Observer Perceptions of Pain in Children with Cognitive Impairments: Vignette Development and Validation

Abstract

Aim: Develop vignettes depicting different pain types in verbal and nonverbal children with cognitive impairments that could help examine pain assessment and management decisions of secondary caregivers, and conduct initial convergent and divergent validity analyses. Methods: For six vignettes, 76 undergraduate students (38 females, mean age = 19.55) rated (0–10): pain intensity, difficulty rating pain intensity, need for medical attention and need for other attention (e.g., physical comfort). Results: Ratings significantly varied by pain source (e.g., headache was rated more painful than injections). Verbal ability did not impact ratings. Conclusion: Vignettes could serve as an alternative method to study pain decisions by caregivers of children with cognitive impairments when ethical barriers limit more naturalistic research.

KEYWORDS :

• children
• cognitive impairment
• pain assessment
• pain management
• vignettes

Acknowledgements

The researchers would like to thank Dr Scott Colwell for his statistical consultations.

Author contributions

All authors discussed results and commented on the manuscript.

Disclosure

The participants from this study were a subset of a sample within a larger scale study; therefore parts of their responses were utilized in analyses presented at the following conferences: Ontario Association on Developmental Disabilities Research Special Interest Group Annual Research Day (April 2013, April 2014); International Forum on Pediatric Pain (October 2013); Canadian Pain Society (May 2014); International Association on the Study of Pain World Congress (October 2014).

Financial & competing interests disclosure

This research was funded by a faculty start-up grant. This research was part of an honors thesis research project under the supervision of CM McMurtry. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate insti­tutional review board approval or have followed the princi­ples outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investi­gations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

This research was funded by a faculty start-up grant. This research was part of an honors thesis research project under the supervision of CM McMurtry. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.