Pediatric Pain Knowledge Research Articles

Exploring Pediatric Procedural Pain Assessment Practices, Knowledge, and Attitude among Nurses in a Tertiary Health Facility in Ghana

Background: Effective management of procedural pain is important for general patient care and quality of life. The study aimed at exploring paediatric procedural pain assessment practices, knowledge, and attitude among nurses at the Korle-Bu Teaching Hospital. Methods: An exploratory qualitative design was used in the study. This research was conducted among nurses at the Child Health Department of the Korle-Bu Teaching Hospital. Purposive sampling technique was used to select participants until data saturation was reached. The qualitative data was collected using a semi-structured interview guide via direct interviews and tape recorded. Data was transcribed and analysed manually using thematic content analysis. Findings: Data saturation was achieved after the interview with the 20th respondent in the study hence a total of twenty nurses participated in this study. Most 17 (85.0%) of the nurses were females. Majority 8 (40.0%) were aged between 31-40 years. The mean age of the participants was 35.2±7.5 years. Three themes emerged out of the study namely; knowledge and attitude towards procedural pain, assessment of procedural pain, and interventions for lessening procedural pain. Conclusion: Nurses in this study had limited knowledge about procedural pain management and assessment. Nevertheless, most of the nurses expressed positive attitude and willingness to be trained in procedural pain management.

The effect of evidence-based pain assessment protocol in pediatric emergency department on nurses' knowledge, attitudes, and practices towards pain

PurposeThis study aimed to determine the effect of the “Evidence-Based Pain Assessment Protocol in Pediatric Emergency Department” on nurses' knowledge, attitudes, and practices towards pain. MethodA pretest–posttest quasi-experimental study was conducted with 11 nurses. Before the protocol was applied, 337 nurses' records were assessed for one month. Subsequently, the nurses were educated in the Evidence-Based Pain Assessment Protocol in the Pediatric Emergency Department. After the education, the researchers assessed 315 nurses' records for one month to evaluate the protocol's effect on the nurses' clinical practice. ResultsThe study found no significant difference in the mean scores of nurses' Pediatric Pain Knowledge and Attitude Scale between the pre-and post-education periods (p > 0.05). However, there was a significant difference in the types of pain assessment tools used between these two periods (p < 0.001). In the post-education period, the frequency of both pharmacological and non-pharmacological interventions implemented increased significantly compared to the pre-education period (p < 0.001). Additionally, the study found that the frequency of nurses describing pain and reassessing pain increased significantly in the post-education period compared to the pre-education period (p < 0.001). ConclusionsThe study found that there was no significant change in the nurses' Pediatric Pain Knowledge and Attitude Scale scores before and after the training. However, it was observed that the frequency of nurses reassessing pain, using non-pharmacological interventions, and describing pain increased after the protocol was applied in the emergency department. In particular, therapeutic communication and the walking method were used more frequently in the post-training period among the non-pharmacological interventions applied by the nurses for pain.

Pediatric pain knowledge and attitudes among health care professionals-A National Danish Survey.

To explore and compare Danish health-care professionals' attitudes and knowledge towards pain management of children. The cross-sectional study was carried out using the Pediatric Pain Knowledge and Attitudes Questionnaire. The questionnaire was distributed to all health care professionals caring for children in three hospital settings, including nurses and physicians in departments of pediatric, emergency, and anesthesia and medical laboratory technologists. The study was conducted in 2020 and 765 health care professionals participated. Within the six main categories included in the questionnaire, there were significant differences between nurses and physicians in three subcategories: view on the care of children in pain, using drugs to relieve pain, and the four mandatories. Comparing nurses with medical laboratory technicians, there were significant differences in the subcategory "view on the care of children in pain." Comparing types of clinical departments, there were significant differences in the subcategories' view on the care of children in pain, using drugs to relieve pain, and the four mandatories. Overall, we found that the participating health professionals did not have a uniform understanding of pain management and therefore might treat children differently. The present study highlights the need to align health care professionals' knowledge regarding pain assessment and management of children, as well as the need to develop and test interventions that support the use of knowledge in practice.

Child maltreatment and pediatric pain: A survey of healthcare professionals' pain knowledge and pain management techniques.

