Objective: The aim of this paper was to discuss differences between having a child perspective and taking the child’s perspective based on the problem being investigated. Methods: Conceptual paper based on narrative review. Results: The child’s perspective in research concerning children that need additional support are important. The difference between having a child perspective and taking the child’s perspective in conjunction with the need to know children’s opinions has been discussed in the literature. From an ideological perspective the difference between the two perspectives seems self-evident, but the perspectives might be better seen as different ends on a continuum solely from an adult’s view of children to solely the perspective of children themselves. Depending on the research question, the design of the study may benefit from taking either perspective. In this article, we discuss the difference between the perspectives based on the problem being investigated, children’s capacity to express opinions, environmental adaptations and the degree of interpretation needed to understand children’s opinions. Conclusion: The examples provided indicate that children’s opinions can be regarded in most research, although to different degrees. Read More: http://informahealthcare.com/doi/abs/10.3109/17518423.2013.801529

There are several concerns in relation to children living with a parent suffering from a mental illness. In such circumstances, the health-care professionals need to involve the whole family, offering help to the parents on parenting as well as support for their children. These children are often helped by participating in meetings that provide them with contact with others with similar experiences. The aim of this study was to investigate young adults' childhood experiences of support groups when living with a mentally ill parent. Seven young women were chosen to participate in this study. A qualitative descriptive method was chosen. The main category emerged as 'the influence of life outside the home because of a parent's mental illness' from the two generic categories: 'a different world' and 'an emotion-filled life'. The participants' friends did not know that their parent was ill and they 'always had to…take responsibility for what happened at home'. These young adults appreciated the support group activities they participated in during their childhood, stating that the meetings had influenced their everyday life as young adults. Despite this, they associated their everyday life with feelings of being different. This study highlights the need for support groups for children whose parents suffer from mental illness.

Needle fear is a common problem in children undergoing immunization. To ensure that the individual child’s needs are met during a painful procedure it would be beneficial to be able to predict whether there is a need for extra support. The self-reporting instrument facial affective scale (FAS) could have potential for this purpose. The aim of this study was to evaluate whether the FAS can predict pain unpleasantness in girls undergoing immunization. Girls, aged 11-12 years, reported their expected pain unpleasantness on the FAS at least two weeks before and then experienced pain unpleasantness immediately before each vaccination. The experienced pain unpleasantness during the vaccination was also reported immediately after each immunization. The level of anxiety was similarly assessed during each vaccination and supplemented with stress measures in relation to the procedure in order to assess and evaluate concurrent validity. The results show that the FAS is valid to predict pain unpleasantness in 11-12-year-old girls who undergo immunizations and that it has the potential to be a feasible instrument to identify children who are in need of extra support to cope with immunization. In conclusion, the FAS measurement can facilitate caring interventions.

The aim of this study was to test how distraction influences pain, distress and anxiety in children during wound care. Sixty participants aged 5-12years were randomized to three groups: serious gaming, the use of lollipops and a control group. Self-reported pain, distress, anxiety and observed pain behaviour were recorded in conjunction with wound care. Serious gaming, an active distraction, reduced the observed pain behaviour and self-reported distress compared with the other groups. A sense of control and engagement in the distraction, together, may be the explanation for the different pain behaviours when children use serious gaming.

Background. Preoperative anxiety complicates treatment and requires assessment by nurses in children. Children, with or without disability, are helped when pictures are used to support communication. The purpose of this pilot study was to test the reliability and validity of the modified short State-Trait Anxiety Inventory (STAI) using a modified Talking Mats method in children undergoing day surgeries. Method. A modified short STAI with pictorial support along the lines of the Talking Mats method was pre- and postoperatively administered to 42 typically developing children aged three to nine years. The parents assessed the children's anxiety, simultaneously and independently, by scoring the short STAI by proxy. Results. The modified short STAI showed moderate internal consistency and good construct validity in the age group seven to nine years. Conclusions. The results of this study support the use of the instrument for self-reports in children aged seven to nine years. Future research will explore the possibilities of also using this instrument for children with cognitive and communicative difficulties.

