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Pain Defined

Pain Defined. Pain is a subjective response Pain in childhood can be acute or chronic Children's pain is influenced by many factors. Scope of the Problem. Children’s pain experience Effect of pain on quality of life. Populations at risk. Chronic conditions Trauma/injury

tanya-butler
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Pain Defined

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  1. Pain Defined Pain is a subjective response Pain in childhood can be acute or chronic Children's pain is influenced by many factors

  2. Scope of the Problem Children’s pain experience Effect of pain on quality of life

  3. Populations at risk Chronic conditions Trauma/injury Neurological impairment Neonates/infants Non-English speaking Cultural, gender stereotyping

  4. Barriers to Pain Relief Healthcare professionals Healthcare system Related to parents/children

  5. Myths Related to Pain and Pain Management in Children • Respiratory depression • Addiction • Child that is sleeping/or playing does not have pain • Presence of pain indicates worsening of disease and approaching death

  6. Facts About Childhood Pain Opioid addictions are rare Repeated exposure to painful procedures leads to increased anxiety and perception of pain Studies have shown that children as young as 3 years old can use pain scales Carter et al., 2004; Goldman et al., 2006; Hockenberry & Wilson, 2006; Schecter, 2003

  7. Myths Related to Neonatal/Infant Pain • Incapable of feeling pain • Immature nervous system • Incomplete myelinization • No memory • Objective assessment impossible • Neonates cannot communicate pain • Analgesics unsafe

  8. Facts About Neonatal/Infant Pain Pain perception occurs early in life Neonates exhibit physiologic and behavioral cues

  9. Modifying Contextual Factors of Pain Expression in Infants • Behavioral state • Postnatal age • Severity of medical illness • Technician effects/procedural modifiers • Environmental stress • Sensitization after repeated stimulation • Total number of invasive procedures • Time since last painful procedure

  10. Impact of Pain • Research asked ‘What is it like to have a child with pain?’ • Unendurable • Sense of helplessness • Sense of total commitment • Unprepared/unknowledgeable • Horrible/frightening • No pain in heaven Ferrell et al., 1994a & 1994b

  11. Developmental Aspects of Pain Infants Toddlers

  12. Developmental Aspects of Pain Pre-school School age

  13. Developmental Aspects of Pain Adolescents

  14. Special Populations Injury/trauma ER PICU

  15. Special Populations Cancer pain Chronic non-malignant pain

  16. Special Populations • Sickle cell • Numerous complications of SCD result in pain • Vaso-occlusive crisis, priapism, dactylitis, splenic sequestration, spinal cord compression and avascular necrosis of joints

  17. Special Populations Pancreatitis Musculoskeletal/rheumatic Juvenile Primary Fibromyalgia Juvenile Idiopathic Arthritis Complex Regional Pain Syndrome

  18. Special Populations • Neurocognitive impairment • Pain experience • Pain indicators • Effect of uncontrolled pain • Assessment • Knowing child • Recognizing patterns • Intersubjective process with HCP

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