Factors affecting pain assessmentFFactors affecting pain assessmentFactors affecting pain assessmentEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-15T04:00:00ZToni Crowell, BA, MSc, CCLS11.000000000000054.0000000000000424.000000000000Flat ContentHealth A-Z<p>Learn about the factors that affect pain assessment such as our emotions, behaviour and cultural attitudes to pain.</p><p>Several factors besides age and development can affect an accurate assessment of pain. These include a child’s gender, their psychological and emotional state, their overall behaviour and temperament and their family and cultural background.</p> <p>The role of parents and, in the case of older children, their peers, can be influential on the assessment of a child’s pain. Children often take cues from their parents’ own pain behaviours; they have in part learned how to behave by watching their parents. Children are also aware of how they are expected to behave in certain situations. That expectation can affect the child’s response to pain and their way of showing or hiding it. </p><ul><li>An accurate assessment of pain can be affected by a number of factors, including a child's age, gender, level of understanding and previous pain experiences.</li> <li>Cultural and family norms also influence the degree to which your child may experience and express their pain.</li> <li>What your child thinks and feels about pain, and how they respond to it, are other factors that affect an accurate assessment.</li> <li>All children should be encouraged to freely express their pain so they can receive an accurate assessment and appropriate treatment.</li></ul>

 

 

