Competence In Pain Management Research Articles

Interventions for Assessment and Enhancement of Pain Management Competencies among Healthcare Professionals

To pain management competencies among healthcare professionals is crucial for improving patient care and outcomes. Healthcare professionals must possess the necessary knowledge, skills, and techniques to effectively manage and treat pain in their patients. This includes understanding different types of pain, assessing pain levels, and utilizing appropriate interventions. By accurately assessing pain levels and implementing a multimodal approach to pain management, healthcare professionals can optimize patient outcomes and minimize risks. Effective communication skills and staying updated on the latest evidence-based practices are also essential. Continuous education and professional development are vital for healthcare professionals to enhance their pain management competencies and deliver the best possible care.Include training healthcare professionals in pain assessment techniques, educating them on the multidimensional nature of pain, providing resources and tools for accurate and comprehensive pain evaluation, encouraging interdisciplinary collaboration to enhance pain management strategies, fostering a patient-centered approach that values the individual's self-reporting of pain, promoting ongoing education and professional development to ensure up-to-date knowledge and skills, conducting regular assessments and evaluations to monitor the effectiveness of pain assessment training programs, and supporting a culture of continuous improvement and innovation in pain assessment practices. Additionally, technology-based solutions such as electronic pain diaries and telemedicine can be utilized to enhance pain assessment and monitoring capabilities.Include successful implementation and execution of transformative educational programs, catering to diverse learner needs. These initiatives foster holistic learning, instilling a love for knowledge in students. Outcomes show remarkable progress, enhanced critical thinking, creativity, and problem-solving abilities. Innovative teaching and cutting-edge technologies empower countless individuals, unlocking their potential and achieving academic excellence. Collaborative approach establishes a foundation for lifelong learning and personal development. Equipped with acquired knowledge and skills, individuals make a lasting impact in their fields, shaping a brighter future for themselves and society.Pain management is an incredibly crucial aspect of healthcare, and it is absolutely essential for healthcare professionals to possess the necessary competencies to accurately assess and greatly enhance their ability to provide highly effective pain management interventions. Ensuring that patients receive optimal pain relief and care should be a top priority for all healthcare providers, as it positively contributes to their overall wellbeing and enhances the quality of their medical treatment. Therefore, healthcare professionals must continuously invest time and effort in expanding their knowledge and skills related to pain management to ensure they can deliver the highest level of care to their patients. By doing so, we can strive towards a healthcare system that prioritizes pain management and empowers healthcare professionals to make a significant difference in their patients' lives.

A framework for capacity enhancement of Rwandan nurse educators and preceptors facilitating nursing students to learn pediatric pain management

IntroductionIn low- and middle- income countries like Rwanda, children are most likely to suffer from painful and life-limiting conditions due to various factors predominant in these settings. Adequate pre-licensure pain management training can improve pain relief nursing practices. Educators and nurses in practice have a responsibility to teach the soon-to- be nurses for holistic competent nursing care of children, emphasizing the importance of and addressing child’s suffering, yet inconsistencies were reported in what was taught regarding pediatric pain management from a theoretical perspective by nurse educators as compared to their counterparts in clinical settings in Rwanda.DesignThis study applied a qualitative approach using group discussions based on nominal group technique (NGT) to develop and validate a conceptual framework supporting the capacity enhancement of nurse educators and preceptors facilitating students’ learning about pediatric pain management in Rwanda.MethodsNGT meetings were conducted with academic nurses (n = 8), nurse clinicians (n = 4), and nursing students (n = 2) during a 2-day workshop to identify strategies, discuss the relevance of each strategy and to agree on key concepts of a framework for improving the ability of nurse educators and preceptors to teach PPM to nursing students. After four weeks another round of NGT meetings were done with nursing faculty (n = 6), academic nurse leaders (n = 3), nurse preceptors (n = 2), clinical nurse leaders (n = 2), a nurse leader from a regulatory body (n = 1), and nursing student (n = 1) to validate the developed framework.FindingsFour main strategies corresponding to the key concepts were mapped in a framework. Participants had a consensual agreement on the importance of the developed framework, they confirmed its completeness and practicality. In addition, participants found that the developed framework is logical, and confirmed that it is applicable for its purpose.ConclusionThe developed framework presents an opportunity to respond to the gaps in nursing pain education in the context of limited resources settings such as Rwanda. It can also be applied in nursing practice and nursing research, aligning with the need of improving the quality of care of suffering children. Furthermore, the framework can be adapted and utilized to meet the needs of healthcare professionals other than nurses.Clinical relevanceStrategies are suggested to improve the ability of nurse educators and preceptors in clinical settings to facilitate the acquisition of pediatric pain management competencies by the next generation of nurses. Future Rwandan nurses could then use the competencies acquired to provide optimal health care to children with pain in the best way possible during their practices.

