Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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Behavioural assessment methods have been used to signal the need for intervention and to evaluate treatment effectiveness. Direct observation and rating scales have been used to assess pain and distress associated with acute medical procedures, postoperative pain, critical care, analogue pain induction procedures and other sources. Two recent scholarly reviews of behavioural assessment methods were conducted by the Society of Pediatric Psychology Evidence-Based Assessment Task Force and the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials, which classified various instruments as well established, approaching well established or promising. ⋯ There is considerable overlap among the behavioural indicators of pain used in the different scales. Furthermore, the behavioural codes indicative of pain may occur before, during and after painful events. Recommendations for future research are provided, including using behavioural assessment to focus on children's coping and adults' behaviours, as well as pain.
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Culture is commonly regarded as a factor in pain behaviour and experience, but the meaning of the term is often unclear. There is little evidence that pain perception is modified by cultural or ethnic factors, but pain expression by children and interpretation by caregivers may be affected by the culture of the patient or the caregiver. The present paper examines some of the research regarding cultural influences on children's pain assessment, and addresses directions for future research. A focus on cultural influences should not distract clinicians from the need to be sensitive to individual beliefs and attitudes.