Els van Meijel

48 Chapter 3 | Acute pain and posttraumatic stress symptoms Acute pain When asked to rate the worst pain since the accident, the majority of the children reported moderate (n = 67, 50%) or severe (n = 58, 43%) pain, while ten children (7%) reported no tomild pain, including one child reporting no pain. The mean andmedian pain values are shown in Table 3.1. Severe pain was reported across all categories of injury severity. Ten children specifically reported medical procedures, like insertion of peripheral venous cannula or urethral catheterization, as very painful or most painful ever. The worst pain children reported referred to pain shortly after the accident while in the ambulance, during treatment in the trauma room, or during hospitalization. Posttraumatic stress On the self-report measure CRIES, the scores of 20 children (15%) were above the cut- off point (≥30), indicating serious PTSS. Additional information on the CRIES scores is reported in Table 3.1. Acute pain and posttraumatic stress The findings on the association between acute pain, child characteristics and posttraumatic stress are summarized in Table 3.2. In the total group, the continuous pain score had a positive correlation ( r s = .28; p = .001) with the total score on the self- report measure CRIES. In girls, we found no significant association between acute pain and the total score on the CRIES ( r s = .23; p = .09). In boys, however, acute pain was significantly associated with the total score on the CRIES ( r s = .27; p = .02). After splitting the sample into pain categories, we found no significant association between continuous pain scores and the severity of posttraumatic stress for children with “no or mild pain” ( r s = .14; p = .71) or “moderate pain” ( r s = .13; p = .30). However, for children with “severe pain” this association was statistically significant ( r s = .32; p = .02). Separate examination of data for girls ( r s = .22; p = .28) and boys ( r s = .33; p = .07) revealed no statistically significant association between severe pain and posttraumatic stress, although these results are based on small subgroups.