Judith Ann Ward

How do children describe pain? A tentative assessment

Abstract In a study to determine how children describe the experience of pain, we queried a convenience sample of 100 children in hospitals and 114 children in church and private schools who were between 9 and 12 years old. The questions were designed to seek correlations by age among boys and girls and between hospitalized and non‐hospitalized children that would aid health professionals in strategies that will identify and assist the child who is in pain. The preliminary results show that children clearly describe pain, that there are no appreciable differences by age groups, but that children who are hospitalized describe pain differently from children who are not.

Measuring pain quality: validity and reliability of children's and adolescents' pain language

&NA; Although considerable research has been conducted to identify childrens and adolescents language of pain, research is lacking regarding a method to quantify the pain quality described by this language. Three descriptive studies involving 1223 children, aged 8–17 years, were conducted in school and hospital settings. The aims were to develop and examine the validity and reliability of a word list for measuring pain quality that was free of age, gender, and ethnic biases. A word list with 43 words was developed and resulted in sensory, affective, evaluative, and total scores that correlated with pain location and pain intensity scores (r = 0.19−0.44; P ⩽ 0.01). Pain quality scores decreased over time in a postoperative pain model. Test‐retest reliability of the word list scores was high (r = 0.78–0.95; P < 0.001). This world list was revised and resulted in a word list with 56 words relatively free of gender, ethnic, and developmental biases. Additional research is needed to assess the psychometric properties of this world list in pediatric populations experiencing different pain syndromes.

Description of the Pain Experience: A Study of School-Age Children

Analysis of childrens responses describing the pain experience revealed that 9- to 12-year-olds can identify causes of pain, can select words that describe pain, and can express how they feel when in pain. Hospitalized children described painful experiences related to surgery and medical procedures and used words related to tension, fear, and overall pain intensity significantly more often than nonhos-pitalized children.Funded by the Committee on Research of the Academic Senate of the University of California, San Francisco.

Coping Strategies of Children in Pain

A total of 214 children, 9–12 years of age, 100 hospitalized and 114 in school, participated in a study to describe their experience with pain. The children were asked to report what made them feel better when they had pain; 182 were able to identify at least one approach they used to cope with pain. Findings indicated that children could identify a variety of strategies for coping with pain. Girls more than boys and the school more than the hospitalized children reported a larger number and variety. There were also marked differences in the categories of coping strategies between the hospitalized and non-hospitalized and between boys and girls.

Children's language of pain

Electrical Engineering , McGill University; INRSTelecommunications , Montreal, Quebec, Canada. Aim of Investigation: Various acoustical features have been associated with infant pain cries: fundamental frequency and total time crying being most often reported as discriminating pain from hunger or pleasure cries. The purpose of this study was to determine which acoustical features distinguished responses to three negative situations: 1) pain (routine immunization), 2) anger (head restraint), and 3) fear (jack-in-the-box). Formant structure, not previously reported in infant literature, was also examined. Methods: Thirty-nine cry episodes from 2 to 6 month-old infants resulting from the above stimuli were visualized as spectrographs via fast Fourier analysis. Fundamental frequency (maximum, minimum, shift), total time crying, cry duration, melody, phonai;ion (harmonic structure), jitter and formant structure were compared across stimulus situations. Results: Pain cries were significantly different from anger and fear cries in their falling melody, high percentage of dysphonation, and the greater intensity of high frequency formants (second formants). They were similar to fear cries in fundamental frequency and total time crying, and to anger cries in occurence of jitter. Conclusion: Acute pain cries cannot be distinguished on the basis of fundamental frequency or total time crying from fear/startle cries. However, phonation or harmonic structure, formant structure, and melody appear to be better discriminators. These features may reflect changes in musculature or excitation in response to acute pain stimuli.