Influences shaping nurses' use of distraction for children's procedural pain

Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia

BACKGROUND

Traditionally, pharmacological pain relief methods have been the most acceptable option for controlling labor pain, accompanied by numerous adverse consequences. Non-pharmacological labor pain relive methods can reduce labor pain while maintaining an effective and satisfying delivery experience and delaying the use of pharmacological methods. This study explores the utilization of non-pharmacological labor pain relive methods and its associated factors among midwives and maternity nurses.

METHODS

A cross-sectional research was conducted in Maternal and Children Hospital/Najran, Saudi Arabia, from April to May 2023 and incorporated a convenience sample of 164 midwives and maternity nurses. The data was collected using a self-reported questionnaire composed of five sections; basic data, facility-related factors, non-pharmacological labor pain relive utilization and attitude scales, and knowledge quiz. A logistic regression was used to determine the associated factors with non-pharmacological labor pain relive utilization.

RESULTS

The results revealed that 68.3% of participants utilized non-pharmacological labor pain relive methods. The midwives and maternity nurses helped the parturient to tolerate labor pain by applying the non-pharmacological labor pain relive methods, including; positioning (55.5%), breathing exercises (53.7%), comfortable and relaxing environment (52.4%), therapeutic communication (47%), positive reinforcement (40.9%), relaxation (40.2%), and therapeutic touch (31%). In addition, working unit, providers-patient ratio, working hours, non-pharmacological labor pain relive training, years of experience, and non-pharmacological labor pain relive attitude were significant determinants of non-pharmacological labor pain relive utilization (P < 0.05).

CONCLUSIONS

High non-pharmacological labor pain relive utilization was significantly associated with nurses' older age and higher education, working in the delivery room, lower nurse-patient ratio, lower working hours, in-services training, increased years of experience, and positive attitude. The study sheds light on the importance of handling the pre-mentioned factors to enhance non-pharmacological labor pain relive utilization.

Nurses' use of non-pharmacological pain management methods in intensive care units: A descriptive cross-sectional study

BACKGROUND

Pain is a common and unpleasant feeling among patients in intensive care units. Therefore, the use of proper pain management methods, such as non-pharmacological interventions, is a priority in intensive care units.

OBJECTIVE

This study aimed to ascertain the extent of the use of non-pharmacological pain management methods by intensive care unit nurses in Iran and to identify the obstacles that hindered the use of these methods.

MATERIAL AND METHODS

This study used a descriptive cross-sectional design which involved a convenience sample of 224 nurses who worked in 16 intensive care units across northern Iran. Data were collected using the non-pharmacological pain management questionnaire and a researcher-developed checklist of the obstacles that hindered the use of non-pharmacological pain management methods.

RESULTS

A moderate number of ICU nurses used non-pharmacological pain management methods (55.8 %). The most common method used by nurses was repositioning (M = 2.72), while methods such as acupuncture and reflexology were used less frequently. Furthermore, the most common obstacles to the use of non-pharmacological pain management methods were nurses' fatigue (M = 2.92) and multiple responsibilities (M = 2.91). Demographic variables such as age, gender, educational level, and work experience were not significantly associated with the use of non-pharmacological pain management methods.

CONCLUSIONS

Due to factors such as fatigue, multiple responsibilities, a heavy workload, and an insufficient number of nurses per shift, the rate of utilization of non-pharmacological pain management methods among intensive care unit nurses in Iran was low. Furthermore, most of the participants in this study had not attended courses on non-pharmacological pain management.

Exploring distraction and the impact of a child life specialist: Perceptions from nurses in a pediatric setting

PURPOSE

The purpose of this study is to explore perceptions held by nurses on the use of distraction and the role of a child life specialist in caring for children undergoing painful procedures.

DESIGN AND METHODS

A qualitative focus-group design was conducted with 18 nurses from a 24-bed pediatric unit in New South Wales, Australia; this represented 51% of the staff from the unit. Three focus groups were conducted and transcribed verbatim followed by thematic analysis.

RESULTS

Findings revealed five main themes that reflected the perceptions of the nurses' use of distraction and the impact of the child life specialist. The theme "Distraction as part of everyday nursing practice" was viewed by nurses as an integral component of nursing practice. The theme "Influence of child life specialist" revealed that the child life specialist created a feeling of ease during procedures. Differences were acknowledged between the two roles, "Contrast of roles" the child life specialist was seen as positive for children and families, whereas nurses viewed themselves as mean and unkind due to the nature of their work. The theme "The value of collaboration for positive healthcare experiences" acknowledged distraction as a contributing factor in ensuring the child and their family had a positive healthcare experience. The types of "nurses perception of the child's experience with distraction" shared in each of the focus groups identified nurses felt their techniques for distraction were much more simplified than the child life specialist; nurses felt disadvantaged at times in not having access to the same tools.

PRACTICE IMPLICATIONS

The findings indicate the positive impact that a child life specialist has on a nurse's role while caring for children undergoing painful procedures. Nurses felt they were able to focus on the procedure, therefore ensuring the physician received the right amount of assistance. This reassured the nurses in knowing the child and their families emotional needs were being taken care of. The child life specialist was viewed as being able to provide a positive healthcare experience for the child and families, nurses felt this added to the value of care provided in the pediatric unit. Recommendations include further exploration of the child life specialist role in the pediatric inpatient setting.

Critical care nurses' use of non-pharmacological pain management methods in Egypt

AIM

To examine Critical Care Nurses' Practices of Non-pharmacological Pain Management Interventions in Egypt.

METHODS

Descriptive exploratory design was utilized in the current study with a convenience sample of 60 critical care nurses working in three intensive care units at Al Manial university Hospital, Egypt. The questionnaires included; nurses' demographic data, non-pharmacological pain management checklist utilizing likert scale, and perceived barriers to the practice of non-pharmacological pain management interventions. Comparisons were made between the nurses' responses about practices of non-pharmacological pain management and selected demographic variables.

RESULTS

The non-pharmacological methods used by few nurses were putting the patient in comfortable position, communication with the patients and their families and using comfort devices. Moreover, nurses' education, work experience and the work area showed no statistically significant association with the few of non-pharmacological pain relief interventions they used. Finally, the barriers that hindered non-pharmacological pain practices from being used by nurses were lack of nurses' knowledge, lack of time, nurses' workload and patients' instability.

CONCLUSION

Most of the critical care nurses didn't apply non-pharmacological pain interventions practices with their patients in pain. The approaches used by a few nurses were changing position and the use of some comfort devices. Moreover, no significant correlations were found between nurse' application of non-pharmacological pain measures and either educational level and work area.

RECOMMENDATIONS

Barriers need to be explored and continuing education is needed to eliminate some of these perceived barriers. Moreover, theoretical and practical non-pharmacological pain management interventions should be incorporated in nursing curricula.

Procedural Preparation and Support as a Standard of Care in Pediatric Oncology

Youth with cancer undergo many repeated and invasive medical procedures that are often painful and highly distressing. A systematic review of published research since 1995 identified 65 papers (11 review articles and 54 empirical studies) that investigated preparatory information and psychological interventions for a variety of medical procedures in pediatric cancer. Distraction, combined cognitive-behavioral strategies, and hypnosis were identified as effective for reducing child pain and increasing child coping. Low- to high-quality evidence informed strong recommendations for all youth with cancer to receive developmentally appropriate preparatory information and psychological intervention for invasive medical procedures.