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612 CURRENT PAEDIATRIC PAIN ASSESSMENT PRACTICES IN CANADA
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Poster Sessions / European Journal of Pain 13 (2009) S55–S285
OP = 341 ms, FP = 372 ms] and “RW” (OP = 1203 ms, NP = 1340 ms, FP = 1526 ms). There are significant age differences in “A” [F(1.98) = 8.707, p = 0.004] and “SA” [F(1.98) = 9.963, p = 0.002]. Boys make more mistakes than girls [F(1.98) = 5.039, p = 0.027; 5.48 vs. 3.88 mistakes]. Attention processes are depending on the cognitive development, the quality of pain and on the complexity of task. 611 EVALUATION OF CAUSES OF LOW-BACK PAIN IN CHILDREN D.J. Stevanovic-Papic *, D. Dragic, B. Marjanovic, V. Solaja, G. Mirkovic, N. Tomic. Institute for Physical and Rehabilitation Medicine “Dr Miroslav Zotovic”, Banjaluka, Bosnia & Herzegovina Introduction: The last few years, more children with symptoms of low-back pain lasting from few months to two years, are referred to our Institute. Objective: To evaluate cause of the pain in the adolescents. Material and Methods: We have analyzed 16 in-patients treated in our Institute Patients aged from 6 to 17 years. out of which there were 12 girls and 4 boys. Eleven patients had intermitent pains for a longer period of time, while in 5 patients pain started suddenly, 2 months prior hospitalization. Follow up included pain intensity, clinical finding as well as MRI of the spine. A neurologist and a neurosurgeon were consulted prior and during the treatment. EMNG was performed in 5 patients. Results: Clinical finding in all children showed pain during palpation of the spinous process, change in paravertebral muscles tone, scoliosis, poor dynamic control of the pelvis. Causes of the low-back pain in treated children were of various etiology. Twelve children underwent immediate physical treatment, two children were included in physical treatment following surgical treatment of the herniated disk. Two patients with tumors were sent for additional diagnostics and treatment to the specialized institutions. Conclusion: Contemporary diagnostic methods verified more causes of the low-back pain in adolescents. Also, serious conditions were timely revealed and sent for an adequate treatment. Taking into consideration the shift of problem towards the younger patients all of this requires more caution and adequate evaluation of symptoms of low-back pain in this population. 612 CURRENT PAEDIATRIC PAIN ASSESSMENT PRACTICES IN CANADA B. Stevens1,2 , D. Harrison2 , J. Yamada1,2 , L. Abbott1 , M. Barwick1 , F. Campbell1 , C. Chambers3,6 , J. Cohen4 , G. Cummings5,15 , C. Estabrooks5,15 , G.A. Finley3,6 , C. Johnston7 , T. Kavanagh2 , M. Latimer3 , S. Le May8,13 , S. Lee1,2,9 , P. McGrath3,6 , J. Rashotte4 , C. Rosmus7,16 , D. Sawatzky-Dickson10 , S. Scott5 , S. Sidani11 , J. Stinson1,2 , R. Stremler2 , A. Synnes12 , A. Taddio1,2 , E. Villeneuve13 , F. Warnock14 , A. Willan1,2 . 1 The Hospital for Sick Children, Toronto, Canada; 2 University of Toronto, Toronto, Canada; 3 Dalhousie University, Halifax, Canada; 4 Children’s Hospital of Eastern Ontario, Ottawa, Canada; 5 University of Alberta, Edmonton, Canada; 6 IWK Health Centre, Halifax, Canada; 7 McGill University, Montreal, Canada; 8 Universite de Montreal, Montreal, Canada; 9 Mount Sinai Hospital, Toronto, Canada; 10 Children’s Hospital of Winnipeg, Winnipeg, Canada; 11 Ryerson University, Toronto, Canada; 12 BC Children’s Hospital, Vancouver, Canada; 13 CHU Ste-Justine, Montreal, Canada; 14 University of British Columbia, Vancouver, Canada; 15 Stollery Children’s Hospital, Edmonton, Canada; 16 Montreal Children’s Hospital, Montreal, Canada Background and Aims: Many valid and reliable paediatric pain assessment tools exist; however, acute pain assessment in hospitalized children is not regularly performed leading to suboptimal pain management. The aim was to determine the nature and frequency of paediatric acute pain assessment practices in Canada.
