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Children (Basel). 2018 Jan 18;5(1). pii: E13. doi: 10.3390/children5010013.

'Total Pain' in Children with Severe Neurological Impairment.

Author information

1
All Wales Paediatric Palliative Care Managed Clinical Network, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. twarlow@doctors.org.uk.
2
All Wales Paediatric Palliative Care Managed Clinical Network, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. richard.hain@wales.nhs.uk.

Abstract

Many children with palliative care needs experience difficulty in managing pain. Perhaps none more so than those with severe neurological impairment. For many years; behaviours in these children were misunderstood. As a result; pain was poorly recognised and inadequately managed. Significant advances have been made in the assessment and management of pain in this challenging group of patients. We summarise these advances; drawing on our own experience working with infants; children and young adults with palliative care needs within a UK tertiary paediatric palliative care service. We expand on the recent understanding of 'Total Pain'; applying a holistic approach to pain assessment and management in children with severe neurological impairment.

KEYWORDS:

cerebral palsy; chronic pain; cognitive impairment; neurological impairment; paediatric palliative care; persistent pain; ‘Total Pain’

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