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Paediatric pain management: knowledge, attitudes, barriers and facilitators among nurses - integrative review
K Alotaibi1, I Higgins1, J Day1
1School of Nursing and Midwifery, the University of Newcastle, Callaghan NSW 2308, Australia.
Insights
Nurses globally demonstrate inadequate knowledge and attitudes regarding pediatric pain assessment and management. Improving education and addressing barriers like insufficient analgesia are crucial for effective pediatric pain relief.
Area of Science:
- Pediatric Nursing
- Pain Management
- Healthcare Quality
Background:
- Effective pain management is a fundamental right for children.
- Hospitalized children frequently experience unrelieved pain.
- Nurses play a critical role in pediatric pain management.
Purpose of the Study:
- To synthesize evidence on nurses' knowledge and attitudes towards pediatric pain.
- To identify barriers and facilitators to effective pain assessment and management in children.
- To inform strategies for improving pediatric pain care.
Main Methods:
- Systematic review following Whittemore & Knafl's framework.
- Searched CINAHL, PubMed, ProQuest, PsycINFO, and Scopus for English articles (2000-2018).
- Included 27 primary studies (18 quantitative, 5 qualitative, 4 mixed-methods).
Main Results:
- Nurses worldwide exhibit poor knowledge and attitudes regarding basic pain assessment and management.
- Barriers include lack of education/tools, parental reluctance, and insufficient physician-prescribed analgesia.
- Facilitators include parental involvement, positive nurse-child relationships, and adequate nurse-patient ratios.
Conclusions:
- Enhanced education for nurses, doctors, and families on pediatric pain management is necessary.
- Addressing identified barriers and leveraging facilitators can improve the quality of pediatric pain management.
- Policy changes and compulsory education are recommended to prioritize pediatric pain care.
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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