Appendix F

FOUR PAIN COMMANDMENTS FOR PARENTS

1) Pay attention to your child's reports of pain and the impact of pain on his/her quality of life.

• What words does your child use to describe pain?
• What factors help to relieve the pain?
• What factors make the pain worse?
• When does your child experience the pain? Is it constant? Is there a pattern to the pain cycle?
• What effect is the pain having on your child's moods, sleep, social activities, school, etc.?

2) Be proactive in learning about your child's pain.

• Ask your child's physician(s) to explain the cause of the pain and the pros and cons of possible treatment options.
• Find out if the health care provider can provide you with educational materials about pediatric pain assessment and treatment options. If appropriate, ask for additional sources of information about your child's particular type of pain (web sites, pain organizations, etc.).
• Explore non-pharmacologic methods that can be used in conjunction with pain medication to help relieve your child's pain (e.g., massage, exercise, distraction, humor).
• Find out what you can do to comfort your child prior to and during a painful procedure.
• Ask for guidance on the best way to explain pain and pain treatments to your child. Educating your child will help reduce anxiety and promote cooperation.

3) Participate in pain control decisions and management.

• Ask your child's doctor to explain the details and goal of the treatment plan, including the time frame for achieving the goal.
• If your child is scheduled for surgery, find out what pain medication will be available on a scheduled basis as well as an as needed basis for break-through pain.
• If narcotics (e.g., morphine) will be used to treat severe pain, make sure you are informed of all potential risks.
• If your child requires a painful needle stick procedure, make sure a numbing agent will be used.
• If appropriate, clarify your role in administering pain medication at home and what to look for in terms of possible side effects.
• Ask your pediatric physician about using a pain diary and how often to communicate the data being collected.
• Find out what you should do if your child continues to complain of pain.
• Notify your child's doctor immediately if he/she refuses to comply with pain treatment.

4) Communicate with Your Child's Pain Management Team

• Do not hesitate to ask questions, express concerns and/or relay information you think would be of value in preventing/relieving your child's pain.
• Get to know all of the members of your child's pain management team; learn about their areas of expertise and the best way to communicate with them.

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