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Ülgen H, Tüfekci FG. The Effect of Pain Management Education on Nurses' Pain Knowledge and Attitudes. Pain Manag Nurs 2024; 25:e186-e191. [PMID: 38342705 DOI: 10.1016/j.pmn.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND Pain is a nursing diagnosis. As such, it should be evaluated and recorded regularly. Nurses should possess a high level of pain management knowledge and a positive attitude toward pain, as these are the most important factors affecting pain control and management in children. AIM To evaluate the effect of the pain management training provided to pediatric nurses on their pain knowledge and attitudes. METHODS The study, conducted as a pretest-posttest experiment with a control group, was carried out from January-March 2019 with 61 nurses in the institutions of the Ministry of Health in Turkey. The content of the pain management for children education consisted of the definition of pain, pain theories, factors affecting pain, pain in children, the effects of pain on children, pain symptoms in children, perception of pain according to the developmental levels of children, false beliefs, and facts about pain, pain assessment, and factors preventing pain control in children. Data were obtained using the Personal Information Form, the Pediatric Pain Information form, and an Attitude Scale. Data were analyzed using descriptive statistics, a chi-square test, a t test, and validity and reliability analyses. All ethical principles were adhered to. RESULTS No significant difference was found between the nurses' pain knowledge and attitudes on the pretest scores in the experimental and control groups, while the mean posttest scores of the nurses in the experimental group increased significantly (p < .001). As for the pain and knowledge sub-dimensions of nurses in the experimental and control groups, no significant difference was found between the pretest scores for care, pain physiology, painless medication methods, pain relief with medication, pain psychology, and sociology. The mean posttest scores in all subdimensions increased significantly in favor of nurses in the experimental group (p < .001). CONCLUSIONS Mean posttest scores of pain knowledge and attitude and subdimensions of the nurses in the experimental group increased significantly, indicating that nurses' knowledge deficiencies in the realm of strong pediatric pain management can be overcome by education, and that their attitudes can be improved.
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Affiliation(s)
- Hanife Ülgen
- Burdur Mehmet Akif Ersoy University, Health Sciences Faculty, Department of Nursing (Pediatrics), Burdur, Turkey.
| | - Fatma Güdücü Tüfekci
- Atatürk University, Faculty of Nursing, Department of Nursing (Pediatrics), Erzurum, Turkey
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Achaliwie F, Wakefield AB, Mackintosh-Franklin C. The impact of education on the knowledge and attitudes of Ghanaian nurse tutors towards the assessment and management of pain in children: A quantitative study. NURSE EDUCATION TODAY 2023; 121:105680. [PMID: 36495595 DOI: 10.1016/j.nedt.2022.105680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/19/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Undertreatment of pain in children is an international problem as many children reports unresolved moderate to severe pain. One key factor which may contribute to under treatment of pain in children by nurses is lack of knowledge. In Ghana opportunities for nurses to learn about pediatric pain have been limited due to gaps in the undergraduate curriculum and inadequate continuing professional education post qualification. OBJECTIVE To assess tutors' knowledge and attitudes to pediatric pain management before and after an educational workshop. DESIGN Single group pre-test-post-test design. SETTING One Ghanaian Nursing Training College. PARTICIPANTS All (37) nursing tutors in the college. METHOD Total population sampling was used to access 37 tutors, data were collected using the Knowledge and Attitude Survey Regarding Pain at 3 stages; pre-intervention, immediately after the train-the-trainer based Pediatric Pain Educational Workshop and at 3-months follow-up. Data from the survey were analyzed using descriptive and inferential statistics. RESULTS Results at pre-intervention showed low scores in the survey. However, post-intervention results at both the immediate and 3-months follow-up stages revealed a significant increase from pre-intervention: Mean (SD) of 20.35 (4.56), to immediate follow-up Mean (SD) 26.93 (5.02), and 3-months follow-up Mean (SD) 25.19 (5.80) and a p-value of <0.001. CONCLUSION The results suggest tutors' knowledge and attitudes regarding pediatric pain management can be directly improved through a nurse tutor focused educational program. However, knowledge declines with time and as such there is the need for regular update through Continuing Professional Development activities.
