Investigating nurses' knowledge, attitudes and perceptions regarding pain management in hospitalized children

Abstract

Methodology: The present cross-sectional study was conducted in a convenience sample and carried out from February 2020 to February 2021. An online questionnaire was developed and included: a demographic data form and the questionnaire "Nurses' attitudes to pain in children scale". Data analysis was performed with SPSS v.23.0 at a statistical significance level of 0.05, and the x² test and t-test were used.

Results: Nurses consider their knowledge of children's physical, psychological and neurological development to be good (39.8%, 39.8% and 38.9%, respectively), while poor or quite poor knowledge is reported by 11.5%, 9.7% and 18.6%, respectively. Nurses agree fully or to some extent (81.5%) that it is acceptable to perform minimally painful procedures, such as taking a blood sample without the use of analgesics, that during procedures such as aspiration, taking a blood sample or placing a peripheral venous catheter, pain should be eliminated (92%). Regarding neonates, a significant percentage of nurses reported that they did not know whether analgesia (27.4%) or sedation (31.0%) should be administered in specific painful interventions and did not consider the administration of analgesia (54.9%) and sedation (60.2%) necessary in specific painful interventions in infants <1 month of age. Length of service was associated with the reported level of knowledge regarding the physical (x²=9.766, df=4, p=0.045), psychological (x²=10.527, df=4, p=0.032) and neurological development of children (x²=10.274, df=4, p=0.036), with those with shorter professional experience (<10 years) reporting a lower level of knowledge. Men believe that personality influences pain perception more than women (x²=9.919, df=4, p=0.042) and that changes in behavior are a good way to assess pain in children (x²=10.584, df=4, p=0.032).

Conclusions: The majority of PICU nurses self-assess their knowledge regarding effective pain management as adequate. However, their attitudes and perceptions differ significantly and their knowledge is lower than their self-assessment would suggest.