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

*Evans Oduro orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
Abigail Kusi-Amponsah Diji orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
Grace Kusi orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
Albert Amagyei orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
Joana Kyei-Dompim orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
Alberta Lomotey orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
Edward Appiah Boateng orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
Hayford Isaac Budu orcid  -  Kwame Nkrumah University of Science and Technology, Ghana
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Abstract

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<0.05). Nevertheless, the type of hospital facility was the only independent predictor of their PPKA (R2=0.181, p<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. 

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Keywords: Knowledge and attitudes; nurse; pediatric pain

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  1. Abazari, P., & Namnabati, M. (2017). Nurses’ experiences from pain management in children in Iranian culture: A phenomenology study. Journal of Education and Health Promotion, 6(74). doi: 10.4103/jehp.jehp_1_16
  2. Alotaibi, K., Higgins, I., & Chan, S. (2019). Nurses’ knowledge and attitude toward pediatric pain management: A cross-sectional study. Pain Management Nursing, 20(2), 118–125. doi: 10.1016/j.pmn.2018.09.001
  3. Bushnell, M. C., Čeko, M., & Low, L. A. (2013). Cognitive and emotional control of pain and its disruption in chronic pain. Nature Reviews Neuroscience, 14(7), 502–511. doi: 10.1038/nrn3516
  4. Deere, K. C., Clinch, J., Holliday, K., McBeth, J., Crawley, E. M., Sayers, A., …, & Tobias, J. H. (2012). Obesity is a risk factor for musculoskeletal pain in adolescents: Findings from a population-based cohort. Pain, 153(9), 1932–1938. doi: 10.1016/j.pain.2012.06.006
  5. Drendel, A. L., Kelly, B. T., & Ali, S. (2011). Pain Assessment for Children. Pediatric Emergency Care, 27(8), 773–781. doi: 10.1097/pec.0b013e31822877f7
  6. Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., & Failde, I. (2016). A review of chronic pain impact on patients, their social environment and the health care system. Journal of Pain Research, 9, 457–467. doi: 10.2147/JPR.S105892
  7. Ekim, A., & Ocakcı, A. F. (2013). Knowledge and attitudes regarding pain management of pediatric nurses in Turkey. Pain Management Nursing, 14(4), e262–e267. doi: 10.1016/j.pmn.2012.02.004
  8. Friedrichsdorf, S. J., Postier, A., Eull, D., Weidner, C., Foster, L., Gilbert, M., & Campbell, F. (2015). Pain Outcomes in a US Children’s Hospital: A Prospective Cross-Sectional Survey. Hospital Pediatrics, 5(1), 18–26. doi: 10.1542/hpeds.2014-0084
  9. Groenewald, C. B., Rabbitts, J. A., Schroeder, D. R., & Harrison, T. E. (2012). Prevalence of moderate-severe pain in hospitalized children. Pediatric Anesthesia, 22(7), 661–668. doi: 10.1111/j.1460-9592.2012.03807.x
  10. Haraldstad, K., Sørum, R., Eide, H., Natvig, G. K., & Helseth, S. (2011). Pain in children and adolescents: Prevalence, impact on daily life, and parents’ perception, a school survey. Scandinavian Journal of Caring Sciences, 25(1), 27–36. doi: 10.1111/j.1471-6712.2010.00785.x
  11. Hasuo, H., Kusunoki, H., Kanbara, K., Abe, T., Yunoki, N., Haruma, K., & Fukunaga, M. (2017). Tolerable pain reduces gastric fundal accommodation and gastric motility in healthy subjects: A crossover ultrasonographic study. BioPsychoSocial Medicine, 11(1), 4. doi: 10.1186/s13030-017-0089-5
  12. Hua, Y., Zhang, Q., Ting, W., Qiu, R., Yao, W., & Chen, X. (2019). Pediatric Nurse Practitioners’ Knowledge and Attitudes Regarding Pain Management Study in Central China. The Journal of Continuing Education in Nursing, 50(6), 275–281. doi: 10.3928/00220124-20190516-08
  13. Jain, A., Yeluri, R., & Munshi, A. K. (2012). Measurement and Assessment of Pain In Children - A Review. Journal of Clinical Pediatric Dentistry, 37(2), 125–136. doi: 10.17796/jcpd.37.2.k84341490806t770
  14. Kahsay, H. (2017). Assessment and treatment of pain in pediatric patients. Current Paediatric Research, 21(1), 148–157. Retrieved from www.currentpediatrics.com
  15. Kiekkas, P., Gardeli, P., Bakalis, N., Stefanopoulos, N., Adamopoulou, K., Avdulla, C., Tzourala, G., & Konstantinou, E. (2015). Predictors of Nurses’ Knowledge and Attitudes Toward Postoperative Pain in Greece. Pain Management Nursing, 16(1), 2–10. doi: 10.1016/j.pmn.2014.02.002
  16. King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011). The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain, 152(12), 2729–2738. doi: 10.1016/j.pain.2011.07.016
