Nurses' Beliefs Regarding Pain in Critically Ill Children: A Mixed-Methods Study

Area of Science:

• Pediatric critical care nursing
• Pain management in children
• Nursing beliefs and practices

Background:

• Effective pain management is crucial for critically ill children.
• Nurses' beliefs significantly influence pain assessment and treatment.
• Previous research indicates a need for current evaluations of these beliefs.

Purpose of the Study:

• To comprehensively evaluate current nursing beliefs about pain in critically ill children.
• To identify accurate and inaccurate beliefs among nurses.
• To compare beliefs obtained through different methodologies.

Main Methods:

• Convergent parallel mixed-methods design.
• Data collection via questionnaires and interviews with nurses.
• Comparison of beliefs derived from both methods.

Main Results:

• Forty nurses participated in the study.
• Questionnaire data largely aligned with effective pain management, but some inaccuracies were noted (e.g., verifying pain with physical signs, opioid pharmacokinetics).
• Interview data revealed common beliefs about validating pain through behavior, responding to pain, opioid concerns, and starting interventions low. Convergent themes included using physical indicators, trusting child reports, and analgesic concerns. Divergent findings often related to the legitimacy of a child's pain report.

Conclusions:

• Nurses' pain beliefs in critically ill children are consistent with prior research.
• Divergent and conflicting beliefs suggest variability influenced by patient characteristics.
• Interventions are needed to address nurses' concerns about unrelieved pain versus opioid adverse effects.