Background: Painful experiences are common among hospitalized children. Long-term negative biopsychosocial consequences of under-treated pain are recognized. Aims: The study benchmarks pain prevalence, assessment, and treatments as a first step to improve pain care in a Canadian tertiary hospital. Methods: Single-day audits were undertaken on the pediatric ward (PW), emergency department (ED), and maternal services (MS). Participants (child or caregiverproxy) reported hospital pain experiences in the preceding 24 hours; medical records were reviewed for assessment and treatment. Results: Among 84 participants, pain prevalence ranged from 75-88%; mean pain intensity ranged from 5.7-6.5/10. Prevalence of moderate to severe pain was 78% on PW, 65% in ED, and 55% on MS. Needle pokes were the most frequent cause of worst pain. Documentation of pain assessment varied by setting (PW, 93%; ED, 13%; MS, 0%). Documented maximum pain scores were significantly lower compared to participant report (mean difference 4.5/10, SD=3.1, p<0.0001). A total 29% (6/21) of infants with heel lance or injection received breastfeeding or sucrose, and 29% (7/24) of participants receiving other needle procedures had documented or reported topical lidocaine use. All participants on MS underwent needle procedures. Conclusions: Pain is experienced commonly by infants and children in PW, ED, and MS. Pain assessment documentation is not routine and underestimates participant report. Evidence-based pain management strategies are underutilized. An institution-wide quality improvement approach is required to address pain care. Pain assessment and needle pain prevention and treatment should be prioritized in these pediatric acute care and newborn care settings.
Purpose: Self-regulatory efficacy (SRE) is a psychological resource necessary for cardiac rehabilitation (CR) exercise adoption and maintenance. A 2008 review of self-efficacy for CR exercise identified the need for more high-quality research on SRE. The present review had 4 purposes: (a) to review the characteristics of empirical SRE and CR exercise research since 2008; (b) to examine the quality of SRE measurement; (c) to determine whether varying quality of SRE measurement moderated the relationship between SRE, exercise, and CR social cognitions; and (d) to make recommendations for better measurement for future research. Method: An initial search of 766 possible studies identified 29 for review. These included individuals engaged in or completing CR where SRE for exercise and relevant outcomes was assessed. Meta-analysis examined whether SRE measurement quality was associated with the magnitude of effects observed and to determine potential moderation by quality. Results: There were 11 unique operationalizations of SRE for exercise. Problematic factors included: non-SRE variables assessed as the construct, using global versus specific measures, and lack of a time frame over which SRE applied. Effect size was related to stronger relationships as level of study and measurement quality increased. Conclusion: Since 2008, an increase in studies examining SRE and CR exercise was observed. To advance SRE and CR exercise research, measurement and research quality improvements are recommended that have implications for future mediation and CR intervention assessment.
Viewing helpful well-trained CR staff as mainly responsible for participant behavior may be problematic for post-CR exercise maintenance among those more staff dependent.
Background Chronic pain is common and affects 20% of children and youth. Those with chronic pain often have a difficult time regularly attending school, with up to 50% of children and youth with chronic pain missing some school. Specific accommodations that benefit youth are unknown. Nearly half of parents of youth with chronic pain report their child’s grades dropped since pain onset. Both parents and youth report “moderate levels of interference” with learning. Most common accommodations include being sent to the nurse, being sent home and receiving extensions on assignments. While these strategies may be helpful for pain conditions expected to resolve, strategies that support staying in and succeeding at school are required for youth with chronic pain. Objectives This study aims to determine what educators need to know to best support youth with chronic pain in the academic setting. More specifically, 1) to determine what youth with chronic pain, parents of youth, educators, and healthcare professionals want educators to know about supporting students with chronic pain, and 2) to describe health professionals’ and educators’ attitudes and knowledge of pediatric chronic pain. Design/Methods Inclusion criteria include youth age 12-25 years with chronic pain and parents, health professionals and educators of youth with chronic pain. The recruitment strategy includes distribution of the survey via the Saskatchewan pediatric chronic pain clinic research contact lists, the Canadian Paediatric Society Section of Community Paediatrics listserve and social media. This online cross-sectional survey includes participant demographics and questions about accommodations noted to be helpful for youth with chronic pain. In addition, educator and health professional surveys include the 26-item Chronic Pain Myth Scale (CPMS). Results The study group includes 87 participants, 26 youth, 18 family/friends, 19 educators, and 24 health professionals. Some suggested school accommodations include: access to technology in class, teachers providing notes for students, education on chronic pain for teachers and students, and improved communication and collaboration between the youth, their healthcare team and educators. The majority of health professionals and educators report some knowledge, positive beliefs and attitudes towards people suffering from chronic pain (M=3.03, SD= .34). Conclusion Chronic pain is common and affects school attendance and achievement. Suggestions for accommodations to help those with chronic pain in the academic setting are made. Educators and health professionals indicated varying levels of knowledge, attitudes and beliefs, with some educators indicating they would like to receive education about chronic pain. Improved communication between school-based pupil support teams and health care teams is warranted.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.