We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Pain charts (body maps or manikins) in assessment of the location of pediatric pain

    Carl L von Baeyer

    † Author for correspondence

    Departments of Psychology & Pediatrics, University of Saskatchewan, Saskatoon, SK S7N 5A5, Canada.

    ,
    Vivian Lin

    Medical student, Tufts University, Boston, MA, USA

    ,
    Laura C Seidman

    Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    ,
    Jennie CI Tsao

    Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    &
    Lonnie K Zeltzer

    Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Published Online:https://doi.org/10.2217/pmt.10.2

    This article surveys the use of pain charts or pain drawings in eliciting information about the location of pain symptoms from children and adolescents. While pain charts are widely used and have been incorporated in multidimensional pediatric pain questionnaires and diaries, they present a number of issues requiring further study. These include, in particular, the number and size of different locations or areas of pain that need to be differentiated; the age at which children are able to complete pain charts unassisted; and whether the intensity and other qualities of pain can be accurately recorded on pain charts by children and adolescents. Based on data currently available, it is suggested that the unassisted use of pain charts be restricted to children aged 8 years or over, while for clinical purposes many younger children can complete pain charts with adult support. Where the investigator’s interest is restricted to a few areas of the body, checklists of body parts may have greater utility than pain charts. A new pain chart adapted for use in studies of pediatric recurrent and chronic pain is presented.

