Author(s): Fernandes, Ananda Maria ; Batalha, Luís Manuel da Cunha ; Campos, Diana Catarina Ferreira de ; Oliveira, Armando Luis Dinis Mónica ; Oliveira, Miguel
Date: 2012
Origin: Repositório Científico da Escola Superior de Enfermagem de Coimbra
Subject(s): Child; Cancer; pain; language
Aim of investigation The development of language skills provides children with the ability to communicate their needs. To verbally express the subjective experience of pain, children must be able to communicate thoughts, emotions and sensations. The words used to describe their experiences of pain are most likely related to the nature and quality of these experiences. Little is known about how healthy and ill children/adolescents describe their pain and whether illness experience plays a role. The objective of this investigation was to compare the use of pain descriptors between healthy and cancer children. Methods As part of a larger study, 67 pain descriptors from the Adolescent Pediatric Pain Tool were translated to Portuguese language. Semantic validation was conducted with healthy and cancer children and adolescents (n=48). For both groups, a random sample of 24 children and adolescents was included: 6 boys and 6 girls aged 8-12 years old and 6 boys and 6 girls aged 13-17 years old. Following Q-sort procedure, children were asked to recall their pain experiences and allocate each descriptor to one of three categories: a) words that I know and use to describe pain; b) words that I know but don't use to describe pain and c) words that I don't know. Results Mean number of unknown words was similar in both groups. Cancer children used fewer words to describe their pain experiences compared to healthy children. Healthy children used significantly more sensory and affective words to describe pain, but this difference was not significant for evaluative and temporal descriptors of pain. A high standard deviation of the mean number of descriptors used by both healthy and cancer children underscores the diversity of individual pain expression. Conclusions Exposure to repeated pain is associated with different sorting of pain descriptors, especially regarding sensory and affective qualities of pain. Children and adolescents with cancer experience more frequent and intense episodes of pain and the smaller range of descriptors used suggests a more precise representation of pain, eventually related to stronger connexions in their neural pain network. This representation may be shaped more by the sensory and affective components of pain experiences than by the evaluative and temporal components. Further research with larger samples is needed to elucidate this. This study reinforces that children are able to reliably report their pain experiences through verbal language. These descriptions can be helpful for childcare professionals given that an accurate and more complete pain assessment may improve pain management.
