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Assessments of pain in children and adolescents with cerebral palsy : A retrospective population-based registry study

Westbom, Lena LU ; Rimstedt, Amanda and Nordmark, Eva LU (2017) In Developmental Medicine and Child Neurology 59(8). p.858-863
Abstract

Aim: To explore pain screening in CPUP, a follow-up surveillance programme for people with cerebral palsy (CP), specifically to describe reported pain prevalence, localizations, patterns of distribution; to compare with studies using psychometrically sound assessment instruments; and to assess agreement between pain documented in CPUP and medical records. Method: Registry study of a population with CP, born 1993 to 2008, living in Skåne, Sweden in 2013. Descriptive data, cross-tabulations, and chi-square tests to characterize and compare the study groups. Kappa analysis to test the concordance between register and medical record reports on pain. Results: Pain was reported by 185 out of 497 children (37%; females 40%, males 35%). Level V... (More)

Aim: To explore pain screening in CPUP, a follow-up surveillance programme for people with cerebral palsy (CP), specifically to describe reported pain prevalence, localizations, patterns of distribution; to compare with studies using psychometrically sound assessment instruments; and to assess agreement between pain documented in CPUP and medical records. Method: Registry study of a population with CP, born 1993 to 2008, living in Skåne, Sweden in 2013. Descriptive data, cross-tabulations, and chi-square tests to characterize and compare the study groups. Kappa analysis to test the concordance between register and medical record reports on pain. Results: Pain was reported by 185 out of 497 children (37%; females 40%, males 35%). Level V in both Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) was associated with highest prevalence of pain (50% and 54%), and level I with lowest prevalence of pain (30% and 32%). Pain was most frequent in dyskinetic CP (46%) and least frequent in unilateral spastic CP (33%). Feet and knees were the dominant localizations. Fair-moderate agreement (kappa 0.37, prevalence-adjusted bias-adjusted kappa [PABAK] 0.44) was found between documented pain in CPUP and medical records, although more seldom recognized in medical records. Interpretation: The distribution of pain between CP subtypes, functional levels, sex, and age in CPUP is concordant with previous population-based studies, indicating the validity of the CPUP pain screening. Despite this, further clinical evaluation with extended pain assessments and pain management were largely neglected in children reporting chronic pain.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Developmental Medicine and Child Neurology
volume
59
issue
8
pages
858 - 863
publisher
John Wiley & Sons
external identifiers
  • scopus:85019196322
  • wos:000405244100021
ISSN
0012-1622
DOI
10.1111/dmcn.13459
language
English
LU publication?
yes
id
5431be03-e604-4d53-a2fc-3a6afbdc2b6e
date added to LUP
2017-06-15 09:52:05
date last changed
2018-01-16 12:47:06
@article{5431be03-e604-4d53-a2fc-3a6afbdc2b6e,
  abstract     = {<p>Aim: To explore pain screening in CPUP, a follow-up surveillance programme for people with cerebral palsy (CP), specifically to describe reported pain prevalence, localizations, patterns of distribution; to compare with studies using psychometrically sound assessment instruments; and to assess agreement between pain documented in CPUP and medical records. Method: Registry study of a population with CP, born 1993 to 2008, living in Skåne, Sweden in 2013. Descriptive data, cross-tabulations, and chi-square tests to characterize and compare the study groups. Kappa analysis to test the concordance between register and medical record reports on pain. Results: Pain was reported by 185 out of 497 children (37%; females 40%, males 35%). Level V in both Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) was associated with highest prevalence of pain (50% and 54%), and level I with lowest prevalence of pain (30% and 32%). Pain was most frequent in dyskinetic CP (46%) and least frequent in unilateral spastic CP (33%). Feet and knees were the dominant localizations. Fair-moderate agreement (kappa 0.37, prevalence-adjusted bias-adjusted kappa [PABAK] 0.44) was found between documented pain in CPUP and medical records, although more seldom recognized in medical records. Interpretation: The distribution of pain between CP subtypes, functional levels, sex, and age in CPUP is concordant with previous population-based studies, indicating the validity of the CPUP pain screening. Despite this, further clinical evaluation with extended pain assessments and pain management were largely neglected in children reporting chronic pain.</p>},
  author       = {Westbom, Lena and Rimstedt, Amanda and Nordmark, Eva},
  issn         = {0012-1622},
  language     = {eng},
  number       = {8},
  pages        = {858--863},
  publisher    = {John Wiley & Sons},
  series       = {Developmental Medicine and Child Neurology},
  title        = {Assessments of pain in children and adolescents with cerebral palsy : A retrospective population-based registry study},
  url          = {http://dx.doi.org/10.1111/dmcn.13459},
  volume       = {59},
  year         = {2017},
}