Abstract

Institutional adoption of routine measurement of pediatric pain has been impeded partly by the profusion of different metrics (eg, 0 to 5, 0 to 6, 0 to 10, 0 to 100) for reporting pain intensity on various instruments.  The present paper discusses the importance of adopting a common metric, that is, a single numbering system on which estimates of pain intensity from various sources can be recorded. To explore both support and reservations concerning the adoption of a common metric, a survey questionnaire was sent in 1999 to an estimated 600 subscribers to the Pediatric Pain Internet Mailing List. Individuals working in pediatric institutions where children's pain is routinely measured, or where adoption of such measures is planned, were requested to respond by e-mail or mail. Responses (n=37) were from nurses (49%), physicians (24%), psychologists (7%) and others/unlisted (20%) on four continents. Adoption of a common metric was endorsed by 81% of respondents. Among the possible numbering systems, the 0 to 10 system was strongly favoured (70%) over other options. Respondents commented that adoption of a common metric would improve communication and consistency in measurement both within and among institutions.  Some disadvantages, such as staff resistance to altering existing systems, were also suggested. The majority of respondents thought that it would be desirable to adopt a common metric. Among the possible numbering systems, the 0 to 10 system is by far the most favoured. Adopting a common 0 to 10 standard, and adapting existing tools to that metric, would be positive steps toward identifying and relieving children's pain.