Linhares M B M, Doca F N P, Martinez F E, Carlotti A P P, Cassiano R G M, Pfeifer L I, Funayama C A, Rossi L R G, Finley G A
Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Braz J Med Biol Res. 2012 Dec;45(12):1287-94. doi: 10.1590/s0100-879x2012007500147. Epub 2012 Sep 18.
The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients' pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child's pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.
本研究的目的是调查一家公立教学医院中儿童疼痛的患病率、评估及管理情况。研究样本包括121名住院患者（70名婴儿、36名儿童和15名青少年）、他们的家人、40名医生和43名护士。除因临床状况无法沟通的婴儿和儿童外，所有参与者均接受了访谈。访谈包括关于住院患者在数据收集前24小时内疼痛症状的开放式问题，以及疼痛评估和疼痛的药物/非药物管理。数据来自100%符合条件的住院患者。34名儿童/青少年（28%）回答了问卷，另外72%（无法沟通）由家人/医护人员报告疼痛情况。在这34人中，20名儿童/青少年报告有疼痛，其中68%报告他们接受了药物干预以缓解疼痛。在数据收集当天，有82名家庭护理人员。其中，40名家庭护理人员（49%）观察到了孩子的疼痛反应。此外，74%报告住院患者接受了药物管理。医生报告只有38%的住院患者表现出疼痛迹象，主要是在临床操作过程中检测到的急性疼痛。他们报告说66%的患者接受了药物干预。护士报告50%的住院患者有疼痛迹象，是在临床操作过程中检测到的。护士报告说78%的住院患者通过药物和/或非药物干预来管理疼痛。研究结果提供了儿童住院患者疼痛患病率高以及医护人员对疼痛认识不足的证据。