Pain has been highlighted as a main concern for children in conjunction with an acuteradiographicexamination. The aim of this study was to further investigate children’spain and distress while undergoing an acuteradiographicexamination. The study comprised 29 participants with an age range of 5–15 years who were injured and submitted to an acuteradiographicexamination of the upper or lower extremity when the question at issue was fracture. The Coloured Analogue Scale (CAS) and the Facial Affective Scale (FAS) were used as self-reporting scales to measure the children’spain and distress. The Face, Legs, Activity, Cry and Consolability Behavioural scale (FLACC) was used as an observation tool to assess behaviours associated with pain in children. Descriptive statistics were used when analysing the scores, and the results showed that children experience pain and distress in conjunction with a radiographicexamination after an injury. Spearman’s correlation was used to compare variables, and significant correlations were obtained between the self-reported pain and the observed pain behaviour. Fischer’s Exact test was used to compare groups, and when using the cut-off 3.0 on the self-reporting scale no significant correlation was found concerning the pain reported by children diagnosed with and without a fracture. No significant correlations were found concerning the self-reported distress and pain either, regardless of whether it was a first-time visit and whether a parent was near during the examination.

Aim The purpose of this pilot study was to explore the use of massage therapy in children with cerebral palsy undergoing post-operative rehabilitation. Material and method Three participants were randomized to massage therapy and another three participants to rest. All children had undergone surgery in one or two lower limbs. Pain, wellbeing, sleep quality, heart rate and qualitative data were collected for each child. Results The scores of pain intensity and discomfort were low in all participants. Heart rate decreased in participants who were randomized to rest, but no change was found in the massage therapy group. Conclusions The lack of decrease in heart rate in the study group of massage therapy may imply an increased sensitivity to touch in the post-operative setting. Further research with larger study populations are needed to evaluate how and when massage therapy is useful for children with cerebral palsy.

This article reviews the literature describing pharmacological and non-pharmacological strategies that nurses can use to manage pain during wound dressing in children aged between one and 18 years in cases where general anaesthesia is not required. The article discusses the assessment of wound pain and anxiety in children and describes the choices available to nurses when managing pain and anxiety during wound dressings.

En enkät om organisationen av omhändertagandet av akut och återkommande smärta hos barn har besvarats av 26 av landets 34 barnkliniker. Drygt en tredjedel av dessa har organiserad verksamhet för akut och/eller långvarig smärta. En femtedel av barnklinikerna har en verksamhet som är specifikt organiserad för barn. Flertalet av dessa mottagningar är bemannade med deltidsarbetande personal. Endast två läkare och fyra sjuksköterskor arbetar heltid med dessa frågor, och antalet psykologer och sjukgymnaster är begränsat.

Aim.  This paper is a report of the experiences of children (5–10 years) of procedural pain when they underwent a trauma wound care session. Background.  Procedural pain in conjunction with trauma wound care often induces anxiety and distress in children. Children need to alleviate pain and avoid the development of fear in conjunction with examinations and treatments. The nurse could help children to reach this goal by using the comfort theory, which describes holistic nursing in four contexts: physical, psychospiritual, environmental and sociocultural. Few studies have focused on children’s experiences of comforting activities in conjunction with trauma wound dressings. Methods.  This study was conducted between May 2008 and January 2010. Thirty-nine participants aged 5–10 were consecutively included in this study. The wound care session was standardized for all the participants, and semi-structured qualitative interviews with open-ended questions were conducted with all the children in conjunction with the procedure. All the interviews were transcribed verbatim and analysed with qualitative content analysis. Findings.  Four themes were identified: clinical competence, distraction, participation and security. The children were helped to reach comforting activities to enhance pain management. Conclusion.  Children require more than just analgesics in wound care. They also need to experience security and participation in this context. When children feel clinical competence in wound care, they trust the nurse to carry out the wound dressing and instead can focus on the distraction that increases their positive outcomes.