Knowledge of Chinese Pediatric Professionals Regarding Pediatric Pain Management
Abstract
:1. Introduction
2. Research Methods
2.1. Data Collection
2.2. Research Instrument
2.3. Reliability and Validity of Research Questionnaire
2.4. Statistical Analysis
2.5. Ethical Considerations
3. Research Results
3.1. Analysis of Demographic Data
3.2. Clinicians’ Knowledge Scores
- (1)
- Recognition of Pain in Pediatric Patients (Table 2, Q1–Q6 and Q11–Q12)
- (2)
- Pediatric Pain Assessment (Table 2, Q7, Q10, and Q13–Q21)
- (3)
- Pediatric Pain Management Interventions (Q8–Q9 and Q22–Q31)
3.3. Factors Impacting Knowledge Scores
3.4. Profession-Related Barriers to Pain Management
4. Discussion
4.1. Recognition of Pain in Pediatric Patients
4.2. Knowledge of Pediatric Pain Assessment
4.3. Pain Management Interventions
4.4. Factors Impacting Knowledge Scores
5. Study Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | N (%) | Physicians, Number (%) | Nurses, Number (%) | T/X2 | p-Value |
---|---|---|---|---|---|
Age (years), mean ± SD | 32.86 ± 8.13 | 30.30 ± 5.54 | 3.978 | <0.001 a | |
Gender | 200.698 | <0.001 b | |||
Female | 388 (76.53%) | 97 (45.3%) | 291 (99.3%) | ||
Male | 119 (23.47%) | 117 (54.7%) | 2 (0.7%) | ||
Marital status | 0.285 | 0.593 b | |||
Married | 343 (67.65%) | 142 (66.4%) | 201 (68.6%) | ||
Unmarried | 164 (32.35%) | 72 (33.6%) | 92 (31.4%) | ||
Parenting experience | 0.353 | 0.838 b | |||
None | 199 (39.25%) | 83 (38.8%) | 116 (39.6%) | ||
One child | 182 (35.90%) | 75 (35.0%) | 107 (36.5%) | ||
Two or more children | 126 (24.85%) | 56 (26.2%) | 70 (23.9%) | ||
Professional Degree | 176.987 | <0.001 b | |||
Associate Bachelor | 132 (26.04%) | 0 (0.00%) | 132 (45.1%) | ||
Bachelor’s degree | 322 (63.51%) | 161 (75.2%) | 161 (54.9%) | ||
Master’s degree | 53 (10.45%) | 53 (24.8%) | 0 (0.00%) | ||
Professional Position | 0.312 | 0.577 b | |||
Clinical staff | 484 (95.46%) | 203 (94.9%) | 281 (95.9%) | ||
Managers | 23 (4.54%) | 11 (5.1%) | 12 (4.1%) | ||
Department of Employment | |||||
NICU * | 226 (44.58%) | 63 (29.4%) | 163 (55.6%) | ||
PICU ** | 97 (19.13%) | 42 (19.6%) | 55 (18.8%) | ||
Pediatric wards | 184 (36.29%) | 109 (51.0%) | 75 (25.6%) | ||
Experience in Pediatric Profession | 22.479 | <0.001 b | |||
1–5 years | 206 (40.63%) | 101 (47.2%) | 105 (35.8%) | ||
6–10 years | 152 (29.98%) | 40 (18.7%) | 112 (38.2%) | ||
Over 10 years | 149 (29.39%) | 73 (34.1%) | 76 (25.9%) | ||
Hospital of Employment | 45.425 | <0.001 b | |||
Children’s hospital | 271 (53.45%) | 77 (36.0%) | 194 (66.2%) | ||
Medical center | 236 (46.55%) | 137 (64.0%) | 99 (33.8%) |
Characteristic | Pediatricians, Mean ± SD | Nurses, Mean ± SD | z | p-Value |
---|---|---|---|---|
1. It is a patient’s right to expect total pain relief as a consequence of treatment. | 4.48 ± 0.669 | 4.18 ± 0.625 | −5.620 | <0.001 * |
2. Comparable stimuli in different children may produce different pain responses. | 4.58 ± 0.573 | 4.41 ± 0.625 | −3.421 | 0.001 * |
3. Children are more sensitive to painful stimuli than are adults. | 4.20 ± 0.776 | 3.90 ± 0.874 | −4.000 | <0.001 * |
4. Sedation is an effective method of pain relief for neonates. (negative) | 2.71 ± 1.089 | 2.72 ± 0.835 | −0.177 | 0.860 |
5. Pain in the neonatal period has no negative effects on growth and development. (negative) | 3.19 ± 1.220 | 3.15 ± 0.880 | −1.147 | 0.251 |
6. Neonates are more likely to experience long-term consequences from painful experiences than are older children. | 3.82 ± 0.904 | 3.43 ± 0.811 | −5.274 | <0.001 * |
7. It is unnecessary to provide medication or pain relief interventions when an ill infant does not cry or twist his/her body during invasive procedures. (negative) | 3.30 ± 1.188 | 3.17 ± 1.031 | −1.751 | 0.080 |
8. Distraction (using music or relaxation techniques) can decrease the perception of pain or symptoms of discomfort. | 4.10 ± 0.619 | 4.03 ± 0.542 | −1.361 | 0.174 |
9. Distraction activities may be used to replace pain relief medication for children who cry often. (negative) | 2.78 ± 1.081 | 4.03 ± 0.957 | −2.372 | 0.018 * |
10. Infants/children/adolescents may sleep in spite of severe pain. | 3.85 ± 0.888 | 3.72 ± 0.817 | −2.034 | 0.042 * |
11. Parents should not be present during painful procedures. (negative) | 2.82 ± 1.218 | 2.97 ± 1.146 | −1.345 | 0.179 |
12. Children with pain should be encouraged to endure as much pain as possible before resorting to a pain relief measure. (negative) | 2.62 ± 1.076 | 2.89 ± 1.044 | −2.771 | 0.006 * |
