Difficult pain assessment and lack of clinician knowledge are ongoing barriers to effective pain management in children with cognitive impairment

Identification of barriers that inhibit effective pain treatment in children with cognitive impairment (CI) may facilitate targeted interventions to ensure that they receive optimal care. This study was undertaken to identify factors that impede effective treatment of pain in children with CI. Clinicians who provided direct care to children were surveyed regarding perceptions of pain management issues. 215 nurses and physicians completed and returned surveys. Difficulties with pain assessment, the lack of valid pain assessment tools, and poor documentation were ranked by the majority of clinicians as factors that impeded their ability to effectively manage pain in this population. Additionally, 88% believed that inadequate education impedes effective pain management in this population, and 88% would attend continuing education courses on pain in children. These data suggest that development of valid and clinically useful pain assessment tools, and focused continuing education may provide the best interventions toward the improvement of pain management in this and similar vulnerable populations.