Pediatric Pain Management: An Observational Study on Nurses' Knowledge of Non-Pharmacological Techniques

Introduction: Pain represents a significant threat to the physical and psychological well-being of children, negatively affecting their quality of life during hospitalization. Pain is considered the fifth vital sign and must be regularly assessed and managed, as also emphasized by the nursing code of ethics. The interdisciplinary approach to pediatric pain management includes both pharmacological treatments and non-pharmacological techniques (NPTs), taking into account the child's age and specific needs. NPTs comprise a broad set of methods, ranging from simple to complex, that can be applied to children to help them manage pain. The main objective of this study was to explore and analyze which non-pharmacological methods are adopted by nurses in their clinical practice to relieve pain in school-aged children (6-12 years) undergoing surgery. Materials and Methods: This observational study involved nursing staff from pediatric wards in the Italian provinces of Ravenna, Forlì-Cesena, and Rimini, and used a validated online questionnaire. The study focused on school-aged children (6-12 years) who had undergone surgical procedures. The questionnaire included items on which NPTs nurses used to relieve pain in pediatric patients. Participants responded using a Likert scale from 1 (never) to 5 (always), and anonymity and voluntary participation were guaranteed. Data were collected between February and October 2024, involving the pediatric units of three hospitals in the provinces of Ravenna, Forlì-Cesena, and Rimini. Statistical analyses included t-tests, ANOVA, and Kruskal-Wallis tests to identify significant differences. Results: A total of 46 nurses completed the questionnaire. No significant differences were found between nurses' backgrounds and the use of NPTs. Overall, nurses did report using NPTs, although there was limited use of such techniques in the preoperative phase. The study also highlighted a discrepancy in the information provided to children versus parents, with nurses tending to give more information to parents during the preoperative period. Notably, nurses who reported effective multidisciplinary collaboration were also those who better prepared children using NPTs. Conclusions: This study emphasizes the importance of NPTs in pediatric pain management and highlights the need to improve direct communication with children. Adopting an effective multidisciplinary approach is essential to ensuring a less traumatic surgical experience for young patients.