title: Pain management at home in children with cancer: a daily diary study.
abstract: BACKGROUND
  With the transition of care of cancer patients from the hospital to the home setting, parents are largely responsible for children's pain management. Children's cancer pain is undermanaged, yet, there is little empirical data on the occurrence and management of cancer pain in the home setting. The purpose of the present study, therefore, was to employ a daily diary protocol to examine barriers to pain management of children's cancer pain by parents at home.
  
  
  METHODS
  Parent-child dyads were recruited from the Cancer Institute at a major children's hospital in Southern California. A total of 45 patient/parent pairs completed baseline data on demographic and personality characteristics, children's quality of life, and parental beliefs regarding analgesic use for children and then completed daily diaries of pain and analgesic administration for 14 consecutive days.
  
  
  RESULTS
  Most children were reported to experience chronic pain while undergoing treatment for cancer, yet overall analgesic administration at home was low. Parents who reported misconceptions regarding analgesic use for children were less likely to administer pain medication to children. Children who were less shy, more social, or had lower quality of life were more likely to receive analgesics.
  
  
  CONCLUSIONS
  A significant proportion of children receiving outpatient treatment for cancer were rated as experiencing chronic pain and pain was not optimally managed in the home setting. Further understanding and addressing barriers to children's cancer pain management in the home setting will aid in alleviating unnecessary pain in this vulnerable patient population.
authors.affiliation: Department of Anesthesiology & Perioperative Care, University of California-Irvine, Orange, California; Department of Pediatric Psychology, CHOC Children's Hospital, Orange, California.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Fortier
authors.forename: Aditi
authors.initials: A
authors.lastname: Wahi
authors.forename: Colette
authors.initials: C
authors.lastname: Bruce
authors.forename: Eva L
authors.initials: EL
authors.lastname: Maurer
authors.forename: Robert
authors.initials: R
authors.lastname: Stevenson
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety; D002140:California; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D059350:Chronic Pain / Q000188:drug therapy* / Q000523:psychology; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006701:Home Nursing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008499:Medical Records; D009369:Neoplasms / Q000503:physiopathology* / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D010290:Parents / Q000523:psychology; D010361:Patients / Q000523:psychology; D010551:Personality; D011788:Quality of Life; D012959:Socioeconomic Factors
chemical_list: D000700:Analgesics
keywords: daily diary; pain; pain at home; pain management; pediatric oncology