Abstract
The objective of this study was to determine how parents of preverbal children determine
whether their child is having otalgia. We constructed 8 cases describing a 1-year-old
child with acute otitis media (AOM) using various combinations of the following 6
observable symptoms: fussiness, ear tugging, eating less, fever, sleeping difficulty,
and playing less. Parents of children with a history of AOM presenting for well or
sick appointments to an ambulatory clinic were asked to assign a pain level to each
case on a visual analog scale. Sixty-nine parents participated in the study. Each
of the 6 behaviors was associated with increased pain levels (P < .0001). Ear tugging and fussiness had the highest impact on the assigned pain levels.
Higher level of parental education and private insurance were associated with higher
reported pain levels (P = .007 and P = .001, respectively). Because interpretation of symptoms appears to be influenced
by socioeconomic status, we question the utility of using an overall pain score from
a 1-item parent scale as an outcome measure in clinical trials that include preverbal
children.
Perspective
Parents of preverbal children with acute otitis media use observable behaviors to
determine their child's pain level. Interpretation of symptoms, however, appears to
be influenced by socioeconomic status. Thus, we question the utility of using a 1-item
parental pain scale in clinical trials that include preverbal children.
Key words
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Article info
Publication history
Published online: May 13, 2010
Accepted:
March 5,
2010
Received in revised form:
February 26,
2010
Received:
December 18,
2009
Footnotes
Supported in part by Grant Number UL1 RR024153 from the National Center for Research Resources (NCRR) to W.F. and Y.L.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
