dc.description.abstract | Acute pain is one of the most common adverse stimuli experienced by children, occurring as a
result of injury, illness, and necessary medical procedures. Pain is associated with increased
anxiety, avoidance, somatic symptoms, and increased parent distress. Despite the magnitude of
effects that acute pain can have on a child, it is often inadequately assessed and treated,
especially in the African setting, where resources and skills are limited and overwhelming acute
life-saving events override pain management.
Study Objectives
To determine the prevalence, severity and initial management of pain among children
hospitalized at KNH, general paediatric wards
Methods
This was a cross sectional study in children age 1 month to 12 years admitted in KNH general
paediatric ward, within 24 hours of admission. Eligible patients were consecutively recruited into
the study between October and December 2013 until a desired sample size was reached .Using a
structured questionnaire and two age appropriate pain scales; Faces, Legs, Activity, Crying and
Consolability scale (FLACC) for patients aged 1 - 47 months and Revised Faces Pain scale
(FPS_R) for patients age 4 -12 years, data was collected on presence, location and severity of
pain within the first 24 hours of admission into the ward. Patient‘s treatment sheets and nursing
charts were reviewed to determine initial pain management.
Results
Between the months of October to December 2013, out of 503 patients in the general paediatric
wards who met the inclusion criteria, 400 participants/caregivers gave consent and were enrolled
to participate in the study. Participants between the age of 1 – 47 months (Younger children)
were 288/400 (72%) with a median age of 10 months (IQR 3, 20) whereas participants between
the age of 4 -12 years (Older children) were 112/400 (28%) with a median age of 8 years (IQR 5,
10). The male to female ratio for both age groups was 1.2:1 with males comprising 54% of the
total study population.
Overall prevalence of pain among children hospitalized in KNH general paediatric wards was
found to be 78%.Among the younger children, 38% were found to have mild pain, 29%
moderate pain and 2 % severe pain associated with clinical procedures and underlying illness.
Among the older children, 12% reported mild pain, 69% reported moderate pain and 5% reported
severe pain.
Analgesics were provided to 59% of patients in pain, largely a single drug, most commonly
paracetamol which was administered intermittently. According to the pain management index,
only half of the patients in pain received adequate analgesia.
Conclusion
Pain is common among hospitalized children at KNH general paediatric wards occurring in 78%
of the participants most (71%) of whom experience mild to moderate pain.
Pain management is poor with only 50 % of patients with pain receive adequate analgesia
Recommendations
1. Use of Pharmacologic (i.e. Topical analgesic creams/ spray) and non- pharmacologic
interventions by the healthcare workers to reduce pain due to clinical procedures.
2. Training of health care providers on appropriate use and proper dosing of analgesics
in the paediatric population. | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |