Little is known regarding the pain experienced by children with cancer during acute phases of hospitalization.  The purpose of this study was to:  1) characterize the intensity, location, and quality of pain in hospitalized children with cancer; 2) evaluate the management of pain, and 3) examine the relationships between pain and perception of sleep and activity.

METHODS

A descriptive design with repeated measures was used in 49 children (8 to 17 years) who described their pain using the Adolescent Pediatric Pain Tool, rated the perceived amount of pain relief from medications and perceived amount of sleep and activity using a 0 to 10 numeric rating scale.  Data were collected once daily for up to a maximum of five consecutive days.   Medications administered for pain were recorded for each 24 hour day of participation in the study. 

RESULTS

More than half of the patients (27/49) indicated they were having pain; 11 (22.4%) had mild pain (mean 2.3 ± 0.9, range 0.3 to 3.6), 10 (20.4%) had moderate pain (mean 5.3 ± 0.2, range 5.0 to 5.5), and 6 (12.2%) had severe pain (mean 7.6 ± 1.3, range 6.5 to 10.0).  Highest pain intensity ratings occurred on day 1 and the majority of patients reported good relief after pain medications.  Two patients had persistent severe pain that were unrelieved even with hydromophone delivered by patient controlled analgesia.  No significant relationships were found in sleep or activity scores regardless of the intensity of pain.

CONCLUSIONS

Pain experienced by hospitalized children with cancer was responsive to the analgesics used for mild and moderate pain.  However, few patients had unrelieved pain that persisted despite continuous infusion of intravenous opiates. Because the highest pain ratings occurred on day 1, we recommend consistent assessment and implementation of pain interventions within the first 24 hours of admission.