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

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. 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. 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.

Peirce D ，Corkish V ，Lane M ，Wilson S ... -  《-》

Nurses' Knowledge, Attitudes and Clinical Practice in Pediatric Postoperative Pain Management.

Despite readily available evidence to guide practice, children continue to experience moderate to severe pain in hospital postoperatively. Reasons for this may include attitudes of nurses toward pain management and their lack of knowledge in key areas. To identify nurses' knowledge and clinical practice of pediatric postoperative pain management and whether there is a link between knowledge and practice. A descriptive cross-sectional study including a questionnaire and observations was conducted in postanesthesia care (recovery) units in six university hospitals in Norway. Nurses completed the Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain Questionnaire-Norwegian Version (PNKAS-N). We observed their clinical practices using a structured observational tool and field notes. Nurses completed the PNKAS-N (n = 193) and were observed (n = 138) giving postoperative care to 266 children (70 hours per unit, 416 hours in total). The mean PNKAS-N score was 29 (standard deviation 4.2) of 40. We identified knowledge deficits, mainly in pharmacologic management, such as in risk of addiction and respiratory depression. We found that, overall, pain was assessed using validated tools in 19% of the children; this fell to 9% in children aged <5 years. More than 66% of children received an inadequate dose of morphine postoperatively. Nurses have knowledge deficits about pediatric pain management and do not always use their knowledge in practice, particularly in relation to pain assessment. There is a need to improve nurses' knowledge of pediatric pain management and to test interventions that support the use of that knowledge in practice.

Smeland AH ，Twycross A ，Lundeberg S ，Rustøen T ... -  《-》

Knowledge and Practice of Nurses on Pediatric Pain Management in Bangladesh.

Islam MR ，Biswas HB ，Hossain MS ，Kim HS ，Azim A ，Nath P ，Ali MA ... -  《-》

Knowledge and attitudes regarding pain management of pediatric nurses in Turkey.

Nurses play an important role in managing children's pain. The nurse's accurate assessment, appropriate intervention, and evaluation of pain relief measures are necessary for positive patient outcomes. The aim of this study was to determine the level of knowledge and attitudes of pediatric nurses regarding the child's pain. The Pediatric Nurses' Knowledge and Attitude Survey (PNKAS) was used to evaluate the nurses' knowledge and attitudes. The PNKAS consists of 40 questions. In this study, 29.9% of nurses had a diploma and 40.6% associate's, 25.0% bachelor's, and 4.5% master's degree, and respondents had an everage 6.1 years pediatric nursing experience. The total mean score on the PNKAS scale was 38.2%. The highest score was 65%, and the lowest score 15%. The findings of the survey show that pediatric nurses in Turkey have insufficient knowledge regarding pain management and could benefit from additional education on that issue.

Ekim A ，Ocakcı AF 《-》

An Educational Intervention to Improve Nurses' Understanding of Pain in Children in Western India.

Accurate assessment of pain and its management is a challenging aspect of pediatric care. Nurses, usually the primary caregivers, showed inadequate knowledge and restrictive attitudes toward pain assessment. We evaluated an educational intervention to improve nurses' assessment of pain in a teaching hospital in India. A convenient sample of nurses working in the neonatal intensive care unit, pediatric ward, pediatric intensive care unit, and pediatric cardiac intensive care unit were included in the study. Workshops to improve understanding of pain, its assessment, and management strategies were conducted. A modified and consensually validated Knowledge and Attitudes Survey Regarding Pain questionnaire-2008 consisting of 25 true/false questions, eight multiple choice questions, and two case scenarios was administered before, immediately after, and 3 months after the workshops to evaluate impact of the intervention. Eighty-seven nurses participated. Mean (standard deviation) experience was 4.04 (5.9) years. Thirty-seven percent felt that they could assess pain without pain scales. About half (49.4%) of the nurses had not previously heard of pain scales, while 47.1% reported using a pain scale in their routine practice. Significant improvement was observed between pretest and post-test total scores (15.69 [2.94] vs. 17.51 [3.47], p < .001) as well as the pretest and retention score (15.69 [2.94] vs. 19.40 [4.6], p < .001). Albeit the study site and sampling frame may limit the reliability of the findings, the educational intervention was successful, and better retention test scores suggest a cascading effect. Pain assessment and management education of children should be incorporated in the nursing curriculum and should be reinforced in all pediatric units.

Dongara AR ，Nimbalkar SM ，Phatak AG ，Patel DV ，Nimbalkar AS ... -  《-》