Opioid Treatment in Primary Care: Knowledge and Practical Use of Opioid Therapy.

Primary care physicians play a key role in initiating opioid therapy. However, knowledge gaps in opioid use and pain management are significant barriers to providing optimal care. This research study aims to investigate the educational needs of primary care physicians regarding opioid therapy and opioid use in pain management. A computer-assisted web interview (CAWI) protocol was used to collect data from primary care physicians. Drug selection criteria, knowledge of opioid substitutes and dosage, and practical use of opioid therapy were evaluated. While 84% of participating physicians (724 respondents) reported initiating opioid treatment, only a minority demonstrated accurate opioid dosage calculations. Significant discrepancies between physicians' self-perceived knowledge and their clinical skills in opioid prescribing and pain management were observed. In total, 41% of physicians incorrectly indicated dose conversion rates for tramadol (the most frequently used drug according to 65% of responders). Targeted educational programs are essential to bridge the knowledge gap and increase physicians' competence in pain management. The proper self-assessment of one's own skills may be the key to improvement. Further research should focus on developing specialized educational courses and decision-support tools for primary care physicians and examining the impact of interprofessional pain management teams on patient outcomes.

"Thai Nurses' and Midwives' Perceptions Regarding Barriers, Facilitators, and Competence in Neonatal Pain Management".

Effective neonatal pain management is reliant upon the expert care of nurses and midwives working in neonatal intensive care units (NICUs). Previous research has explored barriers, facilitators, and some aspects of nurse competence in managing neonatal pain; however, this research has been predominantly performed in Western countries. To date, little is known about the barriers, facilitators, and perceived competence of Thai nurses and midwives in relation to neonatal pain management in NICUs. Exploring Thai nurses' and midwives' perceptions in these areas is crucial for understanding the contextual nuances of neonatal pain management, which can guide the provision of care for these high-risk neonates. To investigate nurses' and midwives' perceptions of barriers, facilitators, and competence regarding effective neonatal pain management in Thai NICUs. Data were collected using virtual one-to-one, semistructured interviews with 12 neonatal nurses and midwives between July and August 2021 in 3 units of 2 tertiary hospitals in Southern Thailand. Inductive thematic analysis was used to examine interview data. These data revealed following 3 major themes: ( a ) barriers to effective neonatal pain management, ( b ) facilitators of effective neonatal pain management, and ( c ) perceptions of competence. Assisting nurses and midwives in overcoming barriers and strengthening facilitators while enhancing their competence may result in better neonatal pain management. This study adds to our understanding that further research is needed to develop the interventions designed to change at individual, unit, and organizational levels, particularly implementing parent-friendly visitation and ongoing professional development in neonatal pain management.

Evaluating an educational program for enhancing neonatal intensive and special care nurses’ and midwives’ competence with neonatal pain management: A quasi-experimental study

Competence in neonatal pain management is influenced by the clinician’s knowledge, attitudes, and skills. The impact of an educational program on enhancing competence among Thai neonatal nurses and midwives has never been explored. This study aims to evaluate the impact of an educational program to increase nurses’ and midwives’ competence in neonatal pain management in Thai neonatal intensive and special care units (NI/SCUs). A web-based learning package with pre-, post-, and follow-up online questionnaire was administered to 68 neonatal nurses and midwives. There was a substantial increase in the total mean scores of knowledge, attitudes, and perceived self-competence in the post- and follow-up phases compared to the pre-test phase (p < 0.001). The educational program had a significant impact on Thai NI/SCU nurse and midwife competence regarding neonatal pain management. Ongoing education is needed to sustain clinicians’ competence in this area.

Exploring Experiences of Pain Management Among Family Caregivers of Community-Dwelling Older Adults With Dementia.

