How Much Does It Hurt to Be a Hospitalized Child or Adolescent in a Latin American Country?

OBJECTIVE

Adopting an optimized approach to pain assessment and treatment in hospitalized children is crucial. This study aims to explore the prevalence, assessment scales, and treatment of pain in hospitalized children.

METHODS

We conducted a cross-sectional study (January 2022-January 2023) of pediatric patients (ages 3-17, hospitalized >24 hours). Pain prevalence, intensity, causes, and satisfaction with management were assessed using an 8-item survey complemented by data from electronic health records.

RESULTS

The study included 300 children, among whom 247 (82.3%) experienced pain during hospitalization, and 269 (89%) patients reported procedural pain. Eighty-nine (29.7%) patients rated the pain as mild. Patients mainly received nonpharmacological therapy (distraction activities: 239 [79.6%]). One-hundred percent of children with cancer diagnosis (87 patients) reported pain due to procedures compared with patients without cancer (182 [85.8%] of 213 patients) (P < .016). Patients with cancer diagnosis received significantly more occupational therapy (44 [51%]), physical therapy (69 [79%]), psychotherapy (53 [61%]), and opioids (24 [27.6%]) (P < .001) compared with patients not receiving oncological care. Older children received nonpharmacological and pharmacological strategies for pain management more frequently, with significant differences across treatment categories. Two-hundred fifty-one (83.6%) achieved pain relief; severe pain was associated with less relief (17 [74%], P = .029).

CONCLUSIONS

It hurts to be a hospitalized child or adolescent. In hospitalized children, pain, especially procedural pain, is common; children with cancer experience greater suffering due to this cause. Multimodal strategies improve outcomes for mild/moderate pain. It is important to take an approach that focuses on assessment and comprehensive pain treatment tailored to the needs of the child.