Navigation

Explore our research

  • Children's Pain

    Child with thermometer

The Children’s Pain and Symptoms group focuses on the experience, assessment and management of children’s pain and other symptoms.

Our pain research addresses how children experience pain and what parents and nurses need to know to ensure that pain is managed well. We focus on the ways that parents, health care and other professionals recognise and respond to children’s pain and the ways in which children experience and express their pain. An area of particular interest is palliative care and the assessment of children who have neurological and learning impairment.

Our work on children’s symptoms ranges from sedation withdrawal to more everyday symptoms. In particular, we are currently focusing on children’s experiences of chronic illness and pain with the aim of gaining insight into children’s perceptions and response to their illness and its associated management, how their lives are shaped (or not) by their illness and how they are involved in health care decisions.

We work closely with Alder Hey Children’s NHS Foundation Trust and the Children’s Nursing Research Unit as well as with colleagues in Research Units in Tasmania and New Zealand. Following development of the Paediatric Pain Profile, a tool to assess pain in children with severe neurological and learning impairment ,we are involved in its disseminate and implementation the tool in the UK and overseas.

Expertise and Subject Areas

Through our well-established team of researchers and doctoral students our international expertise relates to:

  • Assessment of pain in children with neurological and learning impairment
  • Acute and procedural pain assessment
  • Sedation-withdrawal in children
  • Palliative care research in children and adults
  • Tool development
  • Methodological expertise in narrative, arts-based, and appreciative methods

Impact

  • Carter was awarded Fellow of the Royal College of Nursing (2009) for her services to children’s pain.
  • The development and implementation of the Paediatric Pain Profile and its subsequent translation and use internationally.
  • The development of good practice guidance for postoperative and procedural pain in 2008 and updated in 2012.
    Howard R, Carter B, Curry J, et al. (2012) Good Practice in Postoperative and Procedural Pain Management [2nd ed]. Pediatric Anesthesia 22, s1.

Publications and Outputs

Articles

Pasin, S., Avila, F., de Cavata, T., Hunt, A., Heldt, E. (2013) Cross-Cultural Translation and Adaptation to Brazilian Portuguese of the Paediatric Pain Profile in Children With Severe Cerebral Palsy. Journal of pain and symptom management 1 January 2013 (volume 45 issue 1 Pages 120-128 DOI: 10.1016/j.jpainsymman.2012.01.013).

Carter, B. (2015) Parents’ and children’s beliefs and concerns about taking medicines Journal of Child Health Care. 19(1): 3-5

Carter, B., Hawcutt, D.B. & Arnott, J. The restrictions to the use of codeine and dilemmas about safe alternatives. Journal of Child Health Care. 17(4): 335-337, doi:10.1177/1367493513513663

Carter, B. & Ford, K. (2012) Researching children’s experiences: is there a need for child-centred, qualitative data collection techniques? Nursing in Research and Health. (wileyonlinelibrary.com). DOI: 10.1002/nur.21517

Howard R, Carter B, Curry J, et al. (2012) Good Practice in Postoperative and Procedural Pain Management [2nd ed]. Pediatric Anesthesia 22, s1.

Carter, B. & Thomas, M. (2011). Key Working for Families with Young Disabled Children. Nursing Research and Practice. Article ID 397258, doi:10.1155/2011/397258.

Midson, R. & Carter, B. (2010) Addressing end of life care issues in a tertiary treatment centre: lessons learned from surveying parents’ experiences. Journal of Child Health Care. 14(1): (Print ISSN: 0962-1067; Online ISSN: 1365-2702)

Marshall, M., Carter, B. & Brotherton, A. (2009) Living with Type 1 diabetes: perceptions of children and their parents. Journal of Clinical Nursing. 18(12):1703-1710 (Published Online: 15 May 2009) (ISSN: 09621067; Online ISSN: 13652702)

Carter, B. (2009) Tick box for child? The ethical positioning of children as vulnerable, researchers as barbarians and reviewers as overly cautious. International Journal of Nursing Studies. 46: 858-864. (ISSN 0020-7489)

Carter, B. (2008) What pain assessment guidelines tell us and what they may miss. Journal of Child Health Care 12(3):170-172. (Print ISSN: 0962-1067; Online ISSN: 1365-2702)