  17. Kingsnorth, S., Joachimides, N., Krog, K., Davies, B., & Higuchi, K. S. (2015). Optimal pain assessment in pediatric rehabilitation: implementation of a nursing guideline. Pain Management Nursing, 16(6), 871–880. doi: 10.1016/j.pmn.2015.07.009
  18. Kozlowski, L. J., Kost-Byerly, S., Colantuoni, E., Thompson, C. B., Vasquenza, K. J., Rothman, S. K., …, & Monitto, C. L. (2014). Pain prevalence, intensity, assessment and management in a hospitalized pediatric population. Pain Management Nursing, 15(1), 22–35. doi: 10.1016/j.pmn.2012.04.003
  19. Latchman, J. (2014). Improving pain management at the nursing education level: evaluating knowledge and attitudes. Journal of the Advanced Practitioner in Oncology, 5(1), 10–16. http://www.ncbi.nlm.nih.gov/pubmed/25032029
  20. Linhares, M. B. M., Doca, F. N. P., Martinez, F. E., Carlotti, A. P. P., Cassiano, R. G. M., Pfeifer, L. I., …, & Finley, G. A. (2012). Pediatric pain: prevalence, assessment, and management in a teaching hospital. Brazilian Journal of Medical and Biological Research, 45(12), 1287–1294. doi: 10.1590/s0100-879x2012007500147
  21. Manworren, R. C. (2001). Development and testing of the pediatric nurses’ knowledge and attitudes survey regarding pain. Pediatric Nursing, 27(2), 151–158
  22. Mathews, L. (2011). Pain in children: neglected, unaddressed and mismanaged. Indian Journal of Palliative Careare, 17(Suppl), S70-3. doi: 10.4103/0973-1075.76247
  23. Meechan, R., Mason, V., & Catling, J. (2011). The impact of an integrated pharmacology and medicines management curriculum for undergraduate adult nursing students on the acquisition of applied drug/pharmacology knowledge. Nurse Education Today, 31(4), 383–389. doi: 10.1016/j.nedt.2010.07.011
  24. Ndosi, M. E., & Newell, R. (2009). Nurses’ knowledge of pharmacology behind drugs they commonly administer. Journal of Clinical Nursing, 18(4), 570–580. doi: 10.1111/j.1365-2702.2008.02290.x
  25. Ortiz, M. I., Ponce-Monter, H. A., Rangel-Flores, E., Castro-Gamez, B., Romero-Quezada, L. C., O’Brien, J. P., Romo-Hernández, G., & Escamilla-Acosta, M. A. (2015). Nurses’ and nursing students’ knowledge and attitudes regarding pediatric pain. Nursing Research and Practice, 2015(210860), 1–8. doi/10.1155/2015/210860
  26. Peirce, D., Corkish, V., Lane, M., & Wilson, S. (2018). Nurses’ knowledge and attitudes regarding pediatric pain management in Western Australia. Pain Management Nursing, 19(6), 707–717.doi: 10.1016/j.pmn.2018.03.002
  27. Select Statistical Consultants. (2020). Population proportion - sample size. Retrieved from https://select-statistics.co.uk/calculators/sample-size-calculator-population-proportion/
  28. Sessle, B. (2011). Unrelieved pain: A crisis. Pain Research & Management, 16(6), 416–420. doi: 10.1155/2011/513423
  29. Smeland, A. H., Twycross, A., Lundeberg, S., & Rustøen, T. (2018). Nurses’ knowledge, attitudes and clinical practice in pediatric postoperative pain management. Pain Management Nursing, 19(6), 585–598. doi: 10.1016/j.pmn.2018.04.006
  30. Stanley, M., & Pollard, D. (2013). Relationship between knowledge, attitudes, and self-efficacy of nurses in the management of pediatric pain. Pediatric Nursing, 39(4), 165–171. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24027950
  31. Sweet, E., Shusterman, C. S., Nedeljkovic, M. S., & Solodiuk, J. C. (2018). Nurse Practitioner-Administered Chloroprocaine in Children with Postoperative Pain. Pain Management Nursing, 19(4), 424–429. doi: 10.1016/j.pmn.2017.11.003
  32. Taylor, E. M., Boyer, K., & Campbell, F. A. (2008). Pain in hospitalized children: A prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital. Pain Research and Management, 13(1), 25–32. doi: 10.1155/2008/478102
  33. Van Hulle Vincent, C., Wilkie, D. J., & Wang, E. (2011). Pediatric nurses’ beliefs and pain management practices. Western Journal of Nursing Research, 33(6), 825–845. doi: 10.1177/0193945910391681
  34. Wren, A., Ross, A., D’Souza, G., Almgren, C., Feinstein, A., Marshall, A., & Golianu, B. (2019). Multidisciplinary pain management for pediatric patients with acute and chronic pain: A foundational treatment approach when prescribing opioids. Children, 6(2), 33. doi: 10.3390/children6020033
  35. Zisk-Rony, R. Y., Lev, J., & Haviv, H. (2015). Nurses’ Report of In-hospital Pediatric Pain Assessment: Examining Challenges and Perspectives. Pain Management Nursing, 16(2), 112–120. doi: 10.1016/j.pmn.2014.05.003
  36. Ziyaeifard, M., Azarfarin, R., Zamani, K., Alizadehasl, A., Khalili, Y., Moradian, M., & Koleini, Z. (2018). Imperative role of education of ICU nurses regarding postoperative pain management after pediatric cardiac surgery. Iranian Heart Journal, 19(2), 13–19. Retrieved from http://journal.iha.org.ir/Files/Journal/96.pdf

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