TABLE 4.
Pharmacological and nonpharmacological intervention for current, worst and usual pain
| Patient or parent report of phamacological intervention for any pain (>0 of 10) | |||
|---|---|---|---|
| Current (n=50) | Worst (n=100) | Usual (n=77) | |
| Was the patient given medication for pain? | |||
| Yes | 44 (88) | 67 (67) | 59 (77) |
| If yes, did the medication help? | |||
| Yes, more than a little | 31 (71) | 52 (78) | 46 (78) |
| A little | 8 (18) | 8 (12) | 7 (12) |
| No | 5 (11) | 5 (8) | 4 (7) |
| Don’t know/unsure | 0 (0) | 2 (3) | 2 (3) |
|
Pharmacological intervention in medical chart for all patients (n=107)
| |||
| Prescribed | Received | ||
|
| |||
| Acetaminophen and/or NSAID | 93 (87) | 67 (63) | |
| Opioid | 48 (45) | 38 (36) | |
| Adjuvant* | 13 (12) | 13 (12) | |
| Topical anesthetic | 10 (9) | 3 (3) | |
|
Caregiver responses and nonpharmacological interventions
| |||
| Reported in interviews for patients with any pain, n=101† | Medical chart for all patients, n=107 | ||
|
| |||
| Cognitive distraction | 93 (94) | 36 (34) | |
| Praise | 93 (93) | 0 (0) | |
| Reassurance | 88 (88) | 0 (0) | |
| Humour | 75 (77) | 0 (0) | |
| Empathy | 73 (74) | 0 (0) | |
| Apology | 68 (67) | 0 (0) | |
| Comfort positioning | 66 (66) | 22 (21) | |
| Information provision | 58 (64) | 0 (0) | |
| Commands to cope | 55 (64) | 1 (1) | |
| Massage | 50 (50) | 0 (0) | |
| Skin-to-skin contact/cuddling | 48 (48) | 10 (9) | |
| Heat/cold therapy | 38 (38) | 11 (10) | |
| Control to child | 26 (31) | 0 (0) | |
| Criticism | 5 (5) | 0 (0) | |
| Other (eg, rest/sleep, stuffed animals, treats, bath) | 14 (14) | 1 (1) | |
| Patient self-focused coping | |||
| Deep breathing | 38 (48) | – | |
| Cognitive distraction | 31 (42) | – | |
| Making coping statements | 29 (37) | – | |
| Humour | 29 (36) | – | |
| None | 0 (0) | 62 (58) | |
| Did the help from an adult help decrease the pain?‡ | |||
| Yes | 85 (84) | – | |
| No | 11 (11) | – | |
| Don’t know/unsure | 4 (4) | – | |
Data presented as n (%).
*
Adjuvants included amitriptyline, gabapentin, ketamine, lidocaine, pregabalin and nortriptyline;
†
Percentages of patients receiving nonpharmacological interventions as reported during interviews were not always based on the entire sample of patients with pain (n=101) because some strategies were not applicable given child age (eg, infant) or medical status (eg, sedated);
‡
This question was missed for one patient. NSAID Nonsteroidal anti-inflammatory drug