Methods: Data on the nature and frequency of pain assessment during the previous 24-hr period were collected from 3840 patient charts from 32 (14 medical, 10 critical care, and 8 surgical) inpatient units in 8 Canadian paediatric hospitals using the Canadian Paediatric Pain Research database. Results: 2640/3840 (69%) of charts reviewed indicated that pain was assessed at least once within the previous 24-hr period; however, a validated pain measure was documented in only 1443 (38%) of charts. In 1776 (46%) of charts, pain assessment consisted of a narrative note while 589 (15%) charts contained evidence of both a validated pain measure and a narrative note. The top 3 most frequently used pain measures were: the Numeric Rating Scale (n = 840), the Face, Legs, Activity, Cry, Consolability Scale (FLACC) (n = 275), and the Scale for Use in Newborns (SUN) (n = 49). There were 82 (2%) children whose pain was assessed using more than one pain assessment measure. Conclusions: Pain is inadequately assessed in the majority of hospitalized children. For those who do have documentation of pain assessment, considerable variability exists in measures and approaches utilized. The preference for narrative notes for pain assessment instead of validated pain measures requires further exploration and attention. 613 CHILDREN IN PAIN: THE RELATIONSHIP OF FREQUENCY, INTENSITY AND DISABILITY FOR BACK PAIN, ABDOMINAL PAIN AND HEADACHE H. van Gessel *, J. Gaßmann, B. Kroner-Herwig. ¨ Georg-Elias-M¨ ullerInstitut f¨ ur Psychologie, Abteilung f¨ ur Klinische Psychologie und Psychotherapie, G¨ ottingen, Germany Aim: This analysis aims at displaying the relationship between the reported frequency and intensity of and the experienced disability by the pain. In a large epidemiological study we examined paediatric pain, using a regional sample of German families with a child aged 7–14 (n = 8800). In the first year 5572 (63.3%) families responded and were asked to participate in the following three years, which 4159 (74.5%), 3694 (66.7%) and 3461 (63.3%) households, respectively, did. Questionnaires were administered annually over a 4-year period (2003–2006), asking about back pain (BP), abdominal pain (AP) and headache (HA), regarding the frequency in the previous six months. Questions concerning the intensity of the pain and the disability experienced were enclosed in the last two surveys. Results: All correlations found were significant at the 1% level (p < 0.01). The strongest relation was found between intensity and disability for all locations in both surveys (Spearman-Rho= BP: 0.63–0.71, AP: 0.60–0.62, HA: 0.55–0.58). The least related seem frequency and disability, though highly significant related to another (Spearman-Rho = BP: 0.46–0.47, AP: 0.39–0.43, HA: 0.26–0.28). Comparison between the third and fourth survey shows that highly experienced disability is not stable over the years, as was also found for intensity and lesser for frequency (Spearman-Rho= disability: 0.33–0.36, intensity: 0.38–0.45, frequency: 0.49–0.55). Conclusion: A clear relation was found between the frequency and intensity of pain and the disability experienced by it. Children report headache as being the most disabling of all three pain locations. 614 CATASTROPHIC THINKING IN PARENTS CONTRIBUTES TO HEIGHTENED PARENTAL DISTRESS AND TENDENCIES TO RESTRICT THEIR CHILD’S ACTIVITY T. Vervoort1 *, L. Goubert1 , L. Caes1 , C. Eccleston2 , G. Crombez1 . 1 Ghent University, Gent, Belgium; 2 Bath University, Bath, United Kingdom Background and Aims: Pain serves as a sign of threat and demands attention not only from the sufferer, but also the attention and
Poster Sessions / European Journal of Pain 13 (2009) S55–S285