Howard R, Carter B, Curry J, Morton N, Rivett K, Rose M, Tyrrell J, Walker S & Williams G (2008) Good Practice in Postoperative and Procedural Pain Management. Pediatric Anesthesia 18, 1-81. (Print ISSN: 1155-5645; Online ISSN: 1460-9592)

Carter, B. (2008) Guidance, Guidance Everywhere, but One you Need to Read: 0-18 years: guidance for all doctors. British Journal of Occupational Therapy. 71(1):1. (ISSN: 1477-6006)

Hunt, A., Wisbeach, A., Seers, K., Goldman, A., Crichton, N., Perry, l. & Mastroyannopoulou, K. (2007) Development of the Paediatric Pain Profile: Role of video analysis and saliva cortisol in validating a tool to assess pain in children with severe neurological disability. Journal of Pain and Symptom Management, 33, 276-289.

Eccleston, C., Bruce, E., Carter, B. (2006) Chronic pain in children and adolescents. Paediatric Nursing. 18(10):30-33.

Marshall, M., Carter, B. & Rose, K. (2006) Adolescents living with diabetes: Self-care and parental relationships. Journal of Diabetes Nursing. 10(1):

Carter, B. (2004) Pain narratives and narrative practitioners: a plea for working ‘in relation’ with children experiencing pain. Journal of Nursing Management. 12: 210-216

Hunt A. Goldman A. Seers K. Crichton N. Mastroyannopoulou K. Moffat V. Oulton K. and Brady M. (2004). Clinical validation of the paediatric pain profile. Developmental Medicine and Child Neurology 46 (1), 9-18.
Carter, B. (2004) Management of fever and pain in babies and children. RCN Forum Accredited Education Unit.

Hunt A. Mastroyannopoulou K. Goldman A. and Seers K. (2003). Not knowing-the problem of pain in children with severe neurological impairment. International Journal of Nursing Studies 40 (2), 171-183.

Carter, B. (2002) Chronic pain in childhood and the medical encounter: professional ventriloquism and hidden voices. Qualitative Health Research.12(1): 28-41.

Fleming E, Carter, B. & Gillibrand, W. (2002) The transition of adolescents into the adult health care service: the diabetes specialist’s perception of adolescent needs. Diabetic Medicine, 19, (suppl.2) (Abstract), 97, P276.

Marshall, M., Fleming, E, Gillibrand, WP. & Carter, B. (2002) Adaptation and negotiation as a personal approach to care in paediatric diabetes specialist nursing practice: a critical review. Journal of Clinical Nursing. 11: 421-429.

Fleming, E., Carter, B., Gillibrand, W. (2002) The transition of adolescents’ with diabetes from the children’s health care service into the adult health care service: a review of the literature. Journal of Clinical Nursing. 11:560-567.

Carter, B., McArthur, E. & Cunliffe, M. (2002) Dealing with uncertainty: parental assessment of pain in their children with profound special needs. Journal of Advanced Nursing. 38(5):449-457.

Carter, B., Lambrenos, K. & Thursfield, J. (2002) A Pain Workshop: an approach to eliciting the views of young people with chronic pain. Journal of Clinical Nursing. 11: 753-762.

Hunt A. Goldman A. Devine, T. and Phillips M. (2001). Transdermal fentanyl for pain relief in a paediatric palliative care population. Palliative Medicine 15 (5), 405-412.

Carter, B. (2000) Ways of working: Community children’s nursing and chronic illness. Journal of Child Health Care; 4(2): 66-72.

Hunt, A., Joel, S., Dick, G. & Goldman, A. (1999) Population pharmacokinetics of oral morphine and its glucuronides in children receiving morphine as immediate-release liquid or sustained-release tablets for cancer pain. Journal of Pediatrics, 135(1), 47-55.

Carter, B. (1998) Childhood Chronic Illness - a continuing challenge. Journal of Child Health Care 2(3):109

Carter, B. (1997) Pantomimes of Pain, Distress, Repose and Lability: the world of the preterm baby. Journal of Child Health Care. 1(1):20-25

Carter, B. (1995) Observing Neonates: 'real world' difficulties and dilemmas. Journal of Neonatal Nursing 1(3): 15-20.

Hunt, A. & Burne, R. (1995) Medical and nursing problems of children with neurodegenerative disease. Palliative Medicine, 9(1), 19-26.

Carter, B. (1995) Complementary Therapies and The Management of Chronic Childhood Pain. Paediatric Nursing. 7(3): 18-22

Carter, B. (1994) Neonatal Pain Assessment: Difficulties and Dilemmas. Care of the Critically Ill.

