Pain assessment and treatment in children with cognitive impairment: A survey of nurses' and physicians' beliefs

Debra Fanurik, Jeffrey Koh, Michael L. Schmitz, R. Dale Harrison, Paula K. Roberson, Pamela Killebrew

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: To gather information about healthcare providers' beliefs regarding pain and its treatment in children with cognitive impairment. Design: A survey consisting of two acute pain vignettes (a child undergoing surgery and a child undergoing an outpatient medical procedure) was completed by 440 nurses and 146 physicians at Arkansas Children's Hospital. Respondents completed one of four different surveys that systematically varied the child's level of cognitive impairment (none, mild, moderate, severe) in both vignettes. Questions addressed expected pain, pain assessment methods, pharmacologic regimens, and nonpharmacologic interventions. Results: In general, provider discipline and level of cognitive impairment did not significantly influence responses about pain experience and treatment. Potent analgesia, regularly scheduled dosing, and nonpainful administration were selected most frequently. Self-report of pain, patient-controlled analgesia, and behavioral interventions requiring higher cognitive skills were selected less frequently for children with more severe cognitive impairment. Conclusions: The presence of cognitive impairment appeared to influence provider decisions regarding the appropriateness of specific pain assessment and treatment methods requiring skills on the part of the child. Overall, healthcare provider views regarding analgesia and sedation were similar for all children, regardless of impairment. Whether these beliefs are consistent with clinical practice is yet to be documented.

Original languageEnglish (US)
Pages (from-to)304-312
Number of pages9
JournalClinical Journal of Pain
Volume15
Issue number4
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Pain Measurement
Nurses
Physicians
Pain
Therapeutics
Health Personnel
Analgesia
Patient-Controlled Analgesia
Surveys and Questionnaires
Cognitive Dysfunction
Acute Pain
Self Report
Outpatients

Keywords

  • Children
  • Cognitive impairment
  • Developmental delay
  • Postoperative pain
  • Procedural pain
  • Survey

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Pain assessment and treatment in children with cognitive impairment : A survey of nurses' and physicians' beliefs. / Fanurik, Debra; Koh, Jeffrey; Schmitz, Michael L.; Harrison, R. Dale; Roberson, Paula K.; Killebrew, Pamela.

In: Clinical Journal of Pain, Vol. 15, No. 4, 1999, p. 304-312.

Research output: Contribution to journalArticle

Fanurik, Debra ; Koh, Jeffrey ; Schmitz, Michael L. ; Harrison, R. Dale ; Roberson, Paula K. ; Killebrew, Pamela. / Pain assessment and treatment in children with cognitive impairment : A survey of nurses' and physicians' beliefs. In: Clinical Journal of Pain. 1999 ; Vol. 15, No. 4. pp. 304-312.
@article{887f783172e1438994d3b034c6e6e47c,
title = "Pain assessment and treatment in children with cognitive impairment: A survey of nurses' and physicians' beliefs",
abstract = "Objective: To gather information about healthcare providers' beliefs regarding pain and its treatment in children with cognitive impairment. Design: A survey consisting of two acute pain vignettes (a child undergoing surgery and a child undergoing an outpatient medical procedure) was completed by 440 nurses and 146 physicians at Arkansas Children's Hospital. Respondents completed one of four different surveys that systematically varied the child's level of cognitive impairment (none, mild, moderate, severe) in both vignettes. Questions addressed expected pain, pain assessment methods, pharmacologic regimens, and nonpharmacologic interventions. Results: In general, provider discipline and level of cognitive impairment did not significantly influence responses about pain experience and treatment. Potent analgesia, regularly scheduled dosing, and nonpainful administration were selected most frequently. Self-report of pain, patient-controlled analgesia, and behavioral interventions requiring higher cognitive skills were selected less frequently for children with more severe cognitive impairment. Conclusions: The presence of cognitive impairment appeared to influence provider decisions regarding the appropriateness of specific pain assessment and treatment methods requiring skills on the part of the child. Overall, healthcare provider views regarding analgesia and sedation were similar for all children, regardless of impairment. Whether these beliefs are consistent with clinical practice is yet to be documented.",
keywords = "Children, Cognitive impairment, Developmental delay, Postoperative pain, Procedural pain, Survey",
author = "Debra Fanurik and Jeffrey Koh and Schmitz, {Michael L.} and Harrison, {R. Dale} and Roberson, {Paula K.} and Pamela Killebrew",
year = "1999",
doi = "10.1097/00002508-199912000-00007",
language = "English (US)",
volume = "15",
pages = "304--312",
journal = "Clinical Journal of Pain",
issn = "0749-8047",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Pain assessment and treatment in children with cognitive impairment