13. For effective treatment of pain, it is necessary to continuously assess the pain and efficacy of the therapy. | 4.31 ± 0.619 | 4.20 ± 0.600 | −2.149 | 0.032 * |
14. Lack of pain expression in children does not mean lack of pain. | 4.27 ± 0.714 | 4.09 ± 0.669 | −3.570 | <0.001 * |
15.The most accurate judge of the intensity of pediatric patients’ pain is the patient themselves. | 3.93 ± 0.932 | 3.78 ± 0.831 | −2.281 | 0.023 * |
16. The only way to determine the discomfort or pain of infants is to assess their behaviors. (negative) | 2.87 ± 1.147 | 2.88 ± 1.027 | −0.105 | 0.916 |
17. Estimation of pain by an M.D. or R.N. is as valid a measure of pain as a sick child’s self-report. (negative) | 2.56 ± 0.985 | 2.58 ± 0.843 | −0.269 | 0.788 |
18. Children younger than preschool age cannot reliably report their pain intensity. Therefore, nurses should rely on the parents’ assessment of a child’s pain intensity. (negative) | 3.07 ± 1.120 | 3.27 ± 0.962 | −1.832 | 0.067 |
19. When a pediatric patient complains of severe pain his/her vital signs should be evaluated. (negative) | 1.97 ± 0.750 | 2.32 ± 0.832 | −5.096 | <0.001 * |
20. I have confidence in my ability to recognize patient’s pain by assessing their vital signs and behaviors. | 3.48 ± 0.892 | 3.24 ± 0.784 | −3.245 | 0.001 * |
21. Placebo medication may be used to assess pain in children. (negative) | 2.59 ± 0.934 | 2.78 ± 0.717 | −2.271 | 0.023 * |
22. Because narcotics may cause respiratory depression, they should not be used in pediatric patients. (negative) | 2.69 ± 1.190 | 2.57 ± 0.982 | −1.074 | 0.283 |
23. For chronic pain, giving narcotics on a regular schedule is better than on a “prn” schedule. (prn: as needed range orders for medicine) | 3.79 ± 0.880 | 3.41 ± 0.877 | −4.887 | <0.001 * |
24. Pediatric patients should show discomfort before receiving the next dose of pain relief medication. | 3.21 ± 1.101 | 3.30 ± 0.954 | −0.317 | 0.751 |
25. Intramuscular injection is the best way to provide pain relief medication. | 3.24 ± 1.156 | 3.26 ± 0.847 | −0.989 | 0.323 |
26. After the initial recommended dose of opioid analgesic, subsequent doses should be adjusted in accordance with the individual patient’s response. | 4.23 ± 0.653 | 3.93 ± 0.590 | −5.850 | <0.001 |
27. Increasing analgesic requirements indicate that the pediatric patient is becoming addicted to the narcotic. | 2.87 ± 1.012 | 2.86 ± 0.823 | −0.655 | 0.513 |
28. When a pediatric patient or his/her parents request increasing amounts of analgesics for pain control, this usually indicates that the patient may be physiologically dependent. | 2.77 ± 1.061 | 2.80 ± 0.858 | −0.007 | 0.995 |
29. Pediatric patients having severe chronic pain often need higher dosages of pain meds than pediatric patients with acute pain. | 3.39 ± 1.032 | 3.22 ± 0.910 | −1.871 | 0.061 |
30. Appropriate dosage of narcotics depends on the effectiveness of pain management for the patients rather than on the maximum dosage as determined by body weight. | 4.21 ± 0.690 | 4.00 ± 0.654 | −3.847 | <0.001 |
31. When the effectiveness of pain relief medicine is poor, it should not be combined with another pain relief medicine. (negative) | 2.96 ± 1.160 | 3.25 ± 0.876 | −2.544 | 0.011 * |
Variable | B | SE | 95% Wald CI | Wald X2 | p-Value |
---|---|---|---|---|---|
Intercept | 87.766 | 2.867 | (82.147, 93.385) | 937.217 | 0.000 |
Nurses vs. pediatricians a | −2.091 | 0.832 | (−3.722, −0.460) | 6.311 | 0.012 * |
Age | 0.311 | 0.064 | (0.185, 0.437) | 23.304 | <0.001 * |
Children’s hospital vs. medical center a | 2.415 | 0.819 | (0.810, 4.020) | 8.701 | 0.003 * |
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Li, Z.-Z.; Chang, Y.-C.; Gu, L.; Zhou, J.-F.; Wei, B.-R.; Peng, N.-H. Knowledge of Chinese Pediatric Professionals Regarding Pediatric Pain Management. Children 2022, 9, 1785. https://doi.org/10.3390/children9111785
Li Z-Z, Chang Y-C, Gu L, Zhou J-F, Wei B-R, Peng N-H. Knowledge of Chinese Pediatric Professionals Regarding Pediatric Pain Management. Children. 2022; 9(11):1785. https://doi.org/10.3390/children9111785
Chicago/Turabian StyleLi, Zhen-Zhen, Yue-Cune Chang, Lin Gu, Jian-Fu Zhou, Bi-Rong Wei, and Niang-Huei Peng. 2022. "Knowledge of Chinese Pediatric Professionals Regarding Pediatric Pain Management" Children 9, no. 11: 1785. https://doi.org/10.3390/children9111785