Whose pain is it anyway? Comparability of pain reports from children and their parents

S. J. Kamper, K. B. Dissing, L. Hestbaek

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Abstrakt

Background: Evidence suggests that prevalence of pain, and especially chronic pain in children and adolescents, is not only responsible for considerable personal suffering but also for a substantial economic burden. In addition to its contemporaneous burden, pain in adolescents is an important predictor of pain in adulthood. Musculoskeletal pain in children thereby represents a substantial societal problem, worthy of further investigation. Clinical assessment of children's health conditions necessarily involves interaction with both children and their parents. This situation introduces complexity as it can be unclear how reports from the two parties relate to one another. In the case of research into pediatric pain, a parent's report is commonly used as a proxy for the child's rating. This being the case, it is necessary to improve the understanding of the relationship between the two types of pain report. Purpose: To assess the degree of agreement between parents' report of their child's pain and the child's own assessment. Methods: Data were collected as part of a larger cohort study investigating the health of Danish school children. The study sample included 354 child-parent pairs who were independently asked whether the child had experienced musculoskeletal pain in the previous week. The children were between the ages of 10 and 14 years old. Parents provided answers via text message and children were questioned in person at their school. Crosstabulations were presented to assess the concordance of a report of any pain and of pain specific to one of the defined regions; spine, upper limb, or lower limb. Concordance between parent and child report was expressed as percentage agreement and kappa values. All cases were coded as concordant or discordant for the analyses investigating the influence of the various factors on concordance. Results: Preliminary results concerning the presence or absence of pain, regardless of region; percentage agreement was 52.4%. Notably, parents very rarely reported pain when the child did not; the low agreement is almost entirely due to children reporting pain and the parent not. Agreement was only slightly poorer when concordance of pain report specific to a body region was assessed; agreement was 48.8%. These data indicate that while parents often report that their child has no pain when the child reports that he/she does, there is less commonly discordance regarding the site of pain. When parents did report pain, the agreement regarding the site of pain was 78%. Pain of greater intensity or longer duration resulted in better agreement between the child and parent. Child age, gender and volume of sporting activity did not influence the likelihood of agreement. Conclusion(s): Children often experience pain that is not reported by their parents, this was responsible for the poor concordance between pain reports from the two sources. While it is not possible to say which is more valid we can conclude they are not interchangeable. Implications: Reports of pain from children and their parents should be considered differently and further research is needed to determine the situations in which one or other should be prioritised.
OriginalsprogEngelsk
TidsskriftPhysiotherapy
Vol/bind101
Udgave nummerS1
Sider (fra-til)eS712-eS713
ISSN0031-9406
DOI
StatusUdgivet - 2015
BegivenhedWorld Confederation for Physical Therapy Congress 2015 - Singapore, Singapore
Varighed: 1. maj 20154. maj 2015

Konference

KonferenceWorld Confederation for Physical Therapy Congress 2015
LandSingapore
BySingapore
Periode01/05/201504/05/2015

Emneord

  • *pain *child *parent *human *physiotherapy adolescent musculoskeletal pain health leg adulthood school body regions gender prevalence cohort analysis chronic pain school child spine arm clinical assessment

Citationsformater