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Affiliation(s)
- Francisca Achaliwie
- Department of Nursing, School of Nursing and Midwifery, CK Tedam University of Technology and Applied Sciences, P. O. Box 24, Navrongo, Ghana.
| | - Ann B Wakefield
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Carolyn Mackintosh-Franklin
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
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3
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Does Education Improve Nurses' Knowledge, Attitudes, Skills, and Practice in Relation to Pain Management? An Integrative Review. Pain Manag Nurs 2023; 24:273-279. [PMID: 36608996 DOI: 10.1016/j.pmn.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/05/2022] [Accepted: 12/11/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Pain is undertreated in both adults and children and a major factor linked to this is nurses' lack of knowledge as evidenced by studies undertaken globally. OBJECTIVE This review sought to explore the effects educational interventions can have on nurses' knowledge, attitudes, skills, and practice regarding pain management. DESIGN An integrative review DATA SOURCES: Systematic search of CINAHL, MEDLINE, AMED, EMBASE, and Psych INFO. REVIEW/ANALYSIS METHODS Five major databases were systematically searched from the year 2000-December 2019 with a total of 33 studies included in the final review. RESULTS The literature revealed that many nurses had inadequate knowledge and a poor attitude towards pain at baseline, which may be improved through educational intervention. However, misconceptions remained at post-intervention, particularly regarding pharmacological pain management. CONCLUSIONS Education is a possible means to enhance nurses' knowledge and improve attitudes and practices in pain management. However, there was some evidence that this may decline over time, and continuous professional updates are likely required.
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Alotaibi K, Higgins I, Chan S. Culture, religion, language and the assessment and management of children's pain by expatriate nurses in Saudi Arabia: A qualitative study. J SPEC PEDIATR NURS 2023; 28:e12399. [PMID: 36419370 DOI: 10.1111/jspn.12399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Unrelieved pain among hospitalized children is a common problem that affects all aspects of children's health and their quality of life. Cultural and language differences between nurses and patients have been shown to impact the quality and safety of nursing care and management for children with pain. The aim of this study was to identify the cultural factors, barriers, and facilitators impacting the assessment and management of children's pain by expatriate nurses in Saudi Arabia. DESIGN AND METHODS A qualitative descriptive design was employed in this study. A sample of 16 nurses was conveniently recruited and interviewed through face-to-face semistructured interviews. Each interview lasted between 30 and 60 min and was audio-recorded. Content analysis was used to analyze the transcripts. Transcripts were carefully read, significant statements were highlighted, coded, categorized, and clustered thematically. RESULTS Three main themes were identified, namely, (I) low priority of children's pain, (II) culture and religious challenges, and (III) communication challenges. PRACTICE IMPLICATIONS Cultural and language differences described by expatriate nurses hindered their care of children with pain. A systematic education for expatriate nurses, children, and families is urgently needed to enhance inter/cross-cultural understandings and improve childcare in Saudi Arabia. This study identifies the unique challenges faced by expatriate nurses in Saudi Arabia. The findings reveal how a lack of knowledge about cultural values and beliefs can lead to misunderstandings and conflicts between nurses, children, and families and can have an impact on childcare and pain. It also highlights the need to improve pain management practices in multicultural healthcare settings, similar to those of Saudi Arabia and neighboring Arab nations, and across the globe.
