Background & Aims
According to the current definition of the International Association for the Study of Pain (IASP), obtained in 2020, pain is “an anxious sensory and emotional experience associated with actual or potential tissue injury, or described in terms of such injury”. In this sense, although pain is the most common consent of hospital patients, pediatric pain can still be undertreated. When using pain scales, both the Visual Analogue Scale (VAS) and the Face, Legs, Activity, Cry and Consolability Scale (FLACC), the assessments of parents and nurses were always lower than the assessments reported by the children, which may indicate that undertreatment is a consequence of underdiagnosis. Given this scenario, it is necessary to understand more clearly how such health professionals are trained, especially in relation to non-pharmacological treatment, in order to allow disciplines to be developed and the diagnosis and management of pain in future practices to be improved.
Methods
After approval by the research ethics committee of the Universidade Federal de São Carlos (UFSCar), medical students, from the second to the last year of their studies at this same university, were invited to answer a questionnaire with questions about pediatric pain, treatment non-pharmacological aspects of pediatric pain and how these topics were and are addressed in health courses today. Interviews were also carried out with UFSCar’s medical professors, online or in person, with questions on the same topics. Based on these responses, we sought to understand these group’s understanding of the topics covered. With the data collected, an observational, exploratory-descriptive and cross-sectional study and statistical analysis were carried out with a significance of 5%.
Results
In relation to teachers, 24 responses were collected, 13 women and 11 men, with 21 of the participants holding doctorate degrees. Of the interviewees, only one stated that the issue of pediatric pain is addressed in the curriculum of the place where they work, the others did not respond or just believed they were part of it. However, 95.8% believe that the approach and use of non-pharmacological techniques should increase. Regarding students, 92 responses were collected, 53 women and 39 men, with 86.7% between 20 and 30 years old. Of those interviewed, 51% disagreed that children, especially those under 2 years of age, showed increased sensitivity to pain and memory of painful experiences and similar stimuli in different children produced the same intensity of pain. However, 45.9% of students, when asked if they knew how to prevent acute pain in children, disagreed.
Conclusions
Thus, although studies on the topic began to be published in Brazil only in the 90s, conceptions on the subject are already more consolidated today, so that students have an idea of ??the importance of the topic. However, the curriculum seems unclear on the topic, so that the teachers themselves were unable to say exactly whether such themes are covered throughout the undergraduate course, even though they believe that non-pharmacological techniques should be more explored in medical training. Thus, although there is a growing number of publications and studies on pediatric pain, the gaps in this subject highlight the increasing need for medical students to have contact with education about pain in this age group throughout their undergraduate studies, especially so that they can approach and manage it in the most efficient and holistic way possible.
References
Raja, S.N.; Carr, D.B.; Cohen, M.; Finnerup, N.B.; Flor, H.; Gibson, S.; Keefe, F.J.; Mogil, J.S.; Ringkamp, M.; Sluka, K.A.; et al. The revised International Association for the Study of Pain definition of pain. Pain 2020.
Mak WY, Yuen V, Irwin M, Hui T. Pharmacotherapy for acute pain in children: Current practice and recent advances. Expert Opin Pharmacother. 2011;12(6):865–881.
DA CUNHA BATALHA, Luís Manuel; DOMINGUES SOUSA, Ana Filipa. Self-report of pain intensity: correlation between children, parents, and nurses. Revista de Enfermagem Referência, v. 4, n. 17, p. 15-21A, 2018.
ROSSATO, LM, Angelo M. Utilizando instrumentos para avaliação da percepção de dor em pré-escolares face a procedimento doloroso. Revista da Escola de Enfermagem da USP [online]. 1999; 33(3)236-249. Disponível em: <https://doi.org/10.1590/S0080-62341999000300005>.
BARBOSA, SM. Prática Hospitalar. 2006; 8(47): 78-82.
SILVA, APM; BALDA, RCX; GUINSBURG, R.Reconhecimento da dor no recém-nascido por alunos de medicina, residentes de pediatria e neonatologia. Revista Dor. 2021:13(1),35–44. Disponível em https://doi.org/10.1590/S1806-00132012000100007
PAES, TV; SILVA-RODRIGUES, FM; ÁVILA, LK de. Métodos Não Farmacológicos para o Manejo da Dor em Oncologia Pediátrica: Evidências da Literatura. Revista Brasileira de Cancerologia, [S. l.], v. 67, n. 2, p. e–031027, 2021. DOI: 10.32635/2176-9745.RBC.2021v67n2.1027. Disponível em: https://rbc.inca.gov.br/index.php/revista/article/view/1027.
Volpin, M. C.; Ferreira, E. L.; Eduardo, A. A.; Bombarda, T. B. Ensino sobre cuidados paliativos nos cursos da área de saúde: apontamentos sobre lacunas e caminhos. Diálogos Interdisciplinares,v. 11, n. 1, p. 140-153,31 mar. 2022.
Presenting Author
Esther Angelica Luiz Ferreira
Poster Authors
Esther Angelica Luiz Ferreira
PhD
Federal University of São Carlos
Lead Author
Ricardo Patrezi Zanatta
medicine student
Federal University of São Carlos
Lead Author
Lucas Pereira Liberal
medicine student
Federal University of São Carlos
Lead Author
Maycon Rodrigo Sarracini
Physical education student
Federal University of São Carlos
Lead Author
Maria Sagrario Gómez-Cantarino
PhD
University of Castilla La Mancha
Lead Author
Cristina Helena Bruno
PhD
Federal University of São Carlos
Lead Author
Rodrigo Bezerra de Menezes Reiff
PhD
Federal University of São Carlos
Lead Author
Cristina Ortiz Sobrinho Valete
PhD
Federal University of São Carlos
Lead Author
INMACULADA GARCÍA-VALDIVIESO JIMÉNEZ
PhD student
University of Castilla La Mancha
Lead Author
Juan Manuel Pérez
Master's Degree student
University of Castilla La Mancha
Lead Author
Topics
- Education