A Survey of Caregiver Perspectives on Children's Pain Management in the Emergency Department

Objectives: We explored caregiver perspectives on their children's pain management in both a pediatric (PED) and general emergency department (GED). Study objectives were to: (1) measure caregiver estimates of children's pain scores and treatment; (2) determine caregiver level of satisfaction; and (3) determine factors associated with caregiver satisfaction. Methods: This prospective survey examined a convenience sample of 97 caregivers (n = 51 PED, n = 46 GED) with children aged <17 years. A paper-based survey was distributed by research assistants, from 2009-2011. Results: Most caregivers were female (n = 77, 79%) and were the child's mother (n = 69, 71%). Children were treated primarily for musculoskeletal pain (n = 41, 42%), headache (n = 16, 16%) and abdominal pain (n = 7, 7%). Using a 100 mm Visual Analog Scale, the maximum mean reported pain score was 75 mm (95% CI: 70-80) and mean score at discharge was 39 mm (95% CI: 32-46). Ninety percent of caregiver respondents were satisfied (80/89, 90%); three (3/50, 6%) were dissatisfied in the PED and six (6/39, 15%) in the GED. Caregivers who rated their child's pain at ED discharge as severe were less likely to be satisfied than those who rated their child's pain as mild or moderate (p = 0.034). Conclusions: Despite continued pain upon discharge, most caregivers report being satisfied with their child's pain management. Caregiver satisfaction is likely multifactorial, and physicians should be careful not to interpret satisfaction as equivalent to adequate provision of analgesia. The relationship between satisfaction and pain merits further exploration.