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Affiliation(s)
- Khalaf Alotaibi
- Nursing Department, College of Applied Medical Sciences - Dawadmi, Shaqra University, Shaqra, Saudi Arabia
| | - Isabel Higgins
- Older Person Care, School of Nursing and Midwifery, Faculty of Health Sciences and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sally Chan
- Tung Wah College (TWC), Homantin, Hong Kong
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Smeland AH, Twycross A, Lundeberg S, Småstuen MC, Rustøen T. Educational Intervention to Strengthen Pediatric Postoperative Pain Management: A Cluster Randomized Trial. Pain Manag Nurs 2021; 23:430-442. [PMID: 34836822 DOI: 10.1016/j.pmn.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/24/2021] [Accepted: 09/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Pediatric postoperative pain is still undertreated. AIMS To assess whether educational intervention increases nurses' knowledge and improves pediatric postoperative pain management. DESIGN Cluster randomized controlled trial with three measurement points (baseline T1, 1 month after intervention T2, and 6 months after intervention T3). PARTICIPANTS/SUBJECTS The study was conducted in postanesthesia care units at six hospitals in Norway. Nurses working with children in the included units and children who were undergoing surgery were invited to participate in this study. METHODS Nurses were cluster randomized by units to an intervention (n = 129) or a control group (n = 129). This allocation was blinded for participants at baseline. Data were collected using "The Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain: Norwegian Version" (primary outcome), observations of nurses' clinical practice, and interviews with children. The intervention included an educational day, clinical supervision, and reminders. RESULTS At baseline 193 nurses completed the survey (75% response rate), 143 responded at T2, and 107 at T3. Observations of nurses' (n = 138) clinical practice included 588 children, and 38 children were interviewed. The knowledge level increased from T1 to T3 in both groups, but there was no statistically significant difference between the groups. In the intervention group, there was an improvement between T1 and T2 in the total PNKAS-N score (70% vs. 83%), observed increase use of pain assessment tools (17% vs. 39%), and children experienced less moderate-to-severe pain. CONCLUSIONS No significant difference was observed between the groups after intervention, but a positive change in knowledge and practice was revealed in both groups. Additional studies are needed to explore the most potent variables to strengthen pediatric postoperative pain management.
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Affiliation(s)
- Anja H Smeland
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Norway; Institute of Health and Society, University of Oslo, Norway.
| | - Alison Twycross
- Children and Young People's Nursing School of Health, The Open University, UK
| | - Stefan Lundeberg
- Pain Treatment Service, Astrid Lindgren Children's Hospital, Sweden
| | - Milada C Småstuen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Department of Health, Nutrition and Management, Faculty of Health Sciences, OsloMet, Oslo Metropolitan University, Norway
| | - Tone Rustøen
- Institute of Health and Society, University of Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway
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Swift A, Twycross A. Using ways of knowing in nursing to develop educational strategies that support knowledge mobilization. PAEDIATRIC & NEONATAL PAIN 2020; 2:139-147. [PMID: 35548260 PMCID: PMC8975233 DOI: 10.1002/pne2.12037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 06/17/2020] [Accepted: 07/28/2020] [Indexed: 06/15/2023]
Abstract
There are continued challenges in achieving effective pain management for children and young people (CYP). Research has found several barriers to effective CYP pain management, which include, but are not limited to, deficiencies in knowledge among nurses and other healthcare professionals. Calls for improvements in and an increase in pain education ensue, in the expectation that an increase in knowledge will lead to an improved pain care for patients. Educational initiatives, as reported in the literature, have tended to focus on increasing empirical knowledge which has not resulted in the anticipated improvements in practice. An exploration of Carper's and Chinn & Kramer's five ways of knowing helps demonstrate why an over-reliance on empirics fails to equip nurses for the realities of clinical practice and does not facilitate knowledge mobilization or improvements in pain care for CYP. In this paper, we explore these ways of knowing to produce a model for knowledge mobilization in (pain) education. Our model puts forward a multifaceted approach to education using the active learning principles which supports and equip nurses to become effective pain practitioners.