Pain is often underreported and under-treated in older adults with dementia. The role of family caregivers (FCGs) in managing pain for their loved ones with dementia living in community has been significantly burdensome. Surprisingly, research has not delved into the experiences of FCGs' concerning pain management in this context. A qualitative descriptive study was conducted to gain a deep understanding of FCGs' experiences in managing pain for their loved ones. Family caregivers participated in semi-structured face-to-face or telephone interviews. Inclusion criterion included being an adult providing care to community-dwelling older adults with dementia. Recruitment stopped upon reaching thematic saturation. Basic demographic characteristics was also collected. Constant comparison analytic method was employed. The study included 25 FCGs in central Virginia, spanning ages from 29 to 95. Participants were predominantly white, female, married, and had a minimum high school education. Most of them were adult children (52%) or the spouses (28%) of the care recipients. Four thematic categories emerged around exploring FCGs' pain management experiences: (1) Values; (2) Barriers; (3) Support; and (4) Adaptation. Each theme included sub-themes. Family caregivers follow their values to make decisions in pain management. Barriers existed for effective pain management. Adaptation and support from professional or formal caregivers greatly improved FCGs' perception of their competence in pain management. The finding underscores the need for further research and the development of interventions aimed at enhancing FCGs' perception of self-efficacy in this crucial aspect of caregiving.

Developing an educational program to enhance nursing and midwifery competence in neonatal pain management

Developing an educational program to enhance nursing and midwifery competence in neonatal pain management

Strategies to build and maintain competence in pain management: Insights from a SIAARTI survey on educational needs among Italian anesthesiologists.

Fulfilling educational needs in pain management should be a lifelong process, even involving physicians board certified in pain medicine such as the anesthesiologists/pain therapists. The aim of the study was to investigate Italian anesthesiologists' self-perceived competency, confidence, and interest to attend educational programs in relation to their seniority in pain management. SIAARTI members were sent an online questionnaire addressing the following items: education, skills (both soft and hard skills), technical expertise and engaged to participate between December 2020 and January 2021. Participants rated their competence based on the following range (no knowledge, knowledge, competence) while their agreement to attend educational courses was assessed using a 5-point Likert-type scale. Less than one in four participants declare to be dedicated to pain medicine activity with greater proportion among older (over 61 years) compared to younger ones (31-40 years). Regarding cancer and chronic noncancer pain a positive gradient of self-perceived competence has been observed in relation to seniority. In contrast, no gradient of self-perceived competence was reported about musculoskeletal and low back pain. Participants self-perceived competent in both opioid use and prevention of opioid-related adverse event while feeling less competent when managing drugs with abuse potential. The lowest competence has been observed in pediatric pain along with the lowest interest to attend educational courses. Participants were much and very much interested to education regarding cancer, noncancer, musculoskeletal, and low back pain, invasive analgesic procedures but less regarding items for which they declared less competence, such as use of pain scales, pain management in children, and use of drugs with abuse potential. This work provides first evidence of a summative assessment of competency and related educational needs' profile of anesthesiologists/pain therapists thus paving the way for developing a nationwide educational program to improve chronic pain care in Italy.

Updating Ways and Enhancing Pain Management Efficiencies among Healthcare

Introduction: Understanding of the current landscape of interventions is important to enhance pain management competencies among healthcare professionals. This systematic review aimed to assess the prevalence and efficacy of interventions targeted at enhancing pain management competencies among healthcare professionals, with the goal of informing evidence-based practices and facilitating improvements in patient care. Methods: A comprehensive search strategy, tailored to electronic databases including PubMed, MEDLINE, Embase, and the Cochrane Library, was employed to systematically identify relevant studies until August 2023. Eligible studies, meeting specific criteria and published within the last 10 years, underwent a rigorous screening process, with inclusion based on primary research articles focused on pain management competencies among healthcare professionals. The subsequent data extraction and quality assessment, conducted by two independent reviewers, ensured a thorough and methodologically sound review of the literature. Results: The review included seven studies with diverse samples and interventions aimed at enhancing pain management competencies among healthcare professionals. The sample sizes varied from 82 to 358 participants, with an average improvement of 27% in sample knowledge representation. The interventions, spanning educational programs, simulation training, and collaborative strategies, demonstrated consistent effectiveness in improving knowledge and self-efficacy, with simulation training showcasing tangible improvements in practical skills and collaborative approaches leading to enhanced teamwork skills, quantified by a 40% improvement. The quantitative assessments revealed significant overall improvements, including a 23% increase in knowledge scores, a 28% rise in self-efficacy, and a 37% improvement in teamwork. Conclusions: Our study contributes to the existing literature by quantifying the substantial improvements observed in pain management competencies among healthcare professionals through diverse interventions, including educational programs, simulation training, and collaborative approaches, emphasizing the importance of a multifaceted strategy, with calculated odds ratios and percentages providing concrete measures for the development of evidence-based practices and educational strategies.

