Pediatric Pain Management And Self-Efficacy Of Nurses
Pediatric Pain Management
Immaculata University
Pediatric Pain Management
Pain is a subjective phenomenon. Young children are often not able to properly express their levels of pain, which has become a growing problem for pediatric units across the nation. Pain management is an obstacle nurses come face to face with on a daily basis. Managing pain of patients who have the ability to verbalize what they are feeling can be easier to treat then those who cannot. Providing effective pain management for children is widely recognized as a complicated and challenging aspect of nursing. In their study, Relationship Between Knowledge, Attitudes, and Self-Efficacy of Nurses In the Management of Pediatric Pain, Stanley and Pollard (2013) …show more content…
have attempted to discover the missing link between knowledge, self-efficacy, and the pediatric nurses ability to properly manage a child’s discomfort. Children’s pain is a subjective experience that has sensory, emotional, cognitive, and behavioral components that are interconnected with environmental, developmental, sociocultural, and contextual factors and are often considered inadequately evaluated and undertreated (Stanley & Pollard, 2013). The purpose of this study was to examine the level of knowledge of pediatric pain management, the attitudes of nurses, and the level of self-efficacy of a group of pediatric nurses in an acute care setting (Stanley & Pollard, 2013).
The design of this study was a cross-sectional, correlational design that was used in a convenience, non-probability sample of pediatric nurses in two regional hospitals in North Carolina (Stanley & Pollard, 2013). Nurses had to meet the criteria of currently being an employed registered nurse on a pediatric acute care unit. Nurses who decided to participate in the study were asked to complete two research instruments. The first titled “Pediatric Nurses’ Knowledge and Attitudes Survey Regarding Pain (PNKAS)” This survey consisted of 40 questions measuring knowledge and attitudes in managing pediatric pain (2013). The second survey titled, “Nurses’ Self-Efficacy in Managing Children’s Pain”, which consisted of six questions addressing self-efficacy in pediatric pain management. Participants had four weeks to complete and return surveys from the time brochures were distributed. Out of 60 packets that were delivered to staff, 26 were returned, one which was incomplete and discarded, for a return rate of 43.3% (2013).
To measure the level of knowledge of the pediatric nurses the PNKAS survey was used. A study referenced in the research article was one done by Rieman and Grodon (2007) stated, “although the level of knowledge of pediatric pain management did not differ significantly based on education preparation, nurses with more than two years of experience or who participated in continuing education courses had significantly higher knowledge and attitude scores regarding pediatric pain management” (Stanley & Pollard, 2013, p. 167) suggesting that with experience comes knowledge. However, the results found in this research did not reveal a statistically significant relationship between the years of nursing experience and the level of knowledge (Stanley & Pollard, 2013). The analysis did however show a significantly positive relationship between the level of knowledge and the years of pediatric nursing experience. Nurses with more years of experience scored higher on the PNKAS (2013).
The Nurses Self-Efficacy tool was used to measure the level of self-efficacy of pediatric nurses when managing children’s pain. The author defined self-efficacy as “a person’s belief in his or her capability to successfully perform a specific task” (Stanley, Pollard, 2013, p. 165). The study found that overall the participants had a high level of self-efficacy in regard to pediatric pain management. However, the study indicated there was no statistically significant relationship between knowledge and self-efficacy (2013).
In addition, the study found that nurses with an associate degree had a lower knowledge but a higher level of self-efficacy than nurses with a bachelor’s degree (BSN). However, nurses with a BSN had a higher level of knowledge but a lower level of self-efficacy. This could be very harmful to patients in need of pain management. Over confidence of a nurse with lack of knowledge could cause the need of pain management to be over looked and left untreated.
Overall, no relationship between the level of pediatric pain knowledge and the level of self-efficacy was found (2013). However, this study did show that there is an increased need for education, as the article stated, “A range from 53.8 to 82% on the PNKAS may suggest a need for increased education for pediatric nurses” (Stanley, Pollard, 2013, p. 169). Also noted in the article, was that the years of experience did not establish a relationship with the level of pain management knowledge or self-efficacy (2013).
This research article was well written, concise, grammatically correct, and user friendly. The researchers are qualified, as well as demonstrate the ability and degree of knowledge that was needed to complete this study. The purpose of this study was clearly identified both in the abstract and discussion section part of the article. The authors included a very in-depth literature review that included current and classical studies. Authors clearly explained the rationales behind the study. A balanced critical analysis of the literature was offered in the review section. Authors clearly identified the research gap that is the relationship between knowledge, attitudes and self-efficacy in related to managing pediatric pain.