Children who have been maltreated are at an increased risk of having their pain under-recognized and undertreated by healthcare professionals, and thus, are more susceptible to adverse outcomes associated with undertreated pain. This study's aims were to examine: (1) if healthcare professionals' pediatric pain knowledge is associated with their pain assessment methods, (2) if maltreatment-specific pain knowledge is associated with consideration of child maltreatment when deciding on a pain management strategy, and (3) if pediatric pain knowledge would relate to maltreatment-specific pain knowledge. A sample (N = 108) of healthcare professionals responded to a survey designed to examine their current knowledge and utilization of pediatric pain assessment and management with emphasis on the effects of child maltreatment. Findings revealed healthcare professionals' knowledge of pediatric pain is independent of their pain assessment and management practices. However, general pain knowledge was associated with maltreatment-specific pain knowledge and generally, healthcare professionals were knowledgeable of child maltreatment's impact on pediatric pain. Participants who considered a history of maltreatment were also more likely to employ sensitive questioning strategies when asking children about their pain.

The perceptions and practices of parents and children on acute pain management among hospitalized children in two Botswana referral hospitals

BackgroundPerceptions and practices of parties in pediatric pain are critical in children's access to adequate acute pain management. The personal factors of the child and parents have been shown to be central to pediatric pain management by the Symptom Management Theory. AimTo describe children and parents/guardians' perceptions (knowledge, attitudes and beliefs) and practices regarding pediatric acute pain management and explain the influence of socio-cultural and environmental factors on those perceptions and practices. MethodsDescriptive cross-sectional survey using modified versions of the American Pain Society Patient Outcome Questionnaire-Revised among parents/guardians and children. ResultsA convenience sample of 275 parents/guardians and 42 children aged 8 to 13 years admitted between date November 2018 and February 2019 to two Botswana tertiary hospitals completed the surveys. Forty-seven percent (n = 129) of parents/guardians reported the child to be in moderate-severe pain, while 38% (n = 16) of children reported pain as moderate-severe at the time of the survey. The children mean scores for cm-APS-POQ-R were 113(33) while parents/guardian's guardians for m-APS-POQ-R were 123(26). The subscales except for the parents/’guardians' pain interference (p = .96) were statistically significant (p = .000), showing adequate knowledge, positive attitudes and high pain intensity for both parents/guardians and children. ConclusionParent/guardians and children reported a high incidence of acute pain, were content with pain management services, and showed adequate knowledge of pediatric pain and its management. The incongruence between the intensity of pain, satisfaction on the adequacy of pain management and knowledge and attitudes demonstrated in this study need further inquiry.

Integrative pediatric pain management: Impact & implications of a novel interdisciplinary curriculum

ObjectivesObjectives of this paper are to: 1) Describe a novel interdisciplinary, integrative pain curriculum for pediatric residents. 2) Describe changes in residents’ understanding of pain epidemiology, physiology, and management; application of the biopsychosocial model in pain management; and understanding and application of non-pharmacologic approaches to pain management. Design, settingThis study was done in a pediatric residency program within an urban pediatric teaching hospital. It employed both anonymous, Likert-scale surveys administered via Qualtrics, as well as open-ended, free response questions. InterventionsWe provided a multidisciplinary pain education curriculum to pediatric residents with a focus on pain neuroscience, a history of pain management, the biopsychosocial model of care, and exposure to non-pharmacologic interventions to pain management over six hours of instruction conducted in two blocks of three hours each. Outcome measuresSelf-identified changes via survey measuring resident physician knowledge, comfort, approach, and management of pediatric pain through an interdisciplinary pain curriculum. ResultsPrior to this training, many residents were not confident in their understanding of pain neuroscience, the biopsychosocial model of care, and non-pharmacologic interventions. At completion of training, residents indicated positive changes in knowledge of, and comfort with, all of the domains taught. Ninety percent of residents indicated that the curriculum changed the way they conceptualized, approached, and/or managed pain, and reported thinking more holistically about pain management. Nearly all residents indicated they would like to have more training (98 %, N = 57) in integrative modalities. ConclusionsPediatric resident physicians are receptive to training in an interdisciplinary, integrative, pediatric pain management education intervention, and subsequently show positive changes in knowledge and comfort levels. There is a need and desire for additional pain education in resident training programs.

