A qualitative study of the language of satisfaction in children with pain

Abstract

Background: Measures of satisfaction are essential to understanding patient experience, in general, and particularly with pain management. Objectives: (A) To identify the words children commonly use to communicate satisfaction, in general, and for pain management and (B) to determine if this vocabulary matches their caregivers. Methods: A study of child–caregiver pairs seen at a paediatric emergency department (PED) from July to November 2014 was conducted. Children were interviewed using ten open-ended questions. Grounded theory was employed for data coding and analysis. Caregivers completed a written survey. Results: A total of 105 child interviews were completed (n=53 females, mean age 9.91, SD 3.71, age range 4 to 16); 105 caregiver surveys were completed (n=80 females). Children (n=99) most commonly used ‘good’, ‘better’ and ‘happy’ to express satisfaction with pain management (27%, 21% and 22%, respectively), with PED care (31%, 14% and 33%) and in general (13%, 5% and 49%). Children (n=99) used the words ‘sad’, ‘bad’ and ‘not good’ to communicate dissatisfaction with pain management (21%, 7% and 11%, respectively) and with PED care (21%, 13% and 12%). Only 56% of children (55/99) were familiar with the word ‘satisfaction’. Children’s word choices were similar to their caregivers’ word choices, 14% (14/99) of the time. Conclusion: Children use simpler words than their caregivers, including good, better and happy, when communicating satisfaction. A child’s vocabulary is seldom the same as the vocabulary their caregiver uses, therefore caregiver vocabulary should not be used as a surrogate for paediatric patients. The word ‘satisfaction’ should be avoided, as most children lack understanding of the term.