The assessment of pain related to invasive procedures in Anglo and Hispanic children with cancer.

Abstract

This study examined the methods used to assess children’s pain related to invasive procedures. Children with cancer frequently experience pain and anxiety due to diagnostic testing and treatment protocols. The variable of acculturation is an additional stress for the families of the Hispanic cultural group. This study adds to the information related to pain assessment and variations that may exist for children of other cultural groups. The research questions addressed by the study were concerned with the reliability and validity of methods used to assess pain in children of two cultural groups who are undergoing invasive procedures as part of their treatment for cancer. A sample of 78 Anglo and Hispanic outpatient pediatric oncology patients ranging in age from 3 to 15 years were both observed and interviewed related to the pain of an invasive procedure. The Procedure Behavioral Checklist (PBCL) was used to observe the child’s response. The Children’s Procedural Interview (CPI), based on the items in the PBCL, with visual analogues (scales of faces indicating varying degrees of pain/anxiety) was administered to the child after the invasive procedure. Data analysis included the determination of the reliability and validity of the two methods in each ethnic subgroup. Due to the possible effect of factors such as ethnicity/acculturation, age, sex, parental and child anxiety, illness duration and stage, and caregivers’ perceptions, information about these factors was gathered. Correlations among these independent variables were done to determine associations with the dependent variables. The findings included reliability coefficients of the behavioral observation scale demonstrating cultural group variability, .78 for Anglos and .54 for Hispanics. Alpha coefficients for the self-report (CPI) were .79 for Anglos and .72 for Hispanics. The Faces rating scales were shown to enhance the reliability coefficient for the CPI, and also to display