Autor(es):
Batalha, Luís Manuel da Cunha 
; Costa, Luisa Paula Santos ; Reis, Gina Maria Rodrigues ; Jacinto, Florinda Maria Reis Cerol ; Santos, Paulo Miguel Gomes ; Machado, Rosa
Data: 2013
Origem: Repositório Científico da Escola Superior de Enfermagem de Coimbra
Assunto(s): pain; management; hospitalized; child;
Descrição
Pain management in hospitalized children in Portugal
Negligence in pain management practice is a recognized problem. Since 2001, Portugal has been making a strong effort to improve health care practices in this area through the development of awareness-raising campaigns, training sessions and publication of guidelines and best practice manuals. However, there is a lack of information on the prevalence of pain in hospitalized children and on the type of treatments used to manage pain1,2.
This study aimed to identify the prevalence of pain in hospitalized children and characterize the type of treatments.
A cross-sectional descriptive study was conducted based on an analysis of the clinical records over the last 24 hours. The sample was composed of children up to 18 years old with at least 24 hours of hospitalization in 4 pediatric hospitals. The clinical records were randomly selected and included 20% of staffing from each ward, in a total of 810 hours. Data were collected between August and December, 2011. Pain intensity was measured on a 0-10 scale: No pain <1; mild 1-3; Moderate 3-6; Severe or very severe 6-10.
The analysis of the clinical records showed that children's mean age was 5 years, ranging between 0.4 and 18 years. Most participants were male (n=457, 56.4%), with at least 3 days of hospitalization, while 233 participants (28.8%) had undergone surgery. The most common diagnosis and/or reason for hospitalization were infections and fever. Pain prevalence was 24.6%: 12.4% had mild pain, 9.9% had moderate pain and 2.3% had severe or very severe pain. More than half of the clinical processes had a record of pain history (n=429, 53.0%). The prevalence of record of pain intensity every 8 hours was 63.7%. The prevalence of pharmacological treatment was 41.5% and non-pharmacological treatment was 15.3%. Non-opioid analgesics were the most frequently used drugs (36.2%), whereas distraction was the most common non-pharmacological strategy (6.3%).
It can be concluded that there is a good pain management, a low prevalence of record of pain history and pain intensity assessment. Non-opioid analgesics continue to be more widely used than opioid analgesics, and there is a low prevalence of non-pharmacological techniques.
References
1. Bhatia A, Brennan L, Abrahams M, Gilder F. Chronic pain in children in the UK: a survey of pain clinicians and general practitioners. Paediatr Anaesth. 2008;18(10):957-966.
2. Batalha L. Dor em pediatria: compreender para mudar. Lisboa: Lidel; 2010.