Children’s Nurses’ Knowledge and Attitudes on Paediatric Pain: A Descriptive Cross-Sectional Survey in a Developing Country

Background: Children’s nurses’ knowledge of pain affects their pain management practices. Even though poor knowledge and attitudes have been reported in several studies, most were carried out in developed settings. However, little has been reported on the management of paediatric pain by nurses in resource-limited settings such as in sub-Saharan Africa.Purpose: This study sought to assess the knowledge and perceptions of children’s nurses regarding paediatric pain in a Ghanaian context.Methodology: A descriptive cross-sectional survey was carried out among 65 nurses at eight hospitals at various levels of healthcare in Ghana. Over three months, participants’ demographic data and responses on the Pediatric Nurses Knowledge and Attitude Survey Regarding Pain (PNKAS) instrument were collected. Data were analyzed and presented using descriptive and inferential statistics.Results: Participants’ average (SD) knowledge and attitudes regarding paeditric pain was 36.7% (6.9%) and ranged from 21.4% to 57.1%. Pediatric pain knowledge and attitudes (PPKA) of the nurses differed based on working years in the children’s unit and the hospital type they worked in (p&lt;0.05). Nevertheless, the type of hospital facility was the only independent predictor of their PPKA (R2=0.181, p&lt;0.001).Conclusion: Children nurses in this setting generally had insufficient knowledge and attitudes on paediatric pain. They should be motivated to undertake self-directed learning and regular continuing professional education to update their knowledge, attitude and skills on evidence-based pediatric pain assessment and management.

Evaluating the content validity of two versions of an instrument used in measuring pediatric pain knowledge and attitudes in the Ghanaian context.

In this article, we compared the content validity of two instruments used in measuring pediatric pain knowledge and attitudes. This was considered necessary due to the universal differences in culture, semantics and healthcare resources in different parts of the globe. Thirteen (13) pediatric experts in Ghana assessed the content validity of two instruments: the 42-item Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS) and the 41-item Pediatric Healthcare Providers' Knowledge and Attitudes Survey Regarding Pain (PHPKASRP). The relevance and clarity of each item on these instruments were rated on a four-point likert scaled options from 1 (not relevant/ not clear) to 4 (very relevant/ very clear). The item-level content validity index (I-CVI) was calculated by dividing the number of experts who rated an item with 3 or 4 by the total number of experts. The average scale-level content validity index (S-CVI/Ave) was also estimated by summing up the I-CVIs of all items and dividing them by the total number of items. The I-CVIs on the PNKAS ranged from 0.62 to 1.00 for the relevance component and 0.69 to 1.00 for the clarity component. The I-CVIs on the PHPKASRP ranged from 0.62 to 1.00 for both the relevance and clarity components. The S-CVI/Ave were 0.87 and 0.89 for the relevance and clarity aspects on the PNKAS respectively. The S-CVI/Ave for the PHPKASRP instrument were 0.86 and 0.89 for the relevance and clarity aspects correspondingly. At the end of the validation process, 5 items were revised on both instruments whilst 37 and 36 items were maintained on the PNKAS and PHPKASRP instruments respectively. The PNKAS and PHPKASRP have an acceptable level of content validity in the Ghanaian context and recommended for educational and research purposes. Other forms of validity and reliability of these instruments should also be examined in future studies.

50 Bridging the gap between education and health: What youth need educators to know about chronic pain

Abstract Background Chronic pain is common and affects 20% of children and youth. Those with chronic pain often have a difficult time regularly attending school, with up to 50% of children and youth with chronic pain missing some school. Specific accommodations that benefit youth are unknown. Nearly half of parents of youth with chronic pain report their child’s grades dropped since pain onset. Both parents and youth report “moderate levels of interference” with learning. Most common accommodations include being sent to the nurse, being sent home and receiving extensions on assignments. While these strategies may be helpful for pain conditions expected to resolve, strategies that support staying in and succeeding at school are required for youth with chronic pain. Objectives This study aims to determine what educators need to know to best support youth with chronic pain in the academic setting. More specifically, 1) to determine what youth with chronic pain, parents of youth, educators, and healthcare professionals want educators to know about supporting students with chronic pain, and 2) to describe health professionals’ and educators’ attitudes and knowledge of pediatric chronic pain. Design/Methods Inclusion criteria include youth age 12-25 years with chronic pain and parents, health professionals and educators of youth with chronic pain. The recruitment strategy includes distribution of the survey via the Saskatchewan pediatric chronic pain clinic research contact lists, the Canadian Paediatric Society Section of Community Paediatrics listserve and social media. This online cross-sectional survey includes participant demographics and questions about accommodations noted to be helpful for youth with chronic pain. In addition, educator and health professional surveys include the 26-item Chronic Pain Myth Scale (CPMS). Results The study group includes 87 participants, 26 youth, 18 family/friends, 19 educators, and 24 health professionals. Some suggested school accommodations include: access to technology in class, teachers providing notes for students, education on chronic pain for teachers and students, and improved communication and collaboration between the youth, their healthcare team and educators. The majority of health professionals and educators report some knowledge, positive beliefs and attitudes towards people suffering from chronic pain (M=3.03, SD= .34). Conclusion Chronic pain is common and affects school attendance and achievement. Suggestions for accommodations to help those with chronic pain in the academic setting are made. Educators and health professionals indicated varying levels of knowledge, attitudes and beliefs, with some educators indicating they would like to receive education about chronic pain. Improved communication between school-based pupil support teams and health care teams is warranted.