Carter, B. (1990) A universal experience, Paediatric Nursing, Sep, 8-10.

Hunt, A. (1990) A survey of signs and symptoms and symptom control in 30 terminally ill children. Developmental Medicine and Child Neurology, 32(4), 341-346.

Carter, B. (1989) Problems and nursing management strategies related to respiratory distress syndrome in the very preterm baby, Intensive Care Nursing. 5, 55-64.

Burne, R. & Hunt, A. (1987). Use of opiates in terminally ill children. Palliative Medicine 1(1) 27-30

Books

Carter, B. & Simons, J. (2014) Stories of Children’s Pain: linking experience to evidence and practice. Sage Publications. Sage Publications: London.

Carter,B. (1998) Perspectives on Pain. Mapping the Territory. Arnold: London.

Carter,B. (1994) Child and Infant Pain: Principles of Nursing Care and Management. Chapman and Hall, London.

Chapters

Hunt A. (2012) Pain - Assessment. In: Goldman A, Hain R, Liben S, editors. 2nd Edition. Oxford Textbook of Paediatric Palliative Care. Oxford: Oxford University Press.

Glenn SM, Poole H, Horgan M, Hunt A, Sloane J. 2011. What factors influence individual variations in judgements of neonatal pain?. In Treatment Strategies - Pediatrics. Holcroft R (Ed.). The Cambridge Research Centre.

Carter, B. & Jonas, D. (2009) Postoperative Pain Management. Chapter for Shields, L. [Ed] Perioperative Care of the Child: A Nursing Manual. Wiley-Blackwell Print ISBN: 9781405155953 Online ISBN: 9781444314625.

Carter, B. Marshall, M. & Sanders, C. (2009) An Exquisite Knowing of Children. In: Locsin, R.C. & Purnell, M. Contemporary Process of Nursing: The (Un)Bearable Weight of Knowing Persons in Nursing? Springer Publishing, New York. 9780826125781.

Hunt A. (2006). Pain - Assessment. In: Goldman, A., Hain, R., Liben, S. (Eds.), Oxford Textbook of Paediatric Palliative Care. Oxford University Press, Oxford, pp. 281-303.

Hunt A, Elston S. and Galloway J. (2003). Voices for Change. Current Perceptions of Services for Children with Palliative Care Needs and their Families. Association for Children with Life-threatening or Terminal Conditions and their Families (ACT), Bristol. ISBN: 1 898447 02 0.

Carter, B. (1999) There’s a Whole Family Hurting: The Experience of Living with a Child with Chronic Pain. In: Glasper, A. [Editor] Evidence-Based Child Health Nursing. Macmillan: London.

Carter,B. (1998) Children and their Experience of Pain In: Carter,B. (1998) Perspectives on Pain. Mapping the Territory. Arnold: London.

Carter,B. (1998) Researching Pain: Paradigms and Revolutions. In: Carter,B. (1998) Perspectives on Pain. Mapping the Territory. Arnold: London.

Carter,B. (1993) Care of the child with pain. In: Carter,B. [Ed] (1993) Manual of Paediatric Intensive Care Nursing, Chapman and Hall, London pp280-291.

Carter, B. & Cooper,D. (1993) Care of the child with polytrauma and thermal injury. In: Carter,B. [Ed] (1993) Manual of Paediatric Intensive Care Nursing, Chapman and Hall, London. Pp 230-279.

Events and News

Children’s Nursing Research Unit Conference 7th May 2013 at Alder Hey Children’s NHS Foundation Trust.

Members

Professor Bernie Carter: Professor of Children’s Nursing

Bernie has been based at the University of Central Lancashire since 2000. Bernie is Professor of Children’s Nursing at the University of Central Lancashire and Director of the Children’s Nursing Research Unit (CNRU) at Alder Hey Children’s NHS Foundation Trust. She is a Fellow of the Royal College of Nursing. She is Visiting Professor at Edge Hill University and Clinical Professor at the University of Tasmania.

Plus linked staff in associate centres

Jennie Craske: Pain Nurse Specialist, Alder Hey Children’s NHS Foundation Trust, UK.

Dr Joan Simons, The Open University, UK.

Dr Annette Dickinson, Child Health Research Centre, Auckland University of Technology.

