Article

AIM: To explore pain screening in CPUP, a follow-up surveillance programme for
people with cerebral palsy (CP), specifically to describe reported pain
prevalence, localizations, patterns of distribution; to compare with studies
using psychometrically sound assessment instruments; and to assess agreement
between pain documented in CPUP and medical records. METHOD: Registry study of a
population with CP, born 1993 to 2008, living in Skane,
Sweden in 2013.
Descriptive data, cross-tabulations, and chi-square tests to characterize and
compare the study groups. Kappa analysis to test the concordance between register
and medical record reports on pain. RESULTS: Pain was reported by 185 out of 497
children (37%; females 40%, males 35%). Level V in both Gross Motor Function
Classification System (GMFCS) and Manual Ability Classification System (MACS) was
associated with highest prevalence of pain (50% and 54%), and level I with lowest
prevalence of pain (30% and 32%). Pain was most frequent in dyskinetic CP (46%)
and least frequent in unilateral spastic CP (33%). Feet and knees were the
dominant localizations. Fair-moderate agreement (kappa 0.37, prevalence-adjusted
bias-adjusted kappa [PABAK] 0.44) was found between documented pain in CPUP and
medical records, although more seldom recognized in medical records. INTERPRETATION:
The distribution of pain between CP subtypes, functional levels,
sex, and age in CPUP is concordant with previous population-based studies,
indicating the validity of the CPUP pain screening.
Despite this, further
clinical evaluation with extended pain assessments and pain management were
largely neglected in children reporting chronic pain.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS