By Barry J. Evans PhD and Graham D. Burrows AO, KSJ, MD (Eds.)
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PROBLEMS IN THE ASSESSMENT OF PAIN IN CHILDREN In addition to consideration of the child’s developmental stage, it is crucial to assess their degree of suffering as one prepares to offer some therapeutic relief. This assessment helps us to determine a baseline of behaviour and experience, as well as to predict the eventual effectiveness of treatment. It is often difficult to obtain a report of pain directly from children. For example, self-reports of pain are impossible for the infant and pre-verbal young child.
Martin complained to his father about the anxiety and pain. His was a family with a strong Christian tradition, so the father suggested that Martin try to relax by reciting Psalm 23 to himself. In fact, his father told him that, if he would do this, the bone marrow aspiration would not hurt. Fortunately, this suggestion was very effective. Following his father’s suggestion, Martin was able to remain relaxed and calm throughout subsequent procedures. His description of the pain suggested it was now greatly diminished.
These are among the qualities that seem to help us achieve success in adult life. Thus, it is often difficult to suspend those treasured qualities and experience and to adopt what (initially at least) may feel like a passive, dependent mode of behaviour, with another person directing our attention and physical behaviour. It is difficult, when in a critical frame of mind, to so intensely imagine having a bag of ice on a sore joint that both the idea and the image become real and compelling. , then we may be able — temporarily — to suspend our usual level of critical evaluation.