Weingarten Laura, Kircher Janeva, Drendel Amy L, Newton Amanda S, Ali Samina
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
J Emerg Med. 2014 Sep;47(3):268-76. doi: 10.1016/j.jemermed.2014.01.038. Epub 2014 Jul 8.
Children's pain is frequently underrecognized and undertreated. This study focuses exclusively on children's perspectives of and satisfaction with their pain management in the emergency department (ED).
Specific study objectives were to 1) describe the pain and ED treatment experienced by children, 2) measure the child's satisfaction with pain treatment, and 3) determine factors associated with satisfaction.
This prospective, descriptive survey examined a convenience sample of 100 children, aged 7-17 years, who were treated for pain in the pediatric ED of a Canadian hospital. We measured children's pain scores, overall satisfaction with their pain management, and perceptions of health care provider communication.
Of the 100 children studied, 53 were male, and the mean age was 12.6 years. The maximum mean pain score was reported as 79 mm (95% confidence interval [CI] 75-82) and the mean score at discharge was reported as 34 mm (95% CI 29-39), using a 100-mm modified visual analog scale. The majority of children (92%) were satisfied; three children (3%) were very unhappy and four (4%) were unhappy with their pain treatment. Satisfaction was correlated with pain resolution (p = 0.018), effective child-provider communication (p = 0.045), and the perception that the medicine worked quickly (p = 0.034).
Despite continued pain upon discharge, most children were satisfied with their pain management. However, it is important that emergency physicians not interpret patient satisfaction as equivalent to adequate provision of analgesia. The relationship between children's pain management and self-reported satisfaction needs to be further explored.
儿童疼痛常常未得到充分认识和治疗。本研究专门关注儿童在急诊科对疼痛管理的看法和满意度。
具体研究目标为：1）描述儿童经历的疼痛及在急诊科接受的治疗；2）衡量儿童对疼痛治疗的满意度；3）确定与满意度相关的因素。
这项前瞻性描述性调查研究了加拿大一家医院儿科急诊科100名7至17岁因疼痛接受治疗的儿童的便利样本。我们测量了儿童的疼痛评分、对疼痛管理的总体满意度以及对医护人员沟通的看法。
在研究的100名儿童中，53名是男性，平均年龄为12.6岁。使用100毫米改良视觉模拟量表，报告的最大平均疼痛评分为79毫米（95%置信区间[CI]75 - 82），出院时的平均评分为34毫米（95%CI 29 - 39）。大多数儿童（92%）表示满意；三名儿童（3%）非常不满意，四名（4%）对疼痛治疗不满意。满意度与疼痛缓解（p = 0.018）、有效的医患沟通（p = 0.045）以及认为药物起效快（p = 0.034）相关。
尽管出院时仍有疼痛，但大多数儿童对疼痛管理感到满意。然而，急诊医生不应将患者满意度等同于充分提供镇痛治疗，儿童疼痛管理与自我报告的满意度之间的关系需要进一步探讨。
