Paediatric procedure-related cancer pain assessment
Introduction Asa consequence of intensive research throughout the last twodecades, a number of unidimensional, multidimensional and composite measures for assessing children’s pain have been developed. Although the number of measures is growing, attention to the establishment of their psychometric properties and clinical utility is not. Moreover, these measures are not yet consistently used in clinical practice. Pain is a subjective, personal event that can be measured only indirectly by one of three strategies. It is agreed that the ‘gold standard’ for measuring pain should be what children report about their experience (self-report measures). In addition, pain can be measured by the way in which children react in response to pain (behavioural measures). Finally, the way in which children’s bodies respond to pain (physiological measures) can be used. In this chapter, the signi¢cance of assessment in pain management is
emphasised and the challenge of assessing pain in children is explored. The professional, political and economic barriers to assessing pain adequately are also discussed. Key concepts of the psychometric theory are brie£y reviewed before existing pain measures for infants, children and adolescents are described and evaluated. Emphasis is placed onmeasures that are utilised in the oncology setting.2.1 The chapter concludes with a discussion of a proposed model of clinical assessment of the psychological dimensions of procedure-related pain.