EXPLORING EXPERIENCES OF PAIN MANAGEMENT AMONG FAMILY CAREGIVERS OF COMMUNITY-DWELLING OLDER ADULTS WITH DEMENTIA

Abstract Pain is often under reported and under-treated in older adults with dementia. Formal caregivers receive training and resources to develop their pain management skills; yet family caregivers (FCGs), who bear the brunt of responsibility for pain management among community-dwelling older adults with dementia have largely been omitted from research. We conducted a qualitative descriptive study to gain a deep understanding of FCGs’ experience in pain management. 25 adult FCGs of community-based older adults with dementia were living in central Virginia were interviewed. Participants were 29 to 95 years old, predominantly white, married, female, and high school graduates. Four themes emerged around exploring FCGs’ pain management experience and each theme included sub themes: 1) Values: family caregivers make values-based decisions that rely on a diverse range of beliefs towards opioids and non-pharmacological approaches. 2) Barriers: pain management was hampered by patient-related factors (comorbidity, complexity of care) and FCG-related factors (lack of training and resources). 3) Support: FCGs perceived greater competence when well supported by professional caregivers (doctors, social workers) and family members. 4) Adaptation: FCGs employed many strategies to support themselves and build a sense of self-efficacy that can either inhibit or facilitate effective pain management for their loved-ones. Adaptation and support from professional or formal caregivers greatly improved FCGs’ perception of competence in pain management, suggesting research and development of interventions targeting FCGs is warranted.

Continuing professional development needs in pain management for Canadian health care professionals: A cross sectional survey

ABSTRACT Background Continuing professional development is an important means of improving access to effective patient care. Although pain content has increased significantly in prelicensure programs, little is known about how postlicensure health professionals advance or maintain competence in pain management. Aims The aim of this study was to investigate Canadian health professionals’ continuing professional development needs, activities, and preferred modalities for pain management. Methods This study employed a cross-sectional self-report web survey. Results The survey response rate was 57% (230/400). Respondents were primarily nurses (48%), university educated (95%), employed in academic hospital settings (62%), and had ≥11 years postlicensure experience (70%). Most patients (>50%) cared for in an average week presented with pain. Compared to those working in nonacademic settings, clinicians in academic settings reported significantly higher acute pain assessment competence (mean 7.8/10 versus 6.9/10; P < 0.002) and greater access to pain specialist consultants (73% versus 29%; P < 0.0001). Chronic pain assessment competence was not different between groups. Top learning needs included neuropathic pain, musculoskeletal pain, and chronic pain. Recently completed and preferred learning modalities respectively were informal and work-based: reading journal articles (56%, 54%), online independent learning (44%, 53%), and attending hospital rounds (43%, 42%); 17% had not completed any pain learning activities in the past 12 months. Respondents employed in nonacademic settings and nonphysicians were more likely to use pocket cards, mobile apps, and e-mail summaries to improve pain management. Conclusions Canadian postlicensure health professionals require greater access to and participation in interactive and multimodal methods of continuing professional development to facilitate competency in evidence-based pain management.

Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge

<i>Context:</i> There is a surplus of contemporary scientific evidence-based indicated numerous precarious positions with inadequate post-surgical pain management in adult surgical patients. The most important barrier in this context was suboptimal postsurgical pain interventions. <i>Aim:</i> This nursing improvement initiative aimed to optimize post-surgical pain nursing interventions in adult surgical patients by training surgical nurses the strategies to enhance their pain management competencies in one teaching hospital in Saudi Arabia.<i> Materials and methods:</i> A descriptive, cross-sectional pain prevalence survey was conducted quarterly in all eight adult surgical inpatients wards to determine and assess if their pain was controlled to a satisfactory level of less than moderate pain. Secondly, pre-and post-test surgical nurses’ knowledge assessment surveys were conducted. Descriptive statistics were used to analyze and interpret and present the data.<i> Results:</i> The outcomes demonstrated that through the improvement nursing initiative strategies implemented, the pain prevalence survey in February 2020 improved by more than 9% with an average of 93.4% (n=142; N=152) of patients with pain intensity less than moderate pain, while in September after omitting quarter three due to Covid-19 surge, all eight surgical wards achieved an average of 88% (n=152; N=173), thus improved by 3,6% compared to the results of November 2019. The average pretest pain knowledge assessment survey taken in January 2020 by 103 surgical nurses in all eight surgical wards was 71%. In October 2020, 114 surgical nurses participated in the post-test and achieved 83%, demonstrated an increase of more than 12% from all 20 questions.<i> Conclusion:</i> The eight surgical wards substantially achieved more than 80% of patients with controlled postsurgical pain levels of less than moderate pain during the last two prevalence cycles, and the posttest revealed pain management knowledge acquisition from the baseline of the pretest conducted. It is therefore postulated that it is essential to monitor the pain management quality of delivered patient nursing care interventions based on the type of pain and consider the provision of refresher training sessions to influence practical skills of pain management competencies.

Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada

ABSTRACT Background National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada. Aims This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context. Methods A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators. Results Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being “very satisfied” with the process. Conclusions This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.

"Challenges and facilitators-navigating in the landscape of spinal cord injury neuropathic pain"-a qualitative study on the use of prescribed drugs.

A qualitative study with an emergent design using semi-structured interviews in focus groups. To explore the expectations, experiences and desires among individuals who are prescribed drugs for spinal cord injury (SCI) neuropathic pain (NP). SCI rehabilitation centre. Eighteen informants with SCI and NP were enrolled. The informants originated from large and small cities in southern Sweden. Data were collected in focus groups consisting of 4-5 individuals in four separate sessions. An emergent design was employed using an interview guide containing open questions. The interviews were transcribed verbatim and data were analyzed according to qualitative content analysis. A model of three themes emerged: "Balancing between pain and side-effects" described the difficult choices the informants had to make between drugs and their unwanted side-effects and pain, "Desiring competence and structure in pain management" described the informants wishes regarding pain management and "From hope to personal solutions" described the process from hope of total pain relief from drugs to the development of personal strategies. There is a great need for improvement of SCI-related neuropathic pain management since recommended drugs are insufficiently effective and accompanied by severe side-effects that impact quality of life but also due to structural limitations and physicians' lack of competence in pain management.

Pediatric pain management competencies taught to nursing students in Rwanda: Perspectives of nurse educators, preceptors and nursing students

Competency for pediatric pain management is fundamental for nurses’ responsibility in caring for pediatric patients with pain. However, effective nursing management of pain in hospitalized children continues to be a challenge more often linked to competency deficit as a consequence of unpreparedness in the pre-licensing education. Previous studies have established that nursing students exhibited lack of knowledge and poor attitudes regarding pediatric pain management, but none of the studies were done in the Rwandan context. The current study explores the pediatric pain management competencies taught to nursing students in Rwanda. An exploratory descriptive qualitative design based on face-to-face individual interviews and focus group discussions was utilized. Fourteen nurse educators and preceptors and nineteen nursing students were recruited from five study settings to explore their perspectives about pediatric pain management competencies taught to nursing students. Participants’ narratives were analysed using thematic analysis from which six main themes emerged. Participants narrated that competencies related to children pain assessment, pain medication and non-drug pain management interventions were taught to students. However, findings also revealed the challenges that impacted the teaching and learning of paediatric pain management, which need to be addressed for the improvement of pre-service training about pain management in children. The findings from the study suggested further research for a better understanding of the nature of those challenges to inform tailored strategies aimed at improving quality health care provision to children through an improved pediatric pain management education at the undergraduate level.

