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Pediatric Pain (First in a series)
9/25/2007
The myth that pediatric patients do not experience the same degree of pain as adults do was routinely taught to clinicians in training until fairly recently. Indeed, pediatric patients present with both acute and chronic pain to clinicians on a regular basis. In fact, it is estimated that 15-20% of children in the United States experience chronic pain today.
Few would argue that the challenges presented to clinicians when attempting to treat children in pain may make the logical approach quite difficult. Unfortunately, these hurdles may result in the under-treatment of pain in young patients. Some of these challenges include:
- The inability of young children to communicate and participate in the assessment process
- The lack of a child’s prior experience with pain, as well as a poor level of understanding about its impact
- Fear associated with the clinical process in general
- Increased anxiety that normally occurs with exposure to the clinical setting
- Parents poor understanding of the behavioral changes that occur when children are in pain
- Parents lack of understanding about how to be a strong advocate for their child in pain
Dr. Leora Kuttner, PhD., has written a book entitled, “A Child in Pain. How to Help, What to Do” that is not only intended to improve the quality and successful treatment of children in pain, but also to improve the level of understanding of parents and primary care clinicians with regard to pain in this patient population.
Dr. Kuttner’s book clearly and thoughtfully lays out thoughts, ideas, and strategies that together comprise a guide to parents that they will want to refer to again and again throughout the course of their children’s growing up years.
Some of the topics covered include: 1) dispelling commonly believed myths about children in pain; 2) basic understanding of pain and why it happens; 3) the value of comforting children in pain; 4) do’s and don’ts; 5) and what to do depending on the individual clinical setting.
Ultimately, this book stresses what is likely the most important point - the fact that just as parents play a central role in protecting the well-being of their children as they go through all of life’s daily experiences, so must they do the same when faced with their child in pain. The hallmark assertion is that the strongest ally that a child has, the parent, should be integrated in the process of assessment and treatment of a child’s pain. Parent involvement is essential in order to successfully capitalize on the parent-child bond that can provide the “strength and guidance to make sense of and manage pain”.
Leora Kuttner, Ph.D. is a pediatric clinical psychologist and mother who specializes in children’s pain management. Dr. Kuttner is a Clinical Professor in the Pediatric Department of the University of British Columbia and BC Children’s Hospital, Vancouver. Dr. Kuttner is the distinguished recipient of the 1998 YWCA Women of Distinction Award and the 2007 Jeffrey Lawson Award for Advocacy in Children’s Pain Relief. As a film-maker, Dr. Kuttner has also co-produced and directed the award winning documentaries on pain management No Fears, No Tears – Children Coping With Pain in 1985, No Fears, No Tears – 13 Years Later in 1998, and When Every Moment Counts – Pediatric Palliative Care in 2003. A full review of “A Child in Pain. How to Help, What To Do” will be posted on PainEDU soon.
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