Pediatric Palliative Care: Pain Management
Posted by Dr. Julia Harder
In pediatric palliative care, the first rule of pain management is to always tailor assessment and treatment to the unique needs of the child and his or her family. Many factors will shape a child's pain, including developmental level, emotional and cognitive state, personality traits, physical condition, and past experiences. The meaning of the pain for the child; the child's fears and concerns about illness and death; issues, attitudes, and reactions of the family; cultural background; and the environment are all elements in a child's perception of pain. Getting to know the child and having knowledge of developmental norms and behavioral competencies are important in the assessment and management of pain.
Open communication about pain among the child, the family, and the health care team is critical to successful pain assessment and management. To encourage open communication, determine the language the child uses for pain (e.g., hurt, owie, booboo) and how and to whom the child communicates pain. Often, parents/caregivers are the primary source of information about how the child exhibits and responds to pain and should be encouraged to be active participants in both assessment and management. Parents/caregivers can also contribute important information including prior painful events, previously used methods for pain control and preferences for assessing and treating pain.