Factors affecting pain assessment2995.00000000000Factors affecting pain assessmentFactors affecting pain assessmentFEnglishPain/AnaesthesiaChild (0-12 years);Teen (13-18 years)BodyCentral nervous system;Peripheral nervous system;Autonomic nervous systemSymptomsCaregivers Adult (19+)Pain2009-09-15T04:00:00ZToni Crowell, BA, MSc, CCLS11.000000000000054.0000000000000424.000000000000Flat ContentHealth A-Z<p>Learn about the factors that affect pain assessment such as our emotions, behaviour and cultural attitudes to pain.</p><p>Several factors besides age and development can affect an accurate assessment of pain. These include a child’s gender, their psychological and emotional state, their overall behaviour and temperament and their family and cultural background.</p> <p>The role of parents and, in the case of older children, their peers, can be influential on the assessment of a child’s pain. Children often take cues from their parents’ own pain behaviours; they have in part learned how to behave by watching their parents. Children are also aware of how they are expected to behave in certain situations. That expectation can affect the child’s response to pain and their way of showing or hiding it. </p><ul><li>An accurate assessment of pain can be affected by a number of factors, including a child's age, gender, level of understanding and previous pain experiences.</li> <li>Cultural and family norms also influence the degree to which your child may experience and express their pain.</li> <li>What your child thinks and feels about pain, and how they respond to it, are other factors that affect an accurate assessment.</li> <li>All children should be encouraged to freely express their pain so they can receive an accurate assessment and appropriate treatment.</li></ul><figure> <img alt="" src="https://assets.aboutkidshealth.ca/akhassets/toddler_learning_to_walk2_BRAND-PHO_EN.jpg" /> </figure> <h2>Situational and child factors that modify pain</h2> <p>Your child’s pain is modified by many situational, personal, and developmental factors. Each of these factors can influence the others. For example, what you and your child think about pain affects what you and your child do about it. Similarly, what you and your child understand about the cause of their pain affects how you both feel. </p> <p>The factors that most influence pain depend on what your child is usually like when they are free of pain. For example, your child may be too young to understand the reasons why a painful procedure is necessary. Young children may automatically think that the procedure is being done as a punishment for their actions and cannot yet understand how this will help them feel better. </p> <p>The following sections further describe the different factors that affect the assessment of pain.</p> <figure> <span class="asset-image-title">Situational factors affecting pain</span> <img alt="" src="https://assets.aboutkidshealth.ca/akhassets/PN_situational_factors_CHART_IMG_EN.jpg" /> <figcaption class="asset-image-caption">(Adapted from Situational Factors Affecting Assessment of Pain by Patricia McGrath, PhD)</figcaption> </figure> <h3>Child factors: What your child is like</h3> <p>Pain is an individual experience. A child’s most basic characteristics will influence how they express and cope with pain. These include their age, level of understanding and previous pain experiences. For example, older children behave very differently than younger children. And all ages may behave differently depending on whether they are with their parents or peers. </p> <p>Other influential characteristics include gender, temperament, family norms and cultural differences.</p> <ul><li>Boys and girls will often react differently to pain. For example, small boys will cry, but as they grow older they may put a lot of effort into making sure they don’t, particularly if others are present. Conversely, young girls may cry more because this behaviour is deemed acceptable.</li> <li>People of some cultures may express themselves freely. Others may repress their emotions or react in a way contrary to what is considered normal in the society in which they live. For example, parents may be very reluctant to show concern or may believe it is disrespectful to ask hospital staff questions. They may even constantly smile through their child's painful procedure though they are not feeling happy. As well, parents and children may behave the way they believe healthcare professionals want them to behave. This is called being the “good patient.<p> <p>To sum up, a good-natured six-year-old boy with little previous experience of pain, who, because of his family and culture, is expected not to complain, will likely have a very different perception of pain than a child with different characteristics such as a teenage girl who has previously had chronic pain. </p> <p>That being said, all children should be encouraged to truthfully express how much pain they are feeling so that healthcare providers can get the most accurate assessment and recommend the most appropriate treatment.</p> <h3>Emotional factors: How your child feels about being in pain</h3> <p>How a child expresses pain is always modified by their emotions. To get a sense of how and to what extent emotions will influence pain, ask yourself the following questions about your child: </p> <ul> <li>Is there stress and anxiety in anticipation of pain?</li> <li>Does pain create a heightened distress?</li> <li>Is there a fear of continuing pain or pain without known cause?</li> <li>Does the pain create situation-specific stress, for example at school or during social activities?</li> <li>How much frustration exists due to new limits on activities?</li> <li>Are there underlying anxiety and depression issues with your child?</li> </ul> <h3>Behavioural factors: What you and your child do to lessen pain</h3> <p>Behavioural factors influencing pain comprise what the child, their parents and other caregivers do about pain. These include:</p> <ul><li>responses to pain-induced stress</li> <li>the use and effectiveness of pain-relieving therapies such as relaxation and distraction</li> <li>how others around the child react to a painful episode</li> <li>how much pain restricts activity such as sports or attending school.</li></ul> <h3>Behavioural factors</h3> <p>A child can have many different behavioural reactions to pain, especially when in the unfamiliar environment of the hospital. Depending on the age of the child and their expectations, emotions, and general beliefs surrounding pain, they may react with anger, fear, denial, or anxiety.</p> <p>The best thing that parents and caregivers can do in these situations is to explain what is going on around the child using examples from their past experiences to make the new ones more familiar and safe.</p> <p>In the case of procedural pain, your child may actively resist treatment. Parents need to be honest with their children around pain from procedures. For example, instead of saying 'this won’t hurt', they need to say 'this will hurt but not too much and only for a minute’.</p> <p>Involving the child in any way possible may help. If there are choices your child can make, such as which arm they receive an injection, these should be offered. Even if the choices are small, the act of making a choice is a step forward. As a result, your child should feel they are regaining control, and may experience less pain along with more positive emotions and behaviour.</p> <h3>Cognitive factors: What you and your child understand and believe about pain</h3> <p>A child’s and a parent’s understanding and beliefs can have an influence on the child's pain. These include:</p> <ul><li>what caused the pain</li> <li>how strong it might be and how long it may last</li> <li>what you know about using medicines and other therapies to lessen the pain</li> <li>how well you expect these therapies to work</li> <li>what you believe triggers pain</li> <li>what you know about sources of stress that may cause pain</li> <li>what you know about reducing the stress in typical childhood experiences, including school, sports and relationships.</li></ul> <h3>Psychological factors</h3> <p>Like an adult, a child’s emotions affect how they behave and respond to pain and required medical treatments, especially when they are in the hospital. It is important to assess all the factors that can affect pain and, since fear and anxiety are so closely related to pain, evaluating whether your child is afraid and anxious is part of evaluating whether they have any pain. Children can sometimes deny that they are hurting for fear of a needle or some more frightening treatment. For these reasons, an accurate assessment of how much pain your child feels is important to make sure that everything is being done to relieve both their pain and any anxiety they may have.</p> <p>A child’s report of pain should always be taken seriously—just as an adult’s would be.</p> <p>Being honest with your child about their pain is a step in the direction of reducing beliefs that might negatively affect pain assessment.</p> <h3>Gender and cultural influences</h3> <p>Much of how we express our pain is learned behaviour. There are also gender differences associated with pain; that is boys and girls will often react differently to pain. For example, small boys will cry, but as they grow older they may put a lot of effort into making sure they don’t, particularly if others are present. Conversely, young girls may cry more because this behaviour is deemed acceptable.</p> <p>Older children behave very differently than younger children and all ages may behave differently depending on whether they are with their parents or peers.</p> <p>Cultural differences can account for a wide variety of reactions to situations. People of some cultures may express themselves freely. Others may repress their emotions or react in a way contrary to what is considered normal in the western world. For example, parents may be very reluctant to show concern or may believe it is disrespectful to ask hospital staff questions. Parents may even constantly smile through their child's painful procedure though they are not feeling happy. As well, parents and children may behave the way they believe health care professionals want them to behave. This is called being the “good patient.”</p> <p>Gender and culture can have an effect on how children express pain. All children should be encouraged to truthfully express how much pain they are feeling so that health care providers can get the most accurate assessment and recommend the most appropriate treatment.</p>Factors affecting pain assessment

Thank you to our sponsors

AboutKidsHealth is proud to partner with the following sponsors as they support our mission to improve the health and wellbeing of children in Canada and around the world by making accessible health care information available via the internet.