title: A Survey of Caregiver Perspectives on Children's Pain Management in the Emergency Department.
abstract: OBJECTIVE
  We explored caregiver perspectives on their children's pain management in both a pediatric (PED) and general emergency department (GED). Study objectives were to: (1) measure caregiver estimates of children's pain scores and treatment; (2) determine caregiver level of satisfaction; and (3) determine factors associated with caregiver satisfaction.
  
  
  METHODS
  This prospective survey examined a convenience sample of 97 caregivers (n=51 PED, n=46 GED) with children aged <17 years. A paper-based survey was distributed by research assistants, from 2009-2011.
  
  
  RESULTS
  Most caregivers were female (n=77, 79%) and were the child's mother (n=69, 71%). Children were treated primarily for musculoskeletal pain (n=41, 42%), headache (n=16, 16%) and abdominal pain (n=7, 7%). Using a 100 mm Visual Analog Scale, the maximum mean reported pain score was 75 mm (95% CI: 70-80) and mean score at discharge was 39 mm (95% CI: 32-46). Ninety percent of caregiver respondents were satisfied (80/89, 90%); three (3/50, 6%) were dissatisfied in the PED and six (6/39, 15%) in the GED. Caregivers who rated their child's pain at ED discharge as severe were less likely to be satisfied than those who rated their child's pain as mild or moderate (p=0.034).
  
  
  CONCLUSIONS
  Despite continued pain upon discharge, most caregivers report being satisfied with their child's pain management. Caregiver satisfaction is likely multifactorial, and physicians should be careful not to interpret satisfaction as equivalent to adequate provision of analgesia. The relationship between satisfaction and pain merits further exploration.
authors.affiliation: *Department of Pediatrics, Faculty of Medicine and Dentistry,University of Alberta,Edmonton,AB.
authors.forename: Samina
authors.initials: S
authors.lastname: Ali
authors.affiliation: ‡Department of Pediatrics,University of Toronto,Toronto,ON.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Weingarten
authors.affiliation: §Department of Emergency Medicine, Faculty of Medicine and Dentistry,University of Alberta,Edmonton,AB.
authors.forename: Janeva
authors.initials: J
authors.lastname: Kircher
authors.affiliation: §Department of Emergency Medicine, Faculty of Medicine and Dentistry,University of Alberta,Edmonton,AB.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dong
authors.affiliation: ¶Department of Pediatrics,Medical College of Wisconsin,Milwaukee,WI,USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Drendel
authors.affiliation: *Department of Pediatrics, Faculty of Medicine and Dentistry,University of Alberta,Edmonton,AB.
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Rosychuk
authors.affiliation: *Department of Pediatrics, Faculty of Medicine and Dentistry,University of Alberta,Edmonton,AB.
authors.forename: Sarah
authors.initials: S
authors.lastname: Curtis
authors.affiliation: *Department of Pediatrics, Faculty of Medicine and Dentistry,University of Alberta,Edmonton,AB.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Newton
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: caregiver; children; emergency; pain; parent; satisfaction