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The measurement of pain in infants, children, and adolescents: from policy to practice.

Although the capacity to perceive and respond to pain contributes to health by alerting people to injury and illness, unrelieved and persistent pain is known to impair health, limit functional capabilities, and compromise quality of life.1 Research and critical review of knowledge generated over the past 3 decades have dramatically increased understanding of pain mechanisms,2–4 consequences,5–7 and management8–10; however, the transfer of this knowledge into clinical practice has been slow and sporadic.1 This slow transfer has precipitated national and international efforts to develop and implement clinical practice guidelines to improve pain identification and management.11

Pain is a common experience during childhood. All children encounter “everyday” pain associated with minor bumps and bruises,12,13 and many endure pain resulting from serious injuries, diseases, and other health conditions requiring medical care.14,15 Despite its prevalence, pain in infants, children, and adolescents is often underestimated and undertreated.16–21 Barriers to good pain management are numerous and reflect biological, psychological, and social factors.1,22 These barriers include erroneous beliefs about the neurobiology of pain, fears about pharmacological management, and deficits in knowledge and skills by health care professionals who care for children.23–27 One area of professional expertise that is reported to be consistently lacking is the knowledge and systematic use of pediatric pain measures that yield valid and reliable data.1,23,25,28 The purposes of this update are: (1) to inform readers about recent policy initiatives to improve identification and management of pain in infants and children and (2) to provide a brief overview of pediatric pain measures currently used in clinical practice.

Although pain is defined in many ways, 3 definitions are relevant to …