A qualitative study of the at-home pain experience for children with an arm fracture.

Objective: Most children treated in the emergency department (ED) with painful conditions are discharged home to the care of their parents. There is growing evidence that at-home pain management is inadequate. No studies have evaluated the child's report of their at-home pain experience. Our objective was to explore the child's perspective on the pain experience at home after ED discharge.

Methods: We performed semistructured interviews with children aged 4 to 14 years discharged from the ED with an arm fracture. Interviews occurred at the child's home and were recorded and transcribed verbatim. Using a narrative analysis, themes were identified.

Results: A total of 30 children were interviewed. Overall, three distinct themes regarding the pain experience were identified: (1) issues of communication between children and their parents regarding pain management, (2) issues of communication between children and ED health care personnel and (3) misunderstandings by children about pain and pain medication.

Conclusion: Communication is a critical barrier to optimizing the at-home pain experience. This novel information may be used to develop innovative interventions directed at the child and parent to improve the at-home pain experience.