Final Year Nursing Students’ Knowledge and Attitudes regarding Children’s Pain

Pain is one of the commonest reasons why children visit the hospital. Inadequately treated pain in children can negatively affect their physical, psychological, and social well-being; it also places financial burden on families of affected children and healthcare systems in general. Considering the eventual suffering of vulnerable children and their families if nursing students are insufficiently educated and ill-prepared, the current study aimed at assessing final year nursing student's knowledge and attitudes pertaining to pediatric pain. A descriptive cross-sectional study was conducted among 100 final year undergraduate nursing students at a private university college in Ghana. In addition to their ages and gender, the students responded to the 42 individual items on the Pediatric Nurses' Knowledge and Attitudes Survey regarding pain (PNKAS) instrument. Descriptive statistical analysis was aided by the Statistical Package for Social Sciences version 25 software. The mean age of the final year nursing students was 29 years (range of 21 to 47 years); a majority of them were females (78%). Participants had an average (SD) correct answer score of 44.0% (10.6%). Good pediatric pain knowledge and attitudes were observed in items that were related to the individualized and multidimensional nature of the pain experience and its treatment, benefits of pre-emptive analgesia, pharmacodynamics, and pain assessment. Poor pediatric pain knowledge and attitudes occurred in items that focused on pain perceptions, opioid drug administration, useful pain medications, pain physiology, and nonpharmacological pain management interventions. Final year nursing students have insufficient knowledge and attitudes toward children's pain management. Areas of good and poor pediatric pain knowledge and attitudes should be considered when designing and implementing educational interventions on this subject. Curricular revisions should be made on existing nursing curriculum to lay more emphasis on children's pain management and use educational interventions that support knowledge translation for improved care.

Nursing students and nurses' knowledge and attitudes regarding children's pain: A comparative cross-sectional study.

Nurses encounter children who report of pain of diverse and unknown causes in their professional work. The current study therefore assessed and compared nursing students and nurses' knowledge and attitudes pertaining to children's pain in the Ghanaian context. The goal of this was to have a baseline information to guide the development and implementation of the content for a sustainable educational programme (short-course) for nursing students and nurses in Ghana. Between October and December 2018, a cross-sectional study was carried out among 554 final year nursing students and 65 nurses in Ghana. The Pediatric Nurses Knowledge and Attitudes Survey Regarding Pain (PNKAS) was used to collect data from participants who were affiliated to four educational institutions and eight hospitals. Data were descriptively and inferentially analyzed using chi-square test of independence, independent samples t-test and one-way analysis of variance (ANOVA). Our findings revealed that nursing students and nurses generally had unsatisfactory knowledge and attitudes towards pain management in children. Nursing students however, had significantly higher scores than nurses in the total PNKAS score and in 10 out of the 13 identified item-areas. Greater scores were obtained by nursing students in areas which were related to pain physiology, pharmacokinetics, pharmacology of analgesics and pain perceptions (p < .05). All the participating nurses could not accurately determine: the onset of action of orally administered analgesics, equianalgesia of orally administered morphine, and the right dosage of prescribed morphine for a child who consistently reported of moderate to severe pain. Final year nursing students and nurses have unsatisfactory knowledge and attitudes regarding children's pain; which reiterates the need for urgent and effective educational efforts in this area. Regular in-service training should be offered to post-registration nurses to enhance their pediatric pain knowledge and attitudes for improved pain care in children.