    Papers of special note have been highlighted as: ▪ of interest

    Bibliography

    • Paananen MV, Auvinen JP, Taimela SP et al.: Psychosocial, mechanical, and metabolic factors in adolescents’ musculoskeletal pain in multiple locations: a cross-sectional study. Eur. J. Pain14(4),395–401 (2010).
    • Roth-Isigkeit A, Ellert U, Kurth BM: [Assessment of pain in the child and adolescent health survey]. Gesundheitswesen64(Suppl. 1),S125–S129 (2002).
    • van den Hoven LH, Gorter KJ, Picavet HS: Measuring musculoskeletal pain by questionnaires: the manikin versus written questions. Eur. J. Pain14(3),335–338 (2010).▪ Recent comparison of pain charts with written questions (in adults).
    • Melzack R: The McGill pain questionnaire: major properties and scoring methods. Pain1(3),277–299 (1975).
    • Margoles M: The pain chart: spatial properties of pain. In: Pain Measurement and Assessment. Melzack R (Ed.). Raven Press, NY, USA, 215–225 (1983).▪ The earliest comprehensive discussion of ways to assess pain location.
    • Carnes D, Ashby D, Underwood M: A systematic review of pain drawing literature: should pain drawings be used for psychologic screening? Clin. J. Pain22(5),449–457 (2006).
    • Varni JW, Thompson KL, Hanson V: The Varni/Thompson Pediatric Pain Questionnaire. I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis. Pain28(1),27–38 (1987).
    • Ameringer S: Measuring pain in adolescents. J. Pediatr. Health Care23(3),201–204 (2009).
    • Walco GA, Dampier CD: Pain in children and adolescents with sickle cell disease: a descriptive study. J. Pediatr. Psychol.15(5),643–658 (1990).
    • 10  Gragg RA, Rapoff MA, Danovsky MB et al.: Assessing chronic musculoskeletal pain associated with rheumatic disease: further validation of the pediatric pain questionnaire. J. Pediatr. Psychol.21(2),237–250 (1996).
    • 11  Savedra MC, Holzemer WL, Tesler MD, Wilkie DJ: Assessment of postoperation pain in children and adolescents using the adolescent pediatric pain tool. Nurs. Res.42(1),5–9 (1993).
    • 12  Savedra M, Gibbons P, Tesler M, Ward J, Wegner C: How do children describe pain? A tentative assessment. Pain14(2),95–104 (1982).
    • 13  Savedra MC, Tesler MD, Holzemer WL, Wilkie DJ, Ward JA: Pain location: validity and reliability of body outline markings by hospitalized children and adolescents. Res. Nurs. Health12(5),307–314 (1989).▪ The most direct evaluation of the validity and reliability of pediatric pain charts.
    • 14  Savedra MC, Tesler MD: Assessing children’s and adolescents’ pain. Pediatrician16(1–2),24–29 (1989).
    • 15  O’Donnell PJ, Curley H: Validation of a nonverbal instrument for pain location descriptions in children. Percept. Mot. Skills60(3),1010 (1985).
    • 16  Zebracki K, Drotar D: Pain and activity limitations in children with Duchenne or Becker muscular dystrophy. Dev. Med. Child Neurol.50(7),546–552 (2008).
    • 17  Palermo TM, Valenzuela D, Stork PP: A randomized trial of electronic versus paper pain diaries in children: impact on compliance, accuracy, and acceptability. Pain107(3),213–219 (2008).▪ Use of pain charts in electronic versus paper format.
    • 18  Stinson JN, Petroz GC, Tait G et al.: e-Ouch: usability testing of an electronic chronic pain diary for adolescents with arthritis. Clin. J. Pain22(3),295–305 (2006).▪ Approach to assessing the usability of an electronic diary including a pain chart.
    • 19  Calam RM, Jimmieson P, Cox AD, Glasgow DV, Larsen SG: Can computer-based assessment help us understand children’s pain? Eur. J. Anaesthesiol.17(5),284–288 (2000).
    • 20  Cushing C, Connelly M, Lathram N, Schurman J: Initial development and testing of an electronic assessment tool for pediatric pain. Poster, Society for Behavioral Medicine. Ann. Behav. Med.39(Suppl. 1),S150 (2010).
    • 21  Ohnmeiss DD: Repeatability of pain drawings in a low back pain population. Spine25(8),980–988 (2000).
    • 22  Margolis RB, Tait RC, Krause SJ: A rating system for use with patient pain drawings. Pain24(1),57–65 (1986).
    • 23  Connelly M, Anthony KK, Sarniak R, Bromberg MH, Gil KM, Schanberg LE: Parent pain responses as predictors of daily activities and mood in children with juvenile idiopathic arthritis: the utility of electronic diaries. J. Pain Symptom Manage.39(3),579–590 (2010).
    • 24  Lester N, Lefebvre JC, Keefe FJ: Pain in young adults – III: Relationships of three pain-coping measures to pain and activity interference. Clin. J. Pain12(4),291–300 (1996).
    • 25  Stinson J, Connelly M, Chalom E et al.: Ask me where it hurts? Developing a standardized approach to the assessment of pain in children and youth presenting to pediatric rheumatology providers. Arthritis Rheum.60(Suppl. 10),S577 (2009).
    • 26  Tesler M, Ward J, Savedra M, Wegner CB, Gibbons P: Developing an instrument for eliciting children’s description of pain. Percept. Mot. Skills56(1),315–321 (1983).
    • 27  Stinson JN, Stevens BJ, Feldman BM et al.: Construct validity of a multidimensional electronic pain diary for adolescents with arthritis. Pain136(3),281–292 (2008).
    • 28  Willcock E, Morgan K, Hayne H: Body maps do not facilitate children’s reports of touch. Appl. Cognit. Psychol.20,607–615 (2006).▪ Highlights limitations of body maps with a young child (assessing nonpainful touch).
    • 101  Body map from web-based diary study (pilot test, M. Connelly et al.) www.poweredbyu.com/bodymap (Accessed 30 June 2010)
    • 102  Iconic Pain Assessment Tool www.emiliemcmahon.ca/pain-tool.html (Accessed 30 June 2010)
    • 103  Goodenough B, Piira T, von Baeyer CL et al.: Comparing six self-report measures of pain intensity in children. The Suffering Child 8 (2005) www.usask.ca/childpain/research/6scales/6scales.pdf (Version current on 22 May 2010)
    • 104  Childhood Arthritis and Rheumatology Research Alliance www.carragroup.info (Accessed 30 June 2010)