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Updated: Aug 2, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Educational Intervention to Strengthen Pediatric Postoperative Pain Management: A Cluster Randomized Trial
Anja H Smeland1, Alison Twycross2, Stefan Lundeberg3
1Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Norway; Institute of Health and Society, University of Oslo, Norway.
Insights
An educational intervention did not significantly improve pediatric postoperative pain management compared to standard care. However, nurses showed increased knowledge and improved pain assessment practices in both groups, suggesting a need for further research.
Area of Science:
- Pediatric Nursing
- Pain Management
- Clinical Education
Background:
- Pediatric postoperative pain remains inadequately managed.
- Effective strategies are crucial for improving children's recovery and well-being.
Purpose of the Study:
- To evaluate the impact of an educational intervention on nurses' knowledge and pediatric postoperative pain management.
- To assess changes in pain assessment practices and patient-reported pain levels.
Main Methods:
- A cluster randomized controlled trial was conducted in Norwegian postanesthesia care units.
- Nurses received an educational intervention including a training day, supervision, and reminders.
- Data collected via surveys, clinical observations, and child interviews at three time points.
Main Results:
- While knowledge improved in both intervention and control groups, no significant difference was found between them.
- The intervention group demonstrated a significant increase in the use of pain assessment tools and a reduction in moderate-to-severe pain.
- Nurses' knowledge scores (PNKAS-N) improved from baseline to follow-up in the intervention group.
Conclusions:
- The educational intervention did not yield statistically significant differences in pediatric postoperative pain management between groups.
- Positive changes in nurses' knowledge and clinical practice were observed in both groups.
- Further research is needed to identify key variables for enhancing pediatric postoperative pain management.
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.
