Pain in children with cerebral palsy and implications on nursing practice and research: integrative review* Dor em crianças com paralisia cerebral e implicações na prática e pesquisa em enfermagem: revisão integrativa

BACKGROUND AND OBJECTIVES: Due to physical impairment, cerebral palsy (CP) children have pain related to several hospital admissions and multiple knowingly painful procedures. This study aimed at identifying in the literature aspects related to pain in CP children and at evaluating implications for nursing practice and research. CONTENTS: The keywords nursing, pain, children and cerebral palsy were queried in Medline, Pubmed, LILACS, Scielo and Cochrane Library databases. Starting date was not limited and final date was October 30, 2011. Among 69 publications, 19 have met the inclusion criteria. The analysis has resulted in four categories: CP children acute pain management; CP children chronic pain management; use of validated tools for pain evaluation; and family participation in CP children’s care. Results reflect the complexity of CP children pain management and the need for specialized nursing care and multidisciplinary approach. CONCLUSION: Notwithstanding the scarcity of publications on this subject, we have identified major aspects of nursing practices for CP children pain management. Faced to complex CP children damages, the evaluation of the painful process should permeate not only the physical dimension, but also psychological, social and spiritual dimensions, which are still seldom discussed in clinical settings. The nursing team should be equipped, should adopt evidence-based practices and translate them into clinical and managerial indicators.