Nurses' Knowledge and Attitudes Regarding Pediatric Pain Management in Western Australia

Background and Aim: Despite clinical guidelines, suboptimal pediatric pain management persists. A local audit found poor guideline compliance. Inadequate knowledge is a recognized barrier to the delivery of evidence-based care. The aim of the study was to investigate nurses' knowledge and attitudes regarding pain management at an Australian tertiary pediatric hospital. Design, Setting, Participants and Method: A cross-sectional, descriptive study using the Pediatric Pain Knowledge and Attitudes Questionnaire (Revised) was distributed to 590 nurses in an Australian pediatric hospital. Results: The mean knowledge score (n = 201) was 77.56 out of 100 (range 49.82-94.16, standard deviation [SD] 8.55); mean attitude score (n = 229) was 72.46 out of 100 (range 33.33-93.33, SD 11.76). Significant differences in mean knowledge scores were found between nurses' designations (p = .018), with the greatest mean difference (MD) between clinical nurses and enrolled nurses (10.5; p = .002). Nurses with experience in critical care had significantly higher mean knowledge scores (MD 3.1; p = .012). Senior registered nurses had the most positive mean attitude score (82.4, SD 6.2), which was significantly higher than clinical nurses (73.77, SD 10.0), registered nurses (71.64, SD 12.6), and enrolled nurses (68.89, SD 8.8) (p < .05). Nurses with specialist pediatric qualifications had significantly more positive attitude scores (mean 75.65, SD 11.6) than those without (mean 70.86, SD 11.7; p = .005). However, 51% of respondents believed that children tolerate pain better than adults do. Conclusion: Although nurses' overall knowledge and attitude toward pediatric pain were among the highest reported, areas for targeted education using in-service education and workshops were identified alongside a need for exploration of the impediments to providing best care.

A parent–science partnership to improve postsurgical pain management in young children: Co-development and usability testing of the Achy Penguin smartphone-based app

ABSTRACT Background Young children are at risk for poorly managed pain after surgery, with significant negative consequence to their quality of life and health outcomes. Mobile applications offer a highly accessible, engaging, and interactive medium to improve pain assessment and management; however, they generally lack scientific foundation or support. Aims The aims of this study were to describe a successful parent–science partnership in the development and testing of Achy Penguin, a parent-developed iOS app to help assess and manage acute pain in young children, and to evaluate and refine the usability of Achy Penguin in young children with acute postoperative pain. Methods Three cycles of iterative usability testing were conducted with 20 4- to 7-year-old children (M = 5.8 years) in hospital who had recently undergone surgery (n = 6–7 children/cycle). Semistructured qualitative interviews were analyzed using simple content analysis. Results Feedback from children and further integration of evidence-based pediatric pain knowledge led to refinements in app pain assessment and management content, as well as app flow and functionality. Changes improved children’s ease of use and understanding and satisfaction by simplifying language in app instructions and content, adding audio and pictorial instructions, and increasing the engagement, interactiveness, immersiveness, and general appeal of pain management strategies. Conclusions This article showcases the value of collaborative partnerships between various stakeholders (parents, app developers, and researcher/health care providers) to address gaps in pediatric pain care. The Achy Penguin app shows promise for improving pain assessment and management in young children, although further evaluation of app effectiveness and implementation is warranted.

Making Comfort Count: Using Quality Improvement to Promote Pediatric Procedural Pain Management.

Pediatric procedural pain management (PPPM) is best practice but was inconsistent in our large multisite general academic medical center. We hypothesized that quality improvement (QI) methods would improve and standardize PPPM in our health system within inpatient pediatric units. We aimed to increase topical anesthetic use from 10% to 40%, improve nursing pediatric pain knowledge, and increase parent satisfaction around procedures for children admitted to a general tertiary academic medical center. We used QI methods including needs assessment, self-identified champions, small tests of change, leadership accountability, data transparency, and a train-the-peer-trainer approach to implement PPPM. We measured inpatient use of topical anesthetic (goal of 40% of admissions), nursing pain knowledge, and parent satisfaction with child comfort during procedures. We used statistical process control and basic statistics to analyze data in this interrupted time series design. Over 18 months, use of topical lidocaine rose from 10% to 36.5% for all inpatient admissions, resulting in a centerline shift. Nursing pain knowledge scores increased 7%. Mean parent satisfaction around procedural comfort increased from 83% to 88%. A child-focused QI initiative around PPPM can succeed in a multisite general academic medical center. Key success factors for this effort included accountability, multidisciplinary core leadership, housewide training in a novel educational evidence-based framework, and use of data and champions to promote nurse and physician engagement. Future work will focus on sustaining and monitoring change.