Target population was clearly identified and how the samples were selected was described. This study did however receive a limited number of respondents, 25 out of 60, putting the information at risk for error. With small sample sizes, information can become bias. This study was done in two hospitals within the same state, bringing concern to the validity of this study. Participants most likely demonstrate a similar practice of nursing, as well as share the same beliefs and confidence in their knowledge of pediatric pain assessments. As larger sample sizes are used, the risks of sampling errors decrease (Coughlan, Cronin, Ryan, 2007). Also, 92% of the respondents were females, generating concern for over representation. This creates the possibility of being exceedingly demonstrative of small subgroups within the targeted population.
Participants were fully informed of the study at meetings, and through emails and brochures. Autonomy and confidentiality was guaranteed by placing a locked drop-box in the manager’s office for the returned surveys. Though, nothing in the article mentioned if ethical permission was granted for this study. It is not clear if the research was granted permission for the study. In this article they did not discuss human subject protection. The article does not discuss how they protected the autonomy of participants, or if they were informed that they can withdraw at any time.
Research design was clearly identified. The study used two acceptable levels of stability surveys as the data gathering instruments, which were both described in depth. Both surveys were validated by national content experts in pediatrics and pain. However, how the surveys were developed was not mentioned in the article.
Results were discussed using figures and tables, and all information in the text are consistent with the tables. Tables and figures used are self-explanatory and easy to understand. Important results were discussed in a concise and easy to understand way. Research findings were compared with other related studies between the level of knowledge and years of nursing experience. It was surprising to see that the research did not reveal a statistically significant relationship between the knowledge of nurses who held an RN in comparison to a BSN. This particularly comes as a surprise because of the focus and importance that attaining such a degree has been described within the current field of nursing.
Overall, the authors accomplished their goal of assessing the relationship between knowledge and self-efficacy of pain management for pediatric nurses.
Additional information the authors could have explored is the pediatric pain assessment scale participants used. This would have given the authors a better understanding of the knowledge pediatric nurses had in regards to assessing pediatric pain. The author states, “Patients have a right to receive adequate pain assessment and management, and it is important for hospitals to be aware of their nurses’ abilities to perform these tasks” (Stanley, Pollard, 2013, p. 169). Adding this research to the study would have increased knowledge of the nurse’s strengths and weaknesses in assessing and treating pediatric …show more content…
pain.
Another suggestion would be to increase the sample size in order to reduce the risk for bias outcomes. Researchers could have made the study more interesting for participants and enticed nurses to get involved. For example, researchers might offer an incentive such as purchasing lunch for the floor if they receive over 75% participation. This would attract the staff to get involved, as well as benefit the researchers and the study. Also, researchers could have increased the number of hospitals that partook in attempt to increase number of participants.
In order to manage pediatric pain effectively, education needs to be provided for all nurses. This study determined that lack of education and knowledge are the key components enabling nurses to properly treat pediatric pain. It is imperative that all pediatric organizations incorporate extensive training programs and yearly reviews of pediatric pain management knowledge to ensure no child is living with untreated pain while in our care.
This study directly relates to the current practice of pediatric home care.
Nurses are on their own in the patient’s home required to not only assess a child’s pain, but treat it properly with limited resources. New graduates are getting hired for home care positions without being properly trained. For example, home care companies in South Jersey are training new nurses for a total of three hours, then allowing them to begin their first shift alone. Stanley and Pollard state that knowledge comes from experience, and new nurses can gain that experience by following seasoned nurses. Without allowing suitable amount of training, organizations are placing their patients at risk of experiencing untreated pain. Home care nurses may neglect signs and symptoms of pediatric pain due to lack of education and training, as well as lack of resources in the home. It is imperative for companies to reevaluate their training process to insure nurses have the ability to properly assess and treat pediatric pain. “A qualitative study of 21 nurses concluded that a barrier to pain management is a lack of education about pain assessment” (Stanley, Pollard, 2013, p. 166). Helping to prove the point that proper training and education in all fields of nursing will lead to better management of pediatric
pain.
In conclusion, this study was informative, concise, and educational. The study found no relationship between the level of pediatric pain knowledge and the level of self-efficacy. However, the years of pediatric experience demonstrated a positive relationship to knowledge but not self-efficacy (Stanley & Pollard, 2013). Researchers determined the lack of education and knowledge are the key components of untreated pediatric pain. Ongoing education for nurse’s individual needs as well as continued examination will help decrease pediatric discomfort during their time in our care.
References
Coughlan, M., Cronin, P., Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1: quantitative research. British Journal of Nursing, 16, 658-653.
Pollard, D. & Stanley, M. (2013). Relationship Between Knowledge, Attitudes, and Self- Efficacy of Nurses In the Management of Pediatric Pain. Continuing Nursing Education, 39, 165-179.