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Affiliation(s)
- Amelia Swift
- School of NursingUniversity of BirminghamBirminghamUK
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Parvizy S, Tarvirdinasab S, Raznahan R, Aliakbari M. The effect of pain management training in workshop on the knowledge, attitude and self-efficacy of pediatric nurses. J Family Med Prim Care 2020; 9:2880-2884. [PMID: 32984143 PMCID: PMC7491795 DOI: 10.4103/jfmpc.jfmpc_92_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/12/2020] [Accepted: 04/23/2020] [Indexed: 01/15/2023] Open
Abstract
Background and Aims Pain is the fifth vital sign, and pediatric nurses plays a key role in the process of pediatric pain management. The present study aimed to determine the effect of pain management training on the knowledge, attitude and self-efficacy of pediatric nurses. Methods This is a quasi-experimental study including two groups of test and control. The experimental group received a workshop method with a content including (ethical aspect, physiology, assessment tools, and pharmaceutical and non-pharmacological pain management) and was not given in the control group. The PNKAS self-efficacy questionnaires was completed by the participants before and one month after the beginning of the study. The data were analyzed using descriptive statistics and independent T-test, Fisher exact, and Chi-square tests using SPSS version 20 software. Results The mean pre-test scores of knowledge and attitude in the control and experimental groups was 50.79-47.14, and after one month was 47.46-53.09, respectively, showed that, training was significantly effective in the knowledge and attitude of the experimental group (P value = 0.01). The mean pre-test score of self-efficacy in the control and experimental groups was (17.01-18.06), and one month later was 20.36-21.03 respectively. Although the self-efficacy score increased in both groups, training significantly increased the self-efficacy of pediatric nurses in the experimental group (P value <0.001). Conclusion Pain management training is required due to the poor knowledge of pediatric nurses and the importance of pain management in improving the quality of nursing care and the satisfaction of patients with the In addition, feeling high self-efficacy without sufficient knowledge of pain management can disrupt pediatric pain management.
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Affiliation(s)
- Soroor Parvizy
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sakineh Tarvirdinasab
- Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Rasool Raznahan
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mahboobeh Aliakbari
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
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Pediatric Pain Management Knowledge Levels of Intern Nursing Students. Pain Manag Nurs 2020; 21:290-298. [DOI: 10.1016/j.pmn.2019.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 04/16/2019] [Accepted: 06/18/2019] [Indexed: 11/22/2022]
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Kusi Amponsah A, Kyei‐Dompim J, Bam V, Kyei EF, Oduro E, Ahoto CK, Axelin A. Exploring the educational needs of nurses on children's pain management: A descriptive qualitative study. Nurs Open 2020; 7:841-849. [PMID: 32257272 PMCID: PMC7113495 DOI: 10.1002/nop2.459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 01/30/2020] [Indexed: 12/22/2022] Open
Abstract
Aim To explore the educational needs of nurses on children's pain management. Design A descriptive qualitative study. Methods Individual and group interviews were conducted among 28 nurses and four nurse managers at four hospitals in the Ashanti region of Ghana. The recorded interviews were later transcribed verbatim and thematically analysed based on a conceptual interest in the educational needs on paediatric pain management. Results Nurses were acquainted with pain assessment of children who can verbally communicate. They mainly used drugs in treating pain and were familiar with the use of some non-pharmacological interventions. Notwithstanding, they desired to know more about pain assessment for children with non-functional speech. Additionally, they were interested in learning more about both drug and nondrug pain relief methods for children. The sampled nurses and nurse managers indicated diverse preferences on the nature of the paediatric pain educational programme based on their personal choices and working dynamics.
