Children get sick or undergo surgery, and they experience pain similar to adults. However, their perception of pain is different and may at times be exaggerated ( Verghese, & Hannallah, 2010) . Research reveals that female and Caucasian children under five years report more pain perception than males and non-Caucasians which raises the issue of pain assessment in children ( Kozlowski, et al., 2014) . Usually, children are given pain medication using the step up method which means that a mild painkiller is administered and more is added if the previous one is not effective. While this technique meets the clinical standard that the right dosage for pain relief is that which relieves pain with the least side effects, it is not clear how to determine that pain is reduced in some instances ( Verghese, & Hannallah, 2010) .
The reason for picking this topic is that untreated pain is a significant cause of illness and death in children, especially after surgical procedures. Pain in children is assessed through self–reporting for older children that have the cognitive ability to do so. For younger children, those with developmental issues and infants, signs that a health care professional should look for to identify pain have been narrowed down and listed. While this helps reduce pain-related morbidity and mortality in children, it is still a problem because in both cases, there is a risk of overdosing especially while using opioid pain relievers ( Verghese, & Hannallah, 2010) . Some children who can self -report may experience phantom pain due to fear or anxiety while the nurse-directed assessment method does not indicate precisely the level of pain a child is in.
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Background Question
How can nurses and physicians accurately measure and manage pain in children under 13?
Foreground Question
In children under 13 years, how does one accurately determine the actual level of pain as compared to using self-reporting and physician-directed assessment to reduce the risk of overdosing especially after surgical procedures?
References
Kozlowski, L. J., Kost-Byerly, S., Colantuoni, E., Thompson, C. B., Vasquenza, K. J., Rothman, S. K., … Monitto, C. L. (2014). Pain Prevalence, Intensity, Assessment and Management in a Hospitalized Pediatric Population. Pain Management Nursing , 15 (1), 22-35. doi:10.1016/j.pmn.2012.04.003
Verghese, S. T., & Hannallah, R. S. (2010). Acute pain management in children. Journal of Pain Research , 3 , 105-123. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004641/