OP = 341 ms, FP = 372 ms] and “RW” (OP = 1203 ms, NP = 1340 ms, FP = 1526 ms). There are significant age differences in “A” [F(1.98) = 8.707, p = 0.004] and “SA” [F(1.98) = 9.963, p = 0.002]. Boys make more mistakes than girls [F(1.98) = 5.039, p = 0.027; 5.48 vs. 3.88 mistakes]. Attention processes are depending on the cognitive development, the quality of pain and on the complexity of task. 611 EVALUATION OF CAUSES OF LOW-BACK PAIN IN CHILDREN D.J. Stevanovic-Papic *, D. Dragic, B. Marjanovic, V. Solaja, G. Mirkovic, N. Tomic. Institute for Physical and Rehabilitation Medicine “Dr Miroslav Zotovic”, Banjaluka, Bosnia & Herzegovina Introduction: The last few years, more children with symptoms of low-back pain lasting from few months to two years, are referred to our Institute. Objective: To evaluate cause of the pain in the adolescents. Material and Methods: We have analyzed 16 in-patients treated in our Institute Patients aged from 6 to 17 years. out of which there were 12 girls and 4 boys. Eleven patients had intermitent pains for a longer period of time, while in 5 patients pain started suddenly, 2 months prior hospitalization. Follow up included pain intensity, clinical finding as well as MRI of the spine. A neurologist and a neurosurgeon were consulted prior and during the treatment. EMNG was performed in 5 patients. Results: Clinical finding in all children showed pain during palpation of the spinous process, change in paravertebral muscles tone, scoliosis, poor dynamic control of the pelvis. Causes of the low-back pain in treated children were of various etiology. Twelve children underwent immediate physical treatment, two children were included in physical treatment following surgical treatment of the herniated disk. Two patients with tumors were sent for additional diagnostics and treatment to the specialized institutions. Conclusion: Contemporary diagnostic methods verified more causes of the low-back pain in adolescents. Also, serious conditions were timely revealed and sent for an adequate treatment. Taking into consideration the shift of problem towards the younger patients all of this requires more caution and adequate evaluation of symptoms of low-back pain in this population. 612 CURRENT PAEDIATRIC PAIN ASSESSMENT PRACTICES IN CANADA B. Stevens1,2 , D. Harrison2 , J. Yamada1,2 , L. Abbott1 , M. Barwick1 , F. Campbell1 , C. Chambers3,6 , J. Cohen4 , G. Cummings5,15 , C. Estabrooks5,15 , G.A. Finley3,6 , C. Johnston7 , T. Kavanagh2 , M. Latimer3 , S. Le May8,13 , S. Lee1,2,9 , P. McGrath3,6 , J. Rashotte4 , C. Rosmus7,16 , D. Sawatzky-Dickson10 , S. Scott5 , S. Sidani11 , J. Stinson1,2 , R. Stremler2 , A. Synnes12 , A. Taddio1,2 , E. Villeneuve13 , F. Warnock14 , A. Willan1,2 . 1 The Hospital for Sick Children, Toronto, Canada; 2 University of Toronto, Toronto, Canada; 3 Dalhousie University, Halifax, Canada; 4 Children’s Hospital of Eastern Ontario, Ottawa, Canada; 5 University of Alberta, Edmonton, Canada; 6 IWK Health Centre, Halifax, Canada; 7 McGill University, Montreal, Canada; 8 Universite de Montreal, Montreal, Canada; 9 Mount Sinai Hospital, Toronto, Canada; 10 Children’s Hospital of Winnipeg, Winnipeg, Canada; 11 Ryerson University, Toronto, Canada; 12 BC Children’s Hospital, Vancouver, Canada; 13 CHU Ste-Justine, Montreal, Canada; 14 University of British Columbia, Vancouver, Canada; 15 Stollery Children’s Hospital, Edmonton, Canada; 16 Montreal Children’s Hospital, Montreal, Canada Background and Aims: Many valid and reliable paediatric pain assessment tools exist; however, acute pain assessment in hospitalized children is not regularly performed leading to suboptimal pain management. The aim was to determine the nature and frequency of paediatric acute pain assessment practices in Canada.
