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A Survey of Caregiver Perspectives on Children’s Pain Management in the Emergency Department

  • Samina Ali (a1) (a2), Laura E. Weingarten (a3), Janeva Kircher (a4), Kathryn Dong (a4), Amy L. Drendel (a5), Rhonda J. Rosychuk (a1) (a2), Sarah Curtis (a1) (a2) (a4) and Amanda S. Newton (a1) (a2)...

Abstract

Objectives

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.

Objectifs

L’étude a porté sur le point de vue des aidants quant à la prise en charge de la douleur chez les enfants dans un service des urgences pédiatriques (SUP) et dans un service des urgences générales (SUG). L’étude visait à: 1) mesurer l’intensité de la douleur chez les enfants, estimée par les aidants ainsi que le traitement appliqué; 2) déterminer le degré de satisfaction des aidants; et 3) déterminer les facteurs associés à la satisfaction des aidants.

Méthode

Il s’agit d’une enquête prospective, menée dans un échantillon de commodité de 97 aidants (SUP: n=51; SUG: n=46) qui accompagnaient des enfants de moins de 17 ans. Des questionnaires d’enquête sur papier ont été distribués par des assistants de recherche, de 2009 à 2011.

Résultats

La plupart des aidants étaient des femmes (n=77; 79 %) et, bien souvent, la mère des enfants (n=69; 71 %). Les enfants étaient traités surtout pour des douleurs musculosquelettiques (n=41; 42 %), des céphalées (n=16; 16 %) et des douleurs abdominales (n=7; 7 %). Le score maximal moyen, indiqué sur une échelle visuelle analogue de 100 mm s’élevait à 75 mm (IC à 95 %: 70-80) et le score moyen au moment du congé était de 39 mm (IC à 95 %: 32-46). Quatre-vingt-dix pour cent des aidants qui ont répondu à l’enquête se sont dits satisfaits (n=80/89; 90 %); 3 (n=3/50; 6 %) au SUP et 6 (n=6/39; 15 %) au SUG ne l’étaient pas. Les aidants qui ont indiqué que la douleur était forte au moment du congé du SU étaient moins susceptibles d’être satisfaits que ceux qui ont indiqué que la douleur était légère ou modérée (p=0,034).

Conclusions

Malgré la présence d’une douleur persistante au moment du congé, la plupart des aidants se sont déclarés satisfaits de la prise en charge de la douleur chez les enfants. Le degré de satisfaction des aidants est sans doute plurifactoriel, et les médecins devraient veiller à ne pas interpréter la satisfaction des aidants comme l’expression d’une analgésie suffisante. La relation entre la satisfaction et la douleur mérite d’être approfondie.

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Copyright

Corresponding author

Correspondence to: Samina Ali, Department of Pediatrics and Emergency Medicine, Edmonton Clinic Health Academy, 11405 – 87 Avenue, Edmonton, AB, T6G 1C9; Email: sali@ualberta.ca

References

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