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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The present paper reviews the current status of research on assessment of chronic pain in children and adolescents, primarily in the context of treatment outcome research. Two specific primary aims are addressed. First, the degree of attention devoted to several major domains of chronic pain assessment (pain, physical functioning, role functioning, sleep and emotional functioning) is summarized, highlighting areas where further instrument development and validation are needed. ⋯ Clinical implications of integrating assessment tools into clinical practice are discussed. In conclusion, progress in developing and validating specific tools to assess important outcome domains in chronic pain has been realized. Opportunities exist for further measurement validation in most domains, and further theory-driven treatment research to match goals of the treatment with specific interventions and outcomes.
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The present paper provides a short, practical introduction to children's self-report measures of pain intensity, followed by an overview of principles and issues. Details on individual self-report scales were previously reported in a landmark systematic review in 2006 and will not be repeated here. ⋯ Also highlighted are areas in which there has been progress and a lack of progress since the last time this topic was featured at the International Forum on Pediatric Pain in 1996. The present article closes with an outline of key areas for further research on children's self-report of pain and a brief summary of recommendations for clinicians.
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Review Historical Article
Assessing pain by facial expression: facial expression as nexus.
The experience of pain is often represented by changes in facial expression. Evidence of pain that is available from facial expression has been the subject of considerable scientific investigation. The present paper reviews the history of pain assessment via facial expression in the context of a model of pain expression as a nexus connecting internal experience with social influence. ⋯ Applications of facial assessment in the study of adult and pediatric pain are also reviewed, focusing on how such techniques facilitate the discovery and articulation of novel phenomena. Emerging applications of facial assessment in clinical settings are also described. Alternative techniques that have the potential to overcome barriers to the application of facial assessment arising out of its resource intensiveness are described and evaluated, including recent work on computer- based automatic assessment.
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Review
Improving the assessment of pediatric chronic pain: harnessing the potential of electronic diaries.
Current methods for evaluating chronic pain in children suffer from methodological problems. Real-time data capture approaches using electronic diaries have been proposed as a new standard for pain measurement. However, there is limited information available regarding the development, feasibility and validity of these approaches in children. The present paper reviews problems with current measures; rationale for developing real-time data capture approaches using electronic diaries; mechanics of developing electronic pain diaries; current evidence regarding their usability, feasibility and validity; and discusses future directions for research in this area.