title: Accuracy of parental-global-impression of children's acute pain.
abstract: The primary purpose of this study is to compare parental-global-impression of children's level of acute pain at home with parental assessment of children's pain using a structured instrument and with children's self-reports of pain. We recruited 32 parents of children aged 5 to 10 years who were diagnosed with a fractured limb and treated in a tertiary emergency department. After discharge, parents were asked to complete three home-based assessments relating to their child's acute pain: the parental-global-impression of pain, child's reported pain, and structured Parental Postoperative Pain Measure. Data analysis included odds ratios, sensitivity, specificity, positive and negative predictive values, and repeated-measures analysis of variance. When compared with child report of pain, the sensitivity of parental-global-impression was 76% on day 1 and 93% on day 2, whereas specificity was 91% on day 1 and 83% on day 2. When compared with child report of pain, the sensitivity of Parental Postoperative Pain Measure was 71% on day 1 and 66% on day 2, whereas specificity was 82% on day 1 and 83% on day 2. On the basis of acceptable statistical criteria, parental-global-impression has good sensitivity and specificity compared with the child self-report measure. We do not suggest, however, that parental-global-impression can or should replace child report, but rather suggest that it can be used as an adjunct assessment measure as needed.
authors.affiliation: Yale University School of Nursing, New Haven, CT, USA. rachelzisk@yahoo.com
authors.forename: Rachel Yaffa
authors.initials: RY
authors.lastname: Zisk
authors.forename: Margaret
authors.initials: M
authors.lastname: Grey
authors.forename: Barbara
authors.initials: B
authors.lastname: Medoff-Cooper
authors.forename: Zeev N
authors.initials: ZN
authors.lastname: Kain
mesh_terms: D000208:Acute Disease; D000328:Adult; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D016529:Emergency Nursing / Q000379:methods*; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D009730:Nursing Assessment; D010146:Pain / Q000175:diagnosis* / Q000451:nursing*; D010147:Pain Measurement / Q000379:methods / Q000592:standards*; D010287:Parent-Child Relations; D010290:Parents; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity