Acute pain research and marginalized children in the emergency setting: a scoping review.
Academic Pediatrics · 2026-09-29 · Scoping review
Abstract
BACKGROUND: Pediatric pain is prevalent in emergency departments (EDs). Marginalized children are disproportionately affected by disparities in pain care. OBJECTIVES: This scoping review maps the extent and nature of the literature concerning the pain care of marginalized children in the ED. DATA SOURCES: We searched MEDLINE, PsycINFO, CINAHL, Web of Science, iPortal, Native Health Database, and CENTRAL. STUDY ELIGIBILITY CRITERIA: Studies published between 2013 and 2025. PARTICIPANTS AND INTERVENTIONS: Children/youth with pain or undergoing painful procedures in US or Canadian EDs; populations defined by at least one PROGRESS-Plus factor, an internationally recognized framework to identify characteristics that may be associated with inequities in healthcare. STUDY APPRAISAL AND SYNTHESIS METHODS: De-duplicated results from searching were screened in two stages by two reviewers in Covidence, with disagreements resolved through consensus, or a third reviewer. Data were charted using standard forms in Microsoft Excel. We extracted all PROGRESS-Plus criteria quantified in the studies. RESULTS: From 3,056 identified records, we included 33 studies, all conducted in the US. Most (31/33) were retrospective studies. Child age was reported in all studies, race/ethnicity in 97% (32/33), and gender/sex in 94% (31/33). All studies concerned presenting pain; none explored procedural pain. LIMITATIONS: We only searched for literature conducted in Canada and the US and did not include studies documenting general care inequities. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Current research on marginalized children's pain in the ED is dominated by retrospective American studies using administrative data that focus on racial/ethnic disparities. SCOPING REVIEW REGISTRATION NUMBER: 10.1371/journal.pone.0296518.
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Tags
Children · Equity & disparities · Socially vulnerable groups
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