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Children 2018, 5(1), 13;

‘Total Pain’ in Children with Severe Neurological Impairment

All Wales Paediatric Palliative Care Managed Clinical Network, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK
Author to whom correspondence should be addressed.
Received: 28 November 2017 / Revised: 11 January 2018 / Accepted: 12 January 2018 / Published: 18 January 2018
(This article belongs to the Special Issue Pediatric Palliative Care)
PDF [178 KB, uploaded 18 January 2018]


Many children with palliative care needs experience difficulty in managing pain. Perhaps none more so than those with severe neurological impairment. For many years; behaviours in these children were misunderstood. As a result; pain was poorly recognised and inadequately managed. Significant advances have been made in the assessment and management of pain in this challenging group of patients. We summarise these advances; drawing on our own experience working with infants; children and young adults with palliative care needs within a UK tertiary paediatric palliative care service. We expand on the recent understanding of ‘Total Pain’; applying a holistic approach to pain assessment and management in children with severe neurological impairment. View Full-Text
Keywords: ‘Total Pain’; paediatric palliative care; chronic pain; persistent pain; cerebral palsy; cognitive impairment; neurological impairment ‘Total Pain’; paediatric palliative care; chronic pain; persistent pain; cerebral palsy; cognitive impairment; neurological impairment
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Warlow, T.A.; Hain, R.D. ‘Total Pain’ in Children with Severe Neurological Impairment. Children 2018, 5, 13.

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