T2 - A survey of nurses' and physicians' beliefs

AU - Fanurik, Debra

AU - Koh, Jeffrey

AU - Schmitz, Michael L.

AU - Harrison, R. Dale

AU - Roberson, Paula K.

AU - Killebrew, Pamela

PY - 1999

Y1 - 1999

N2 - Objective: To gather information about healthcare providers' beliefs regarding pain and its treatment in children with cognitive impairment. Design: A survey consisting of two acute pain vignettes (a child undergoing surgery and a child undergoing an outpatient medical procedure) was completed by 440 nurses and 146 physicians at Arkansas Children's Hospital. Respondents completed one of four different surveys that systematically varied the child's level of cognitive impairment (none, mild, moderate, severe) in both vignettes. Questions addressed expected pain, pain assessment methods, pharmacologic regimens, and nonpharmacologic interventions. Results: In general, provider discipline and level of cognitive impairment did not significantly influence responses about pain experience and treatment. Potent analgesia, regularly scheduled dosing, and nonpainful administration were selected most frequently. Self-report of pain, patient-controlled analgesia, and behavioral interventions requiring higher cognitive skills were selected less frequently for children with more severe cognitive impairment. Conclusions: The presence of cognitive impairment appeared to influence provider decisions regarding the appropriateness of specific pain assessment and treatment methods requiring skills on the part of the child. Overall, healthcare provider views regarding analgesia and sedation were similar for all children, regardless of impairment. Whether these beliefs are consistent with clinical practice is yet to be documented.

AB - Objective: To gather information about healthcare providers' beliefs regarding pain and its treatment in children with cognitive impairment. Design: A survey consisting of two acute pain vignettes (a child undergoing surgery and a child undergoing an outpatient medical procedure) was completed by 440 nurses and 146 physicians at Arkansas Children's Hospital. Respondents completed one of four different surveys that systematically varied the child's level of cognitive impairment (none, mild, moderate, severe) in both vignettes. Questions addressed expected pain, pain assessment methods, pharmacologic regimens, and nonpharmacologic interventions. Results: In general, provider discipline and level of cognitive impairment did not significantly influence responses about pain experience and treatment. Potent analgesia, regularly scheduled dosing, and nonpainful administration were selected most frequently. Self-report of pain, patient-controlled analgesia, and behavioral interventions requiring higher cognitive skills were selected less frequently for children with more severe cognitive impairment. Conclusions: The presence of cognitive impairment appeared to influence provider decisions regarding the appropriateness of specific pain assessment and treatment methods requiring skills on the part of the child. Overall, healthcare provider views regarding analgesia and sedation were similar for all children, regardless of impairment. Whether these beliefs are consistent with clinical practice is yet to be documented.

KW - Children

KW - Cognitive impairment

KW - Developmental delay

KW - Postoperative pain

KW - Procedural pain

KW - Survey

UR - http://www.scopus.com/inward/record.url?scp=0033406351&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033406351&partnerID=8YFLogxK

U2 - 10.1097/00002508-199912000-00007

DO - 10.1097/00002508-199912000-00007

M3 - Article

C2 - 10617259

AN - SCOPUS:0033406351

VL - 15

SP - 304

EP - 312

JO - Clinical Journal of Pain

JF - Clinical Journal of Pain

SN - 0749-8047

IS - 4

ER -