Methods: Data on the nature and frequency of pain assessment during the previous 24-hr period were collected from 3840 patient charts from 32 (14 medical, 10 critical care, and 8 surgical) inpatient units in 8 Canadian paediatric hospitals using the Canadian Paediatric Pain Research database. Results: 2640/3840 (69%) of charts reviewed indicated that pain was assessed at least once within the previous 24-hr period; however, a validated pain measure was documented in only 1443 (38%) of charts. In 1776 (46%) of charts, pain assessment consisted of a narrative note while 589 (15%) charts contained evidence of both a validated pain measure and a narrative note. The top 3 most frequently used pain measures were: the Numeric Rating Scale (n = 840), the Face, Legs, Activity, Cry, Consolability Scale (FLACC) (n = 275), and the Scale for Use in Newborns (SUN) (n = 49). There were 82 (2%) children whose pain was assessed using more than one pain assessment measure. Conclusions: Pain is inadequately assessed in the majority of hospitalized children. For those who do have documentation of pain assessment, considerable variability exists in measures and approaches utilized. The preference for narrative notes for pain assessment instead of validated pain measures requires further exploration and attention. 613 CHILDREN IN PAIN: THE RELATIONSHIP OF FREQUENCY, INTENSITY AND DISABILITY FOR BACK PAIN, ABDOMINAL PAIN AND HEADACHE H. van Gessel *, J. Gaßmann, B. Kroner-Herwig. ¨ Georg-Elias-M¨ ullerInstitut f¨ ur Psychologie, Abteilung f¨ ur Klinische Psychologie und Psychotherapie, G¨ ottingen, Germany Aim: This analysis aims at displaying the relationship between the reported frequency and intensity of and the experienced disability by the pain. In a large epidemiological study we examined paediatric pain, using a regional sample of German families with a child aged 7–14 (n = 8800). In the first year 5572 (63.3%) families responded and were asked to participate in the following three years, which 4159 (74.5%), 3694 (66.7%) and 3461 (63.3%) households, respectively, did. Questionnaires were administered annually over a 4-year period (2003–2006), asking about back pain (BP), abdominal pain (AP) and headache (HA), regarding the frequency in the previous six months. Questions concerning the intensity of the pain and the disability experienced were enclosed in the last two surveys. Results: All correlations found were significant at the 1% level (p < 0.01). The strongest relation was found between intensity and disability for all locations in both surveys (Spearman-Rho= BP: 0.63–0.71, AP: 0.60–0.62, HA: 0.55–0.58). The least related seem frequency and disability, though highly significant related to another (Spearman-Rho = BP: 0.46–0.47, AP: 0.39–0.43, HA: 0.26–0.28). Comparison between the third and fourth survey shows that highly experienced disability is not stable over the years, as was also found for intensity and lesser for frequency (Spearman-Rho= disability: 0.33–0.36, intensity: 0.38–0.45, frequency: 0.49–0.55). Conclusion: A clear relation was found between the frequency and intensity of pain and the disability experienced by it. Children report headache as being the most disabling of all three pain locations. 614 CATASTROPHIC THINKING IN PARENTS CONTRIBUTES TO HEIGHTENED PARENTAL DISTRESS AND TENDENCIES TO RESTRICT THEIR CHILD’S ACTIVITY T. Vervoort1 *, L. Goubert1 , L. Caes1 , C. Eccleston2 , G. Crombez1 . 1 Ghent University, Gent, Belgium; 2 Bath University, Bath, United Kingdom Background and Aims: Pain serves as a sign of threat and demands attention not only from the sufferer, but also the attention and