Developmental Influences on the Meanings of Pain in Children by

Joshua W Pate (Pages 33-44)

Aim

What does pain mean to a child? As a child develops, so does their meaning of pain. In this chapter, developmental influences on a child’s meaning of pain are explored.

Methods

Scientific literature review and conceptual analysis.

Results

A child learns the meaning of pain when they can understand the word “pain,” or its equivalent in another language, and if a child is a sufficiently fluent participant in the practice of using “pain.” Cognitive, affective, social, and experiential factors influence a child’s personal meaning of pain in unique ways. Pain science education, where learning is focused on the “what,” “why,” and “how” of pain, is considered foundational to education about pain treatment strategies. A child’s meaning of pain is theoretically impacted upon by pain science education, an approach based on conceptual change theory. Individual conceptual changes over time are a key consideration. The helpfulness of using a variety of media (e.g., drawings, videos, and text) appears to relate more to a child’s level of comfort with the medium or level of engagement, rather than their age. Some children may not require any formal pain science education, but rather benefit most from reassurance from a trusted adult with influence such as a parent, teacher, or health professional. More research is needed on the meaning of pain in disadvantaged or vulnerable children, particularly in terms of clinical assessments. Complex concepts develop in children as they grow. Therefore, paediatric pain science education should gradually increase in complexity, building on a child’s previous conceptual developments.

Clarity about the terminology used for conceptual change learning is essential in paediatric clinical practice. Age-appropriate language in conversations by health professionals may facilitate the therapeutic alliance in clinical settings. The recently developed Concept of Pain Inventory (COPI) can aid in individualising pain science education by identifying “gaps” and misconceptions.

Declaration

The authors have nothing to declare.