Measuring Pain in Children

Robin H. Ballard, BA; Joyce M. Engel, PhD; Dagmar Amtmann, PhD

Background

Youths with disabilities experience pain more often than other children. It can affect their health and make it difficult to do normal life activities. Sometimes the pain is a symptom of the disability itself, and sometimes it is caused by treatments or surgeries. There is currently a lot of work being done to prevent and manage the pain that youths with disabilities experience, and an important part of that work is improving pain measurement.

One of the most common types of pain questionnaires is a numerical rating scale (NRS). Numerical rating scales appeal to doctors, researchers, and patients alike. Patients choose a number, usually between 0 and 10, to answer questions about their pain. This is often much quicker and easier than giving a word answer. There has been very little past research on use of these scales with children, however.

The Goal

The goal of this study is to find out if an NRS for pain can successfully be used with youths with disabilities. This is part of a larger goal to improve the way pain in children is measured.

The Study

112 youths with disabilities, ages 8 to 20, volunteered for the study. They each had experienced ongoing pain for at least 3 months. They were asked about their ability to participate in and enjoy normal life activities like spending time with family and friends, walking, etc. The interview included an NRS that asked the youths to rate their worst, least, current, and average pain on a scale of 0-10, in order to get a complete picture of their pain experiences.

Results and Conclusions

Overall, the youths were able to use the scale in the same way that adults do, but some did not understand the meaning of the word “average.” Many children thought about their worst or their current pain when they rated their average pain.

If researchers and doctors ask about “worst” and “least” pain, instead of “average” pain, an NRS can successfully be used with youths with disabilities. This will hopefully save time and help doctors and researchers to better understand their younger patients’ pain experiences.