Article Dans Une Revue Journal of pain management [mars 2008 (Vol. 1, n°1) - octobre 2023 (Vol. 16, n°4)] Année : 2013

Pediatric pain assessment: A pragmatic analysis of dialogues in the interactions of healthcare providers, children and their parents

Résumé

Children with mild to moderate intellectual disabilities may be able to use some self-report tools to provide a rating of the intensity of their pain. They can also describe pain quality with approriate words and use adaptative strategies to cope with their painful experiences.

Objective:
To test the efficiency of mental imagery and autobiographical memory as they could be involved in hypnosis techniques for pain management. Study groups: 21 adolescents with intellectual disabilities, (M= 17 years-old, ages from 13 to 20 years-old), mental age (M= 6.8 years-old, ages from 3.6 to 9.6 years-old) and 10 typical children as a baseline to the autobiographical memory test (M= 6 years-old, ages from 5 to 9 years-old).

Method:
To test the ability to mentally represent events, children were asked to choose a picture to complete a story they had listened to. A semi-directive interview was conducted to assess autobiographical memory for comparison to typical children.

Results:
Children with intellectual disabilities were able to generate a mental image while listening to a story. They were able to recall autobiographical memories of events that were personal and specific.

Conclusion:
Children with intellectual disabilities appear able to take advantage of hypnosis for pain management. Further research should examine their ability to use these techniques in a clinical setting

Abstract
In pediatric care, despite a triadic communication system, only physician and parent are involved in the definition of symptoms, diagnosis and treatment. However, children are competent participants when parents are absent. In this study, our interest is to highlight the pragmatic aspect of the adult-child dialogue comparing chronic versus acute pain and to understand the stages of construction of a common ground. Twenty-three children aged 6 to 15 years (12 girls and 13 boys, m= 9,8 years old) were recorded during a pain assessment interview. Fifteen children aged 7 to 15 years consulted for acute pain (7 girls, 8 boys, m= 10 years old) and eight children aged 6 to 15 years were seen in a chronic pain consultation (4 girls and 4 boys, m= 9,6 years old). In the interviews for pain assessment, healthcare providers can benefit of knowing their referencing process to adapt their discourse in way to promote an understanding of the patient’s pain experience. Verbal self-report of pain is an important way to understand the subjectivity of pain, it also becomes necessary to highlight the dialogue cues. In a patient-centered approach, the child’s role in the consultation should be as important as the parent’s. In the chronic pain context, all the speakers are taking an active part in the interaction. It is now relevant to investigate what is said and especially by who, when there are confused data about the reliability of information given by the parents.

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Dates et versions

hal-03272150 , version 1 (27-09-2023)

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  • HAL Id : hal-03272150 , version 1

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Marc Zabalia, Denis Jacquet, Corinne Grasménil, Chantal Wood. Pediatric pain assessment: A pragmatic analysis of dialogues in the interactions of healthcare providers, children and their parents. Journal of pain management [mars 2008 (Vol. 1, n°1) - octobre 2023 (Vol. 16, n°4)], 2013, 6 (2), pp.159-165. ⟨hal-03272150⟩
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