An Integrative Literature Review on Pain Alleviation Interventions for Hospitalized Children

The purpose of this study was to review pain alleviation intervention for Korean pediatric inpatients with reference to Kolcaba's Theory of Comfort. Whittemore and Knafl's integrative review methods were used. Articles published in Korean or English were identified through electronic search engines and scholarly web sites. Scientific, peer-reviewed articles published between 2006 and 2019 were included in this review. Twenty-seven articles that met the inclusion criteria were analyzed. Among the 27 selected studies, three were descriptive, while 24 were interventional studies related to pain alleviation interventions. Pain alleviation interventions showed three attributes: identifying pain triggers and the child's response to pain, effective strategies for pain relief, and nurses' competence in pain management. The three attributes of pain alleviation interventions using the theory of comfort shown in this study were identified as important factors for obtaining evidence-based data on how to enhance the comfort of hospitalized pediatric patients. In addition, the attributes of pain alleviation interventions should be considered for hospitalized pediatric patients and their family members.

The Effect of Pain Management Education on the Knowledge and Attitude toward Pain Management of the Nursing Staff in a Long-term Care Hospital

Purpose The purpose of this study is to identify the effects of pain management education, which were conducted as part of the quality improvement project, on the knowledge and attitude toward pain management of nurses and certified caregivers. Methods The research design was one group pre- and post-test design. The participants were 113 in total including 60 registered nurses and 53 certified caregivers in a long-term care hospital. The Korean Knowledge and Attitude Survey on Pain Management Scale (K-KASP) was measured a week prior to the education and a week after the education. Data were analyzed by paired t-test. Results The Knowledge and attitude toward pain management were significantly improved between the pre- and post-test in both registered nurses (t=7.94, p<.001) and certified caregivers (t=4.25, p<.001). Conclusion The results of this study demonstrate the positive effects of pain management education on the knowledge and attitude toward pain management of both registered nurses and certified caregivers in a long-term care hospital. Further study is needed to empower pain management competencies of the nursing staff in long-term care hospitals. 주요어: 요양병원, 통증관리, 지식, 태도, ê°„í˜¸ì¸ë ¥ Key Words: Long-term care, Pain management, Knowledge, Attitude, Nursing staff

Pengaruh Pelatihan Manajemen Nyeri terhadap Peningkatan Kompetensi Perawat

The purpose of this study was to analyze the effect of pain management training on improving nurses' competency in adult diseases in Padang Pariaman hospital. The Method This study uses a quasi-experimental design with one group pre-post test design approach. The results of this study obtained statistically shows that there is an increase in the cognitive, affective and skills of pain management by nurses (p &lt;0.05). Variable knowledge of nurses increased with a value of 8,647 ± 3,427, attitudes 7,882 ± 3,789 and skills 14,06 to 16,76. The conclusion of this study that Off the job training is very potential for improving nurse competence in pain management, especially in improving cognitive competence, effectiveness, and pain management skills. Continuous training and evaluation of the application of pain management are expected to improve the ability of nurses to carry out pain management.&#x0D; Keywords: Pain Management Training, Cognitive, Affective, Skill, Competence

“WE do it together!” An Ethnographic Study of the Alliance Between Child and Hospital Clown During Venipunctures

PurposeHospital clowns are widely used as a means of non-pharmacological intervention in the treatment of hospitalized children. However, little research has examined the impact of clowns on common painful needle-related procedures. This study explored children's pain experience and their ability to cope during a venipuncture while interacting with a clown in the acute admission unit. Design and methodsAn ethnographic fieldwork study was conducted. Data were collected over a 10-month period through participant observation and informal interviews, supplemented by video recordings. The participants comprised 38 acutely admitted children aged 4 to 15 years undergoing a venipuncture in the presence of a hospital clown. Analysis was structured in three stages: before venipuncture; during venipuncture; and after venipuncture. ResultsThe development of a responsive interaction between child and clown, identified as a WE, was found to be beneficial to the child during venipuncture procedure. The WE was characterized by three themes “How do WE do this together?”; “WE are together”; and “I/WE did it!” ConclusionsThe study emphasizes the importance of a WE established between child and hospital clown from the first encounter until a final evaluation. This WE was verbalized repeatedly by the clown and the child and was essential in shaping a tailored approach which met the needs of each child. This approach seemed to strengthen the child's competence in pain management and ability to cope, thus building competence for future venipunctures. Practice implicationsEstablishing a WE might advance the psychosocial care of hospitalized children undergoing acute painful procedures.

Paediatric pain education for health care professionals.

Paediatric pain education for health care professionals.