. The aim of the present study was to compare the viewpoints of children and parents with those of professionals, on different aspects of pain in children with cancer. Information was collected through questionnaires and interviews. In particular, we focused on the extent and causes of pain, strategies to reduce procedural pain, pain evaluation, and attitudes to pain treatment. We found that both families and professionals shared the opinion that pain was a common symptom during different phases of cancer treatment but, surprisingly, professionals regarded it as more frequent than families. The groups agreed that treatment related pain is the most critical problem, followed by procedure and cancer related pain. Concerning strategies to decrease procedural pain, there was a high concordance in views between groups. Nurses and physicians more often claimed that failing pain treatment was associated with psychological factors such as high levels of anxiety in parents and children, loneliness, and lack of preparation. The self-report, according to both parents and professionals, is a feasible procedure even in young children from 4 years of age. Both groups asserted that parents were better in ascertaining the extent of their child's pain. In conclusion, although the families and professionals in this study have many comparable views concerning pain in children with cancer, divergences also exist. To acquire a more accurate picture of the situation we must focus on the views of the children first, and then those of parents and professionals. A tendency to overestimate the problems was observed in professionals. Hopefully this reflects a keen awareness of the current situation.
Department of Women's and Children's Health, Children's University Hospital, Uppsala, Sweden. gustaf.ljungman@kbh.uu.se
Gustaf
G
Ljungman
Anders
A
Kreuger
Torsten
T
Gordh
Stefan
S
Sörensen
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002648:Child; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D009726:Nurses / Q000523:psychology; D010146:Pain / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D010147:Pain Measurement; D010290:Parents / Q000523:psychology*; D010820:Physicians / Q000523:psychology