Immaculata University
Pediatric Pain Management
Pain is a subjective phenomenon. Young children are often not able to properly express their levels of pain, which has become a growing problem for pediatric units across the nation. Pain management is an obstacle nurses come face to face with on a daily basis. Managing pain of patients who have the ability to verbalize what they are feeling can be easier to treat then those who cannot. Providing effective pain management for children is widely recognized as a complicated and challenging aspect of nursing. In their study, Relationship Between Knowledge, Attitudes, and Self-Efficacy of Nurses In the Management of Pediatric Pain, Stanley and Pollard (2013) …show more content…
have attempted to discover the missing link between knowledge, self-efficacy, and the pediatric nurses ability to properly manage a child’s discomfort. Children’s pain is a subjective experience that has sensory, emotional, cognitive, and behavioral components that are interconnected with environmental, developmental, sociocultural, and contextual factors and are often considered inadequately evaluated and undertreated (Stanley & Pollard, 2013). The purpose of this study was to examine the level of knowledge of pediatric pain management, the attitudes of nurses, and the level of self-efficacy of a group of pediatric nurses in an acute care setting (Stanley & Pollard, 2013).
The design of this study was a cross-sectional, correlational design that was used in a convenience, non-probability sample of pediatric nurses in two regional hospitals in North Carolina (Stanley & Pollard, 2013). Nurses had to meet the criteria of currently being an employed registered nurse on a pediatric acute care unit. Nurses who decided to participate in the study were asked to complete two research instruments. The first titled “Pediatric Nurses’ Knowledge and Attitudes Survey Regarding Pain (PNKAS)” This survey consisted of 40 questions measuring knowledge and attitudes in managing pediatric pain (2013). The second survey titled, “Nurses’ Self-Efficacy in Managing Children’s Pain”, which consisted of six questions addressing self-efficacy in pediatric pain management. Participants had four weeks to complete and return surveys from the time brochures were distributed. Out of 60 packets that were delivered to staff, 26 were returned, one which was incomplete and discarded, for a return rate of 43.3% (2013).
To measure the level of knowledge of the pediatric nurses the PNKAS survey was used. A study referenced in the research article was one done by Rieman and Grodon (2007) stated, “although the level of knowledge of pediatric pain management did not differ significantly based on education preparation, nurses with more than two years of experience or who participated in continuing education courses had significantly higher knowledge and attitude scores regarding pediatric pain management” (Stanley & Pollard, 2013, p. 167) suggesting that with experience comes knowledge. However, the results found in this research did not reveal a statistically significant relationship between the years of nursing experience and the level of knowledge (Stanley & Pollard, 2013). The analysis did however show a significantly positive relationship between the level of knowledge and the years of pediatric nursing experience. Nurses with more years of experience scored higher on the PNKAS (2013).
The Nurses Self-Efficacy tool was used to measure the level of self-efficacy of pediatric nurses when managing children’s pain. The author defined self-efficacy as “a person’s belief in his or her capability to successfully perform a specific task” (Stanley, Pollard, 2013, p. 165). The study found that overall the participants had a high level of self-efficacy in regard to pediatric pain management. However, the study indicated there was no statistically significant relationship between knowledge and self-efficacy (2013).
In addition, the study found that nurses with an associate degree had a lower knowledge but a higher level of self-efficacy than nurses with a bachelor’s degree (BSN). However, nurses with a BSN had a higher level of knowledge but a lower level of self-efficacy. This could be very harmful to patients in need of pain management. Over confidence of a nurse with lack of knowledge could cause the need of pain management to be over looked and left untreated.
Overall, no relationship between the level of pediatric pain knowledge and the level of self-efficacy was found (2013). However, this study did show that there is an increased need for education, as the article stated, “A range from 53.8 to 82% on the PNKAS may suggest a need for increased education for pediatric nurses” (Stanley, Pollard, 2013, p. 169). Also noted in the article, was that the years of experience did not establish a relationship with the level of pain management knowledge or self-efficacy (2013).
This research article was well written, concise, grammatically correct, and user friendly. The researchers are qualified, as well as demonstrate the ability and degree of knowledge that was needed to complete this study. The purpose of this study was clearly identified both in the abstract and discussion section part of the article. The authors included a very in-depth literature review that included current and classical studies. Authors clearly explained the rationales behind the study. A balanced critical analysis of the literature was offered in the review section. Authors clearly identified the research gap that is the relationship between knowledge, attitudes and self-efficacy in related to managing pediatric pain.
