• Brenna L Morse, Richard W Serna, McKenzie LaLumiere, Micaela Rogal, Kerri Foley, Miranda Lombardo, Christopher Manganello, Victoria Pugh, Amy Veloz, Jean C Solodiuk, and Sangeeta Mauskar.
• Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts. Electronic address: brenna_morse@uml.edu.
• Pain Manag Nurs. 2021 Apr 1; 22 (2): 169-176.

PurposeChildren with medical complexity (MC) must rely on others to notice and address pain. Parents are aware of child pain behaviors and can serve as reliable proxy reporters. Thus, there is a critical need to understand parent perspectives to improve pain practices.DesignIndividual interviews were used as a data collection method in this qualitative study.MethodsParticipants were recruited via mail and social media postings. Interviews were audio-recorded and transcribed verbatim. Transcribed documents were imported to NVIVO for qualitative analysis. Conventional and directed approaches to qualitative content analysis were used.ResultsFrom the data analysis, major themes included: pain experiences, confidence in caregivers, parents are partners, proactive communication, and a spontaneous theme, "they can hear us." Emotional pain and challenges identifying the source pain were identified as sub-themes of pain experiences.ConclusionsParents in this study shared methods helpful to identifying pain in their children, as well as suggestions for discussing pain with caregivers. Priorities for future research include identifying methods for sharing pain information that are thorough, but do not burden parents or providers. Researchers should also determine how parents and caregivers can partner to identify and address pain in children with MC. Going forward, conversations about pain should be a key part of any admission assessment or first encounter. As pain episodes among children with MC can be complex and may not always be re-created in front of a provider, nurses may advise parents to take photos or videos to share with caregivers.Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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