Pain in pediatric oncology — children's and parents' perspectives

European Journal of Pain - Tập 9 - Trang 395-406 - 2005
Boris Zernikow1, Ulrike Meyerhoff1, Erik Michel1, Thomas Wiesel1, Carola Hasan2, Gisela Janssen3, Nana Kuhn4, Udo Kontny5, Rüdiger Fengler6, Irene Görtitz7, Werner Andler1
1Children’s Hospital Datteln, Witten/Herdecke University, Dr.-Friedrich-Steiner Str. 5, D-45711 Datteln, Germany
2Department of Pediatric Hematology/Oncology, University Children’s Hospital Bonn, Bonn, Germany
3Department of Pediatric Hematology/Oncology, University Children’s Hospital Duesseldorf, Duesseldorf, Germany
4Department of Pediatric Hematology/Oncology, University Children’s Hospital Münster, Münster, Germany
5Department of Pediatric Hematology/Oncology, University Children’s Hospital Freiburg, Freiburg, Germany
6Department of Pediatric Hematology/Oncology, University Children’s Hospital Berlin, Berlin, Germany
7Department of Pediatric Hematology/Oncology, University Children’s Hospital Hamburg, Hamburg, Germany

Tóm tắt

AbstractThere is a lack of valid epidemiological data on malignancy‐associated pain in modern pediatric oncology. Pediatric oncology patients (self‐assessment) and their parents from 28 hospitals were questioned using age‐adapted, structured interviews and validated pain assessment tools. Pain intensity was measured by the NRS and Bieri faces scale. We conducted 363 interviews with patients and their parents, and 46 with the parents alone (if patients <2.5 years). Pain was reported at the time of the interview or within the last 24 h, 7 d, or 4 weeks in 15%, 28%, 50% and 58% of cases, respectively. The proportion of patients suffering severe to maximal pain (NRS > 3; Bieri > 2) increased significantly (p = 0.001, χ2 test). The median pain intensity for the most severe pain episode within the last 4 weeks was 6.7 (NRS 0–10). Adverse effects of anti‐tumor therapy were the most frequent cause of pain. Multivariate analyses depicted general physical condition either “severely reduced” (ASA status 3) (OR 4.0, 95% CI 1.1‐14.7, p = 0.037) or “moderately reduced” (ASA status 2) (OR 1.8, 95% CI 1.1‐2.9, p = 0.018), “in‐patient status” (OR 1.8, 95% CI 1.2‐2.9, p = 0.010), and “co‐morbidity present” (OR 3.5, 95% CI 1.1‐10.7, p = 0.030) as risk factors for severe to maximal pain. General anesthesia was the only factor significantly (OR 0.14, 95% CI 0.05‐0.39, p < 0.01) associated with a reduction in the proportion of patients suffering severe to maximal pain during bone marrow aspiration. Our data emphasize both the importance of in‐house acute pain control and the need for general anesthesia during painful procedures in pediatric oncology.

Tài liệu tham khảo

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European Journal of Pain

Tập 9

395-406

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