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Affiliation(s)
- Abigail Kusi Amponsah
- Department of Nursing SciencesFaculty of MedicineUniversity of TurkuTurkuFinland
- Department of NursingFaculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Joana Kyei‐Dompim
- Department of NursingFaculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Victoria Bam
- Department of NursingFaculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | | | - Evans Oduro
- Department of NursingFaculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Collins K. Ahoto
- Department of NursingFaculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Anna Axelin
- Department of Nursing SciencesFaculty of MedicineUniversity of TurkuTurkuFinland
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Nursing and Midwifery Students' Knowledge and Attitudes Regarding Children's Pain. JOURNAL OF RESEARCH DEVELOPMENT IN NURSING AND MIDWIFERY 2020. [DOI: 10.52547/jgbfnm.17.2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Nursing-Related Barriers to Children's Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study. Pain Res Manag 2020; 2020:7125060. [PMID: 32051730 PMCID: PMC6995485 DOI: 10.1155/2020/7125060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/30/2019] [Indexed: 01/21/2023]
Abstract
Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children's pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children's pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children's pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n = 24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses' inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children's pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children's pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management.
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Buyuk E. The effect of video-assisted training given to midwifery and nursing students about pain and its management in newborns on students' level of knowledge. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2020. [DOI: 10.4103/jnms.jnms_56_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The Effect of Educational Strategies Targeted for Nurses on Pain Assessment and Management in Children: An Integrative Review. Pain Manag Nurs 2019; 20:604-613. [DOI: 10.1016/j.pmn.2019.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 01/22/2019] [Accepted: 03/31/2019] [Indexed: 12/19/2022]
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Smeland AH, Rustøen T, Naess T, Nybro L, Lundeberg S, Reinertsen H, Diseth TH, Twycross A. Children's views on postsurgical pain in recovery units in Norway: A qualitative study. J Clin Nurs 2019; 28:2157-2170. [PMID: 30667569 DOI: 10.1111/jocn.14788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/27/2018] [Accepted: 01/14/2019] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore children's postsurgical experiences with pain and pain management in the recovery unit. BACKGROUND Children's pain is underestimated and undertreated. Untreated pain can cause unnecessary suffering, increased complication risks and may lead to chronic pain. Research exploring children's experiences with postoperative pain and pain management is limited. DESIGN A qualitative, exploratory study. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). METHODS Children (N = 20), 8-16 years old, took part in semi-structured interviews about their experiences with pain and postoperative pain management while they were in a recovery unit. Data were collected at two university hospitals in Norway. Content analysis was used to analyse the data. RESULTS Three themes emerged from the interviews: "children's experiences of what felt unpleasant and painful," "children's experiences with pain management" and "children's recommendations for future pain management". About half of the children reported moderate to severe pain while in the recovery unit and they did not always tell their nurses when they had pain. They also reported experiencing pain in places other than their surgical wounds and stated that nausea and vomiting felt unpleasant and painful. The children indicated that pain medications and the use of nonpharmacological methods helped them cope with their pain and provided several recommendations about how to improve pain management. CONCLUSION Paediatric postoperative pain management remains suboptimal. The children in our study provided useful information about their pain experiences, how to improve pain management and explained why they did not tell their nurses when they were in pain. RELEVANCE TO CLINICAL PRACTICE These findings should direct further improvements in paediatric postoperative pain management, such as increased use of pain assessment tools and preparatory information, as well as more appropriate administration of pain medications.
