Personal distress and sympathy differentially influence health care professional and parents’ estimation of child procedure-related pain

Objective. Caregivers\u27 pain estimations may have important implications for pediatric pain management decisions. Affective responses elicited by facing the child in pain are considered key in understanding caregivers\u27 estimations of pediatric pain experiences. Theory suggests differential influences of sympathy versus personal distress on pain estimations; yet empirical evidence on the impact of caregivers\u27 feelings of sympathy versus distress upon estimations of pediatric pain experiences is lacking. The current study explored the role of caregiver distress versus sympathy in understanding caregivers\u27 pain estimates of the child\u27s pain experience. Design, Setting, Subjects and Methods. Using a prospective design in 31 children undergoing consecutive lumbar punctures and/or bone marrow aspirations at Ghent University Hospital, caregivers\u27 (i.e., parents, physicians, nurses, and child life specialists) distress and sympathy were assessed before each procedure; estimates of child pain were obtained immediately following each procedure. Results. Results indicated that the child\u27s level of pain behavior in anticipation of the procedure had a strong influence on all caregivers\u27 pain estimations. Beyond the impact of child pain behavior, personal distress explained parental and physician\u27s estimates of child pain, but not pain estimates of nurses and child life specialists. Specifically, higher level of parental and physician\u27s distress was related to higher child pain estimates. Caregiver sympathy was not associated with pain estimations. Conclusions. The current findings highlight the important role of caregivers\u27 felt personal distress when faced with child pain, rather than sympathy, in influencing their pain estimates. Potential implications for pain management are discussed