Target population was clearly identified and how the samples were selected was described. This study did however receive a limited number of respondents, 25 out of 60, putting the information at risk for error. With small sample sizes, information can become bias. This study was done in two hospitals within the same state, bringing concern to the validity of this study. Participants most likely demonstrate a similar practice of nursing, as well as share the same beliefs and confidence in their knowledge of pediatric pain assessments. As larger sample sizes are used, the risks of sampling errors decrease (Coughlan, Cronin, Ryan, 2007). Also, 92% of the respondents were females, generating concern for over representation. This creates the possibility of being exceedingly demonstrative of small subgroups within the targeted population.
Participants were fully informed of the study at meetings, and through emails and brochures. Autonomy and confidentiality was guaranteed by placing a locked drop-box in the manager’s office for the returned surveys. Though, nothing in the article mentioned if ethical permission was granted for this study. It is not clear if the research was granted permission for the study. In this article they did not discuss human subject protection. The article does not discuss how they protected the autonomy of participants, or if they were informed that they can withdraw at any time.
Research design was clearly identified. The study used two acceptable levels of stability surveys as the data gathering instruments, which were both described in depth. Both surveys were validated by national content experts in pediatrics and pain. However, how the surveys were developed was not mentioned in the article.
Results were discussed using figures and tables, and all information in the text are consistent with the tables. Tables and figures used are self-explanatory and easy to understand. Important results were discussed in a concise and easy to understand way. Research findings were compared with other related studies between the level of knowledge and years of nursing experience. It was surprising to see that the research did not reveal a statistically significant relationship between the knowledge of nurses who held an RN in comparison to a BSN. This particularly comes as a surprise because of the focus and importance that attaining such a degree has been described within the current field of nursing.
Overall, the authors accomplished their goal of assessing the relationship between knowledge and self-efficacy of pain management for pediatric nurses.
Additional information the authors could have explored is the pediatric pain assessment scale participants used. This would have given the authors a better understanding of the knowledge pediatric nurses had in regards to assessing pediatric pain. The author states, “Patients have a right to receive adequate pain assessment and management, and it is important for hospitals to be aware of their nurses’ abilities to perform these tasks” (Stanley, Pollard, 2013, p. 169). Adding this research to the study would have increased knowledge of the nurse’s strengths and weaknesses in assessing and treating pediatric …show more content…
pain.
Another suggestion would be to increase the sample size in order to reduce the risk for bias outcomes. Researchers could have made the study more interesting for participants and enticed nurses to get involved. For example, researchers might offer an incentive such as purchasing lunch for the floor if they receive over 75% participation. This would attract the staff to get involved, as well as benefit the researchers and the study. Also, researchers could have increased the number of hospitals that partook in attempt to increase number of participants.
In order to manage pediatric pain effectively, education needs to be provided for all nurses. This study determined that lack of education and knowledge are the key components enabling nurses to properly treat pediatric pain. It is imperative that all pediatric organizations incorporate extensive training programs and yearly reviews of pediatric pain management knowledge to ensure no child is living with untreated pain while in our care.
This study directly relates to the current practice of pediatric home care.
Nurses are on their own in the patient’s home required to not only assess a child’s pain, but treat it properly with limited resources. New graduates are getting hired for home care positions without being properly trained. For example, home care companies in South Jersey are training new nurses for a total of three hours, then allowing them to begin their first shift alone. Stanley and Pollard state that knowledge comes from experience, and new nurses can gain that experience by following seasoned nurses. Without allowing suitable amount of training, organizations are placing their patients at risk of experiencing untreated pain. Home care nurses may neglect signs and symptoms of pediatric pain due to lack of education and training, as well as lack of resources in the home. It is imperative for companies to reevaluate their training process to insure nurses have the ability to properly assess and treat pediatric pain. “A qualitative study of 21 nurses concluded that a barrier to pain management is a lack of education about pain assessment” (Stanley, Pollard, 2013, p. 166). Helping to prove the point that proper training and education in all fields of nursing will lead to better management of pediatric
pain.
In conclusion, this study was informative, concise, and educational. The study found no relationship between the level of pediatric pain knowledge and the level of self-efficacy. However, the years of pediatric experience demonstrated a positive relationship to knowledge but not self-efficacy (Stanley & Pollard, 2013). Researchers determined the lack of education and knowledge are the key components of untreated pediatric pain. Ongoing education for nurse’s individual needs as well as continued examination will help decrease pediatric discomfort during their time in our care.
References
Coughlan, M., Cronin, P., Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1: quantitative research. British Journal of Nursing, 16, 658-653.
Pollard, D. & Stanley, M. (2013). Relationship Between Knowledge, Attitudes, and Self- Efficacy of Nurses In the Management of Pediatric Pain. Continuing Nursing Education, 39, 165-179.