G35 Health care professonals’ knowledge and attitudes towards paediatric pain in one uk hospital

Aims This study aimed to ascertain and compare the knowledge and attitudes of health care professionals in one UK hospital relating to paediatric pain. Methods A cross-sectional survey was administered to a convenience sample. The Paediatric Pain Knowledge and Attitudes Questionnaire , a previously validated tool 1 , was administered as an online survey using Survey Monkey®. Participants were asked to respond to the survey items on a six-point Likert scale. Data were analysed using IBM SPSS Software Version 21. Results A total of 96 clinicians responded to the questionnaire including doctors (n = 64), nurses (n = 27) and Operating Department Practitioners (n = 3). Overall participants scored more highly on attitudes (64.6%) than knowledge (63.7%). Participants scored the highest on sociology and psychology of pain (68.0%) (significantly higher than every other subscale) and lowest in physiology of pain (61.0%). No significant differences were found between doctors and nurses or between specialties. Participants who had either more than 50%, or 100% of their practice in paediatrics had better pain management knowledge and attitudes scores than those who had less than 50% or no paediatric practice. Conclusions This study is the first to compare paediatric pain knowledge and attitudes across professional groups. Gaps in knowledge exist across professions and specialties. Nurses and medical staff have similar gaps in their knowledge and attitudes. There is a need to address these knowledge gaps and erroneous attitudes. Current methods of pain management education also need evaluating to ensure they are effective as possible. Reference Twycross A, Williams A. Establishing the validity and reliability of a pediatric pain knowledge and attitudes questionnaire. Pain Manag Nurs. 2013;14(3):e47–e53

A novel pain interprofessional education strategy for trainees: assessing impact on interprofessional competencies and pediatric pain knowledge.

Health care trainees⁄students lack knowledge and skills for the comprehensive clinical assessment and management of pain. Moreover, most teaching has been limited to classroom settings within each profession. To develop and evaluate the feasibility and preliminary outcomes of the 'Pain-Interprofessional Education (IPE) Placement', a five-week pain IPE implemented in the clinical setting. The utility (content validity, readability, internal consistency and practical considerations) of the outcome measures was also evaluated. A convenience sample of 21 trainees from eight professions was recruited over three Pain-IPE Placement cycles. Pre- and postcurriculum assessment included: pain knowledge (Pediatric Pain Knowledge and Attitudes Survey), IPE attitudes (Interdisciplinary Education Perception Scale [IEPS]) and IPE competencies (Interprofessional Care Core Competencies Global Rating Scales [IPC-GRS]), and qualitative feedback on process⁄acceptability. Recruitment and retention met expectations. Qualitative feedback was excellent. IPE measures (IEPS and IPC-GRS) exhibited satisfactory utility. Postcurriculum scores improved significantly: IEPS, P<0.05; IPC-GRS constructs, P<0.01; and competencies, P<0.001. However, the Pediatric Pain Knowledge and Attitudes Survey exhibited poor utility in professions without formal pharmacology training. Scores improved in the remaining professions (n=14; P<0.01). There was significant improvement in educational outcomes. The IEPS and IPC-GRS are useful measures of IPE-related learning. At more advanced training levels, a single pain-knowledge questionnaire may not accurately reflect learning across diverse professions. The Pain-IPE Placement is a successful collaborative learning model within a clinical context that successfully changed interprofessional competencies. The present study represents a first step at defining and assessing change in interprofessional competencies gained from Pain-IPE.