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Affiliation(s)
- Anja Hetland Smeland
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Tone Rustøen
- Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Torgun Naess
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Lill Nybro
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Stefan Lundeberg
- Pain Treatment Service, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Hanne Reinertsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Trond H Diseth
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alison Twycross
- School of Health and Social Care, London South Bank University, London, UK
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Alotaibi K, Higgins I, Chan S. Nurses' Knowledge and Attitude toward Pediatric Pain Management: A Cross-Sectional Study. Pain Manag Nurs 2018; 20:118-125. [PMID: 30528361 DOI: 10.1016/j.pmn.2018.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 07/27/2018] [Accepted: 09/02/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pain in infants and children is often poorly assessed and managed. Although there are many studies on this subject, none have been conducted in the Arab world, including the Kingdom of Saudi Arabia, where nurses are largely expatriates. AIMS To examine the knowledge and attitudes of nurses working with infants and children in the Kingdom of Saudi Arabia regarding pain management. DESIGN Descriptive cross-sectional survey. SETTINGS Five government hospitals in Riyadh region of the Kingdom of Saudi Arabia. PARTICIPANTS/SUBJECTS Registered nurses caring for infants and children. METHODS A convenience sample of 410 nurses working at five Saudi Arabian government hospitals was surveyed using the Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS-Shriners Revision). Data were analyzed using descriptive (frequency, percentage, mean, and standard deviation) and inferential statistics, including Pearson correlation, independent t test, and one-way analysis tests. RESULTS Poor overall knowledge and attitudes regarding pediatric pain management was evident in this study. The mean correct score achieved by nurses was 18.1 ± 4.0 out of 40 or 45.2% ± 10.0% of a possible score of 100%. A weak but statistically significant correlation was found between years of pediatric nursing experience and total score (r = -0.129, p = .009). CONCLUSIONS We concluded that intensive education on pediatric pain and its management is urgently needed for nurses working in the Kingdom of Saudi Arabia.
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Affiliation(s)
- Khalaf Alotaibi
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
| | - Isabel Higgins
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sally Chan
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre of Brain and Mental Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
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16
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Nurses’ Knowledge, Attitudes and Clinical Practice in Pediatric Postoperative Pain Management. Pain Manag Nurs 2018; 19:585-598. [DOI: 10.1016/j.pmn.2018.04.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/11/2018] [Accepted: 04/01/2018] [Indexed: 11/18/2022]
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Matula ST, Polomano RC, Irving SY. The state of the science in paediatric pain management practices in low-middle income countries: An integrative review. Int J Nurs Pract 2018; 24:e12695. [PMID: 30251308 DOI: 10.1111/ijn.12695] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/30/2018] [Indexed: 12/31/2022]
Abstract
AIM Examine the state of the science for pain management in children living in low-middle income countries (LMIC). BACKGROUND Significant challenges exist in pain management for children living in LMIC. METHODS An integrative review was conducted using PRISMA guidelines for quality of reporting. Literature searches were completed using Medline, PubMed, Scopus, and CINAHL databases for publications between January 2006 and August 2016 using MeSH and primary search terms pain and LMIC. Full text publications were evaluated using GRADE criterion and methodology specific evaluation tools. RESULTS Of 1510 publications identified, 31 met the criteria for inclusion. Data were categorized into three broad themes: (1) magnitude of the pain problem with subthemes describing the burden of and resources for paediatric pain management; (2) perceptions, experience, and practices for managing pain in children residing in LMIC with subthemes addressing health care providers, parent/caregiver and children, respectively; and (3) pain management practices with pain assessment and treatment strategies as subthemes. CONCLUSION Current data on paediatric pain management in LMIC are limited with respect to describing the burden of pain, children's pain perceptions and experiences, and pain management practices. Rigorous investigations are needed to expand knowledge and address the pervasive problem of pain for children in LMIC.
