Abstract:
Pain and fear of pain are major concerns for many hospitalised patients. Nurses need to understand this pain, and be able to assess and manage it effectively. Despite advances in knowledge and an increased amount of nursing research related to pain management, literature continues to identify that infants, children and adolescents continue to experience unrelieved pain post surgery. Contemporary literature suggests that nurses’ knowledge and attitudes towards pain affects their pain management practices. Nurses in small regional hospitals often don’t have the support of paediatric pain specialists and therefore rely on their own knowledge, education and experience to manage the pain of the infants, children and adolescents in their care.
This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The questionnaire developed was based on the Paediatric Nurses Knowledge and Attitude Survey (PNKAS). The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn’t carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice.
While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses. Wider research into both pain education and clinical practice is needed. - II -
Some of the first steps could be to survey the knowledge and attitude of those who instruct in undergraduate programs related to pain, and review what is being provided in the course programs, and then examine what is being offered within the clinical environments. Research, incorporating chart review and utilising open written questions and/or interviews, or group discussions would provide far more information on which to base recommendations for practice.
