Assessment and management of pediatric pain based on the opinions of health professionals.

Abstract

The present study characterized the opinions of health professionