Journal of Pediatric Psychology Advance Access published online on December 20, 2006
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsl049
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org
Judgments of Infant Pain: The Impact of Caregiver Identity and Infant Age
1York University, 2Hospital for Sick Children and 3University of British Columbia
All correspondence concerning this article should be addressed to Rebecca Pillai Riddell, PhD, C. Psych, Department of Psychology, York University, Atkinson, Room 508, 4700 Keele Street, Toronto, Ontario, Canada M3J 1P3. E-mail: rpr{at}yorku.ca
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Abstract |
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Objective To examine whether caregiver judgments of infant pain would vary systematically with different infant caregiver groups and infant age. Methods A total of 123 caregivers (41 parents, 41 in patient nurses, 41 pediatricians) viewed videotapes of the vigorous behavioral responses of healthy infants (aged 2, 4, 6, 12, and 18 months) to a routine immunization injection and provided ratings of both the affective distress and pain intensity observed. Results A principal components analysis of affective and intensity ratings yielded a weighted pain summary score for each injection event. Older infants were attributed significantly more pain than younger infants, even though the vigor of the behavioral reactions was experimentally controlled across age groups. A profile analysis contrasting observer groups indicated that pediatricians attributed significantly lower levels of pain than parents, while nurses were intermediate to the other groups, not significantly differing from either group. These systematic differences in judgments were consistent across infant age groups. Conclusions The findings reveal systematic sources of significant variations in observer judgments of infant pain. Despite an absence of differences in the behavioral reactions of the children, both the type of caregiver and their knowledge of the child's age systematically influenced attributions of pain to infants. This work suggests the important role of caregiver role variation and perceived developmental maturity as determinants of infant pain judgments and highlights potential areas of difficulty in controlling the unnecessary suffering of infants.
Key words: infant pain; judgment; nurse; parents; physician..
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