Special issue on “Children's and adolescents' rights to participate in their pain management”

​should​engage​with​children​in​one-to-one situations in which their opinions are listened to in a respectful and​non-judgemental​way.​Fourth,​adults​should​act​on​the​opinions​ and/or wishes children shared—also related to how they think their pain should best be managed.


E D I T O R I A L
Special issue on "Children's and adolescents' rights to participate in their pain management"

| CHILDREN ' SOWNVOI CE SS HOULD B ETHEHE ARTB E ATOFANYT YPEOFPAIN MANAG EMENT
The dialogues between children and adolescents and their healthcare providers are essential in managing pain in accordance with the child's interests and wishes.It can, however, be challenging to ensure that pain management is in the child's best interest due to a myriadofreasons.Oneoftheserelatestothespecificcommunicativechallengesthatexistinthispopulation,thatmightarisebecause ofthechild'slevelofdevelopment,includingreceptiveandexpressivecommunicationskills,theparticularillnessandtreatment(e.g., tracheotomy),distress,and/ordisabilities.Itisthereforeunsurprising that children and adolescents are regarded as vulnerable groups in pediatric healthcare.
The importance of using person-centred care has been emphasized in healthcare to facilitate the voices of children and young people and as a way in which their views can be respected.The use of person-centred care promotes the child and adolescent's narratives and emphasizes the use of shared decision-making to be the primary source of pain management decisions. 1This approach is also in line with the United Nation's Convention on the Rights of the Child, 2 and specifically with Article 24 that focusses on health.Other articles of this convention also apply.For example, Article 12 highlights respect for children's views and allows them the opportunity to give their opinions freely, specifically about issues that directly affect them.In addition, Article 13 emphasizes children's right to share their thoughts freely in terms of what they learn, think, and feel and that this can be done by talking, drawing, or writing.The nexus between these two articles and person-centred care is thus clear.Likewise,Article17,whichfocussesonaccesstoinformation fromtheInternet,radio,television,newspapers,books,etcetera,is equallyrelevant.Article17alsourgesadults(inthiscasehealthcare providers) to ensure that the information provided to children is not harmful and that it is in a language format that all children can understand.
Previous research has demonstrated that parent's assessments of pain symptoms in children and adolescents differ from the child's and adolescent's own assessment. 3Self-reports of the evaluation of pain management should be the first choice in pediatric healthcare.
However, children's rights, as described above, are not always prioritized,andhealthcareprovider'sownmeasurementsoftenguide the decision-making around children and adolescents´ pain management. 4This means that it is necessary to develop and implement new strategies that optimize shared decision-making in pediatric healthcare.Inanattempttoallowchildrenandadolescentstotake onagreaterroleintheirownpainmanagement,newtoolsandinterventions are required to support acute and chronic pain measurement and treatment.This special issue includes five papers that showcase and expand knowledge about children's rights in pain management.Articles within the special issue contain three different types of methodologies(i.e.,astudyprotocol,aqualitativedesign,andascopingreview) and include both acute and chronic pain management.In total 49 childrenandadolescentsaged6-19 yearsareincludedinthequalitativestudies,givingabroadrangeofdatacollection.
The first paper describes a study aimed at providing insight into practicalconsiderationswhendesigningclinicaltrials,byfocussing on two clinical trials for headaches in children. 5It specifically focuses on recruitment and retention preferences, potential barriers toresearch,andoptimizingstudydesigns.Theparticipantsindicated that they prefer to be contacted directly by their physician about potential studies that they can participate in and that they enjoy developingrapportwithstudystaff.However,timecommitmentwas mentioned as one of the barriers to participation.The findings from this study could contribute to improved study designs for future studies.
The second paper presents a multi-site project design that combinesquantitativeandqualitativemethods.Itdescribesthedesign of three different studies and produces a study protocol.The overall aim is to evaluate psychometric properties of the newly developed electronicFacesThermometerScale(ascalewith11grades)foras-sessingpaininchildren8-17 yearsofage.Itconcludesbyproposing thatthisnewdigitalpainassessmenttool(i.e.,theelectronicFaces Thermometer Scale) could potentially strengthen the child's voice within pediatric healthcare. 6e aim of the study described in paper three is to illuminate restraint from the perspective of children's and adolescent's experiences of feeling forced during medical procedures.The analysis reveals that it hurts to get forced.This is illustrated clearly in the six themes delineated from the results: bodily misery, emotional rebellion, feeling disregarded, feeling physically limited, desiring escape, and leaving deep traces.The findings emphasize that healthcare providers should take action to support children's self-determination, participation, and integrity in pediatric healthcare. 7per four illuminate adolescents' experiences of Help Overcoming Pain Early (HOPE), a person-centred intervention delivered in a school setting by school nurses.The HOPE intervention was built on person-centred ethics and consisted of four meetings between school nurses and adolescents about stress and pain management.The overarching theme describes how adolescents strived to become themselves again.The study concludes by suggesting that a person-centred intervention applied in a school context could facilitate confidence in adolescents with chronic pain. 8e fifth and final paper focuses on children with autism spectrum disorder and their experience of social interaction and communication challenges.Pain is one of the most complex human stressors, and it remains so when it comes to how children with autism spectrum disorder communicate their pain.This review highlights that children with autism spectrum disorder use different verbal and non-verbal methods to communicate their pain experiences, calling attention to the importance of using holistic pain assessment strategies to meet the goal of upholding children's rights. 9 conclusion, in attempts to foreground child and adolescent perspectives regarding pain measurement and management, at This is an open access article under the terms of the CreativeCommonsAttributionLicense,whichpermitsuse,distributionandreproductioninanymedium, provided the original work is properly cited.©2023TheAuthors.Paediatric and Neonatal Pain published by John Wiley & Sons Ltd.
.Third,adults (i.e.,allhealthcareproviders)shouldengagewithchildreninone-toone situations in which their opinions are listened to in a respectful andnon-judgementalway.Fourth,adultsshouldactontheopinions and/or wishes children shared-also related to how they think their pain should best be managed.K E Y WO R DS autonomy,children'svoices,humanrights,painmanagement,selfreport Juan Bornman 1 Stefan Nilsson 2,3,4