TREATMENT OF PAIN IN PEDIATRIC ONCOLOGY - A SWEDISH NATIONWIDE SURVEY

Pain treatment is a crucial aspect in the care of children with cancer and there are many studies demonstrating inefficient pain treatment. In this study, questionnaires dealing with pain treatment of children with malignant diseases were sent to all (47) pediatric departments in Sweden. The aims of this nationwide survey were to evaluate the exten t and causes of pain, the use of methods for pain evaluation (e.g. ana lysis of type of pain and monitoring of pain intensity), principles of pain management, side effects of pain treatment and the educational n eeds of physicians and nurses regarding these issues, The response rat e was 100%. Answers from physicians and nurses reveal that pain is a c ommon symptom during different periods of cancer treatment, Pain due t o treatment and procedures is a greater problem than pain due to the m alignant disease itself. Instruments for the measurement of pain inten sity and analysis of the type of pain are still rarely used. Most phys icians (63%) follow the analgesic 'ladder' principle recommended by Wo rld Health Organization (WHO). According to a majority of physicians a nd nurses (72%), pain could be treated more effectively than it is pre sently, and 64% state that they need more time for the management of p ain. Both physicians and nurses state that they need additional educat ion in different areas of pain evaluation and pain treatment. Swedish treatment practices for the management of pediatric cancer pain roughl y follow the published guidelines, but many improvements are still nec essary.