Pain assessment in pediatric sickle cell disease

The unpredictability of pain occurrence and the subjectivity of sickle cell pain create unique challenges in the assessment of pediatric sickle cell disease. A description and critique of current pain assessment measures, including verbal, motoric, and physiological-medical indices, and their applications with this population are provided. Pain assessment measures and corresponding research with pediatric sickle cell disease patients were found to be somewhat lacking, especially when compared with assessment of other pediatric problems. Major methodological concerns were revealed in that assessment has frequently relied on a single informant and pain measures often have been extended to a population beyond those on which they were normed. Findings emphasize the need for a multimodal approach to pain assessment, the use of pain ratings from multiple informants, and further development of more reliable and valid measures in order to provide adequate assessment and more effective pain management of pediatric sickle cell disease.