Dr Karen Ford, Practice Development Unit - Nursing and Midwifery Royal Hobart Hospital & University of Tasmania.

Helen Traynor, Play Specialist, Alder Hey Children’s NHS Foundation Trust, UK.

Additional Information

For further information contact:

Professor Bernie Carter
School of Health
University of Central Lancashire
Preston PR1 2HE
Email: bcarter@uclan.ac.uk

Related Research Groups

Key links to:

Related Projects

Current

Carter, B., Bray,L., Blackwell,N., Franck,L. My Child is in Pain Project. WellChild (Uclan, Edge Hill, University of San Francisco).

Tume, L., Baines, P. & Carter, B. Is Bispectral Index (BIS) a useful adjunct in assessing sedation level in general and how does BIS change during noxious interventions: a pilot study? BACCN small grant application.

Carter, B., Bray,L., Ford,K., Courteny-Pratt,H., Dickinson, A., Sanson,K., Water, T. International Children’s Illness and Symptom Study: perspectives of children with chronic illness from the UK, Australia and New Zealand. (Uclan, Edge Hill, University of Tasmania, University of Technology, Auckland and associated hospitals).

Hunt,A., Carter, B., Traynor, H Pain Team of Alder Hey Hospital for Children NHS Foundation Trust. Education and training in the use of the Paediatric Pain Profile for parents and professionals in the North West. Funded by Cumbria and Lancashire Health Innovation and Education Consortium (HIEC).

Hunt, A., Abbott, J. Parker, A. “Pilot Study – Pain experience and expression in boys and young men with Duchenne Muscular Dystrophy”. Funded by the Burdett Trust for Nursing.

Selected previous projects

Hunt et al “Big study for Life-limited children and their families”. In collaboration with Association for Children’s Palliative Care (ACT) (Lead organisation), University of Warwick (Dr Sophie Staniszewska,); University of Coventry (Dr Jane Coad, Erica Brown), University of Greenwich (Professor Liz West), York Heath Economics Consortium (Dr Karin Lowther, Nick Hex). Funded by Big Lottery Fund Research Grants Programme (£499,000).

Carter, B. The Experience of Living with Chronic Pain: A Family Perspective. Scholarship awarded by the Florence Nightingale Foundation.

Carter, B. The Experience of Pain in Children with Special Needs: A Parental Perspective. Research commissioned by the Pain Team, Alder Hey Children’s Hospital, Liverpool.

Carter, B. Caring for Children with Chronic Illness in the Community: the Skills used by Children’s Community Nurses. Research funded by Sims Portex/ABPN Scholarship.

Carter, B. & Fleming,E. Transition of young people with diabetes from child health services to adult health services.

Hunt, A. “Better Care: Better Lives”. A consultation in preparation for a bid for a study of Children’s Palliative Care in the West Midlands. In collaboration with Association for Children’s Palliative Care (ACT) (Lead organisation) and Dr Sophie Staniszewska (University of Warwick). Funded by a Development Grant from the Big Lottery Fund Research Grants Programme

Hunt, A. et al “Implementation and evaluation of the Paediatric Pain Profile, a pain assessment tool for children with severe motor and learning disabilities”. In collaboration with Dr Kate Seers and Dr Rycroft-Malone (RCN Institute). Funded by The Health Foundation.

Hunt, A. et al “Evaluation of the Selby and York 'Big Lottery’ Children's Palliative Care Service”, with Dr Christine Williams (Lead Investigator), Selby and York PCT.

Hunt, A. et al “Systematic review of pain management in osteoporosis” for the NICE Collaborating Centre in Nursing and Supportive Care, RCN Institute, Oxford.

Hunt, A. et al “The development and validation of the Paediatric Pain Profile, a pain assessment tool for children with severe neurological disability. A multi-stage study”. In collaboration with Dr Ann Goldman (Great Ormond Street Hospital, London) and Dr Kate Seers (RCN Institute). Funded by a Smith and Nephew Nursing Fellowship and grants from Action Medical Research and PPP Healthcare Medical Trust

Hunt, A. et al “A survey of perceptions of services for children with palliative care needs and their families”. On behalf of Association for Children with Life-threatening or Terminal Conditions and their Families (ACT).

Hunt, A. et al “An observational study of transdermal fentanyl for pain relief in a paediatric palliative care population”. Lead investigator Dr Ann Goldman (Great Ormond Street Hospital, London). Funded by Janssen Cilag Ltd.