Knowledge and Attitudes Regarding Pediatric Pain in Mongolian Nurses

The World Health Organization and the International Association for Study of Pain cite the significance of pediatric pain as a significant global health issue. Developing countries may have increased needs compared with developed countries because of limited resources and lack of training. In Mongolia a paucity of data exist regarding nursing knowledge of pediatric pain management. The purpose of this project was to assess the current knowledge of pediatric pain and to assess the effectiveness of educational intervention on improving knowledge and attitudes of pediatric nurses working at a major children's hospital in Mongolia. Knowledge and attitudes of Mongolian nurses were evaluated before and after a 2-hour educational intervention. The translated Modified Mongolian Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain—Shriner’s Revision survey was used as a pre- and postintervention assessment instrument with local nurses at a pediatric hospital in Ulaanbaatar, Mongolia. One hundred sixty-seven nurses attended the conference, with 155 nurses completing the pre- and postsurveys. The mean score on the presurvey was 12.7 out of 35 (26.4% correct), whereas the mean score on the postsurvey score was 16.7 out of 35 (47.8% correct). A paired t test showed a significant statistical difference between scores (p < .0001). Pediatric nurses in Mongolia demonstrate insufficient knowledge of pediatric pain management. The educational intervention was effective in improving pediatric pain knowledge and attitudes in Mongolian nurses. It is recommended to establish similar educational endeavors with nurses around the world to improve pain knowledge and attitudes.

Establishing the Validity and Reliability of a Pediatric Pain Knowledge and Attitudes Questionnaire

Children continue to experience unrelieved pain during hospitalization, despite the evidence to guide nurses’ pain management practices being readily available. Nurses’ knowledge and attitudes have been identified as a possible reason for suboptimal pain management. This study examines the validity and reliability of an existing questionnaire to validate it for use in the population of interest. Initial testing demonstrated low reliability and validity. Modifications to the questionnaire were made on the basis of these results and the feedback provided by experts in pediatric pain management. Subsequent testing demonstrated good validity and reliability, suggesting that the questionnaire is appropriate for measuring nurses’ knowledge and attitudes in relation to pediatric pain management.

Knowledge, attitude and practice of pediatric critical care nurses towards pain

Nurses' knowledge, sensitivity and attitudes about pain in children and its management affect their response and therefore management of pediatric pain. Children in critical care units undergo more painful procedures than those in general wards. To study the knowledge, attitude and practice of nursing personnel catering to critically ill children in a developing country. Prospective questionnaire-based survey. The survey was carried out in a tertiary care teaching hospital on nursing personnel in three pediatric/neonatal intensive care units. The domains studied were: i. Training and experience, ii. Knowledge of pediatric pain, iii. Individual attitude towards pain in children, iv. Personal practice(s) for pain alleviation, v. Pain assessment, and vi. Non-pharmacological measures adopted. Descriptive statistics and logistic regression. Of the 81 nursing personnel working in the three critical care units, 56 (69.1%) responded to the questionnaire. Only one-third of them had received formal training in pediatric nursing. Fifty percent of the respondents felt that infants perceive less pain than adults. Training in pediatric nursing was a significant contributing factor in the domain of knowledge (P=0.03). Restraint and distraction were the common modalities employed to facilitate painful procedures. Scientific approaches like eutectic mixture of local anesthetic and the judicious use of sedatives were not adopted routinely. Observing a child's face and posture were widely used parameters to assess pain (83%). None of the three critical care areas used a scoring system to assess pain. There are several lacunae in the knowledge and practice of nurses in developing countries which need to be improved by training.

Education Changes Mexican Nurses' Knowledge and Attitudes Regarding Pediatric Pain

This study explored the effectiveness of a pain education intervention on Mexican nurses' knowledge and attitudes toward pediatric pain. A convenience sample of 106 registered nurses from three hospitals in Mexico City was recruited. A Pediatric Pain Education Program (PPEP) was developed, implemented, and evaluated by a nurse researcher, clinical nurse specialist, and a child life specialist. The 4-hour program, which was translated into Spanish, consisted of pain assessment, physiology, and management, including pharmacology and nonpharmacology. The effects of PPEP were measured in a one-group pretest-posttest design using a translated Spanish version of the Pediatric Nurses' Knowledge and Attitudes Survey (PNKAS). A total of 79 nurses completed both tests. A paired t test indicated significant differences between pre- and posttest results ( p < .0001) on the PNKAS. The hospital site and years of nursing experience were significantly related to nurses' pre- and post-PNKAS scores. One test item on children's ability to reliably report their pain had a significantly lower score after the intervention ( p = .016). The intervention was effective in improving Mexican pediatric nurses' knowledge and attitudes. However, it is not known how long this effect was maintained. Health care professionals can share a common vision for pain management by increasing international collaborative efforts and by advancing pediatric pain knowledge.