Accuracy of parental-global-impression of children's acute pain.

The primary purpose of this study is to compare parental-global-impression of children's level of acute pain at home with parental assessment of children's pain using a structured instrument and with children's self-reports of pain. We recruited 32 parents of children aged 5 to 10 years who were diagnosed with a fractured limb and treated in a tertiary emergency department. After discharge, parents were asked to complete three home-based assessments relating to their child's acute pain: the parental-global-impression of pain, child's reported pain, and structured Parental Postoperative Pain Measure. Data analysis included odds ratios, sensitivity, specificity, positive and negative predictive values, and repeated-measures analysis of variance. When compared with child report of pain, the sensitivity of parental-global-impression was 76% on day 1 and 93% on day 2, whereas specificity was 91% on day 1 and 83% on day 2. When compared with child report of pain, the sensitivity of Parental Postoperative Pain Measure was 71% on day 1 and 66% on day 2, whereas specificity was 82% on day 1 and 83% on day 2. On the basis of acceptable statistical criteria, parental-global-impression has good sensitivity and specificity compared with the child self-report measure. We do not suggest, however, that parental-global-impression can or should replace child report, but rather suggest that it can be used as an adjunct assessment measure as needed.