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

BACKGROUND: 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). OBJECTIVES: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.