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Affiliation(s)
- Samuel T Matula
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Rosemary C Polomano
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sharon Y Irving
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,Division of Anesthesiology and Critical Care Medicine/Critical Care Nursing, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Marshall C, Forgeron P, Harrison D, Young NL. Exploration of nurses' pediatric pain management experiences in rural hospitals: A qualitative descriptive study. Appl Nurs Res 2018; 42:89-97. [PMID: 30029720 DOI: 10.1016/j.apnr.2018.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Hospitalized children continue to experience inadequate pain management. Children in the rural hospital setting may be at risk due to unique challenges experienced by Registered Nurses (RNs) in this context. OBJECTIVES To understand the experience of pain care from RNs who work in rural hospitals with inpatient pediatric patients. DESIGN Qualitative description that used semi-structured interviews to explore RNs' inpatient pediatric pain care experiences. PARTICIPANTS RNs who: 1) worked directly with pediatric in-patients; 2) spoke English; 3) and who worked in rural Northern Ontario. Hospital sites were selected based on population density, from one province in Canada. To reduce heterogeneity, only sites with dedicated pediatric beds were eligible (n = 9). METHODS This qualitative descriptive study used semi-structured interviews over Skype and telephone. Data were analyzed using inductive content analysis. RESULTS Ten participants were recruited from seven sites. Five main categories were identified, with one category that influenced all other categories. Rural RNs needed to practice as generalists as they care for many types of patients. Resource challenges included a lack of specialist expertise and educational opportunities. Pediatric pain was not perceived as a priority within their organizations. Most participants perceived there were no explicit standards for pain care. Moving forward the adoption of built in assessments in electronic documentation was suggested as a solution to standard pain care. CONCLUSIONS Opportunity exists to improve pediatric pain management, however, without a systematic approach that considers the rural context, pain care for children will continue to be based on individual's beliefs and knowledge.
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Affiliation(s)
- Carolyn Marshall
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Rd., Ottawa, Ontario K1H 8M5, Canada.
| | - Paula Forgeron
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Rd., Ottawa, Ontario K1H 8M5, Canada.
| | - Denise Harrison
- University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Rd., Ottawa, Ontario K1H 8M5, Canada.
| | - Nancy L Young
- Laurentian University, Faculty of Rural and Northern Health, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada.
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Alotaibi K, Higgins I, Day J, Chan S. Paediatric pain management: knowledge, attitudes, barriers and facilitators among nurses - integrative review. Int Nurs Rev 2018; 65:524-533. [PMID: 29956310 DOI: 10.1111/inr.12465] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIMS To identify and synthesize evidence regarding the knowledge and attitudes of nurses, and barriers and facilitators to effective pain assessment and management in infants and children. BACKGROUND Pain among children is a common experience. Relief from pain is a fundamental human right, yet hospitalized children continue to experience unrelieved pain. Provision of effective pain management is an integral part of the nurse's role. METHODS Guided by Whittemore & Knafl's five-stage framework, primary peer-reviewed studies published in English between 2000 and 2018 were searched using CINAHL, PubMed, ProQuest, PsycINFO and Scopus. The initial search yielded 292 papers. Twenty-seven papers were included in this review: quantitative (n = 18), qualitative (n = 5) and mixed-methods (n = 4). RESULTS Findings showed that nurses internationally have poor knowledge and attitudes of basic pain assessment and management principles. Barriers to effective pain management include the absence of pain education and assessment tools, parents' reluctance to report pain and insufficient prescription of analgesia by physicians. Facilitators for the effective management of pain include parental participation in care, trusting and respectful relationships between nurses and children, and adequate nurse-patient ratios. CONCLUSION The review findings suggest a need to improve education for nurses, doctors and the patients' family in relation to paediatric pain management, communication and interprofessional collaborations. There is a need to maximize facilitators and overcome barriers, such as those identified in this review, to ensure the quality of paediatric pain management. IMPLICATIONS FOR NURSING AND HEALTH POLICY Nursing and health policy should mandate the prioritization of paediatric pain management and the clinical roles and responsibilities of the interdisciplinary team members. Undergraduate, postgraduate and in-service education for nurses and other health professionals should also address paediatric pain management. In-service education on paediatric pain management should be compulsory for all health professionals caring for children.
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Affiliation(s)
- K Alotaibi
- School of Nursing and Midwifery, the University of Newcastle, Callaghan NSW 2308, Australia
| | - I Higgins
- School of Nursing and Midwifery, the University of Newcastle, Callaghan NSW 2308, Australia
| | - J Day
- School of Nursing and Midwifery, the University of Newcastle, Callaghan NSW 2308, Australia
| | - S Chan
- Priority Research Centre of Brain and Mental Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan Australia
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