van der Heijden MJE, et al. – This investigation was planned to evaluate pain intensity and distress in paediatric patients with burns undergoing wound care procedures without distraction and parental presence in a South–African children’s hospital and sought to identify predictors of the outcomes. The physicians revealed that children received wound care procedures without distraction or parental presence and were evaluated to have high pain intensity and distress. They found a correlation between age and COMFORT–B (COMFORT Behavioural scale) scores: younger children demonstrated higher distress, indicating a great need for better pain and distress control during wound care procedures. It was difficult to recognize whether pain or distress was the specific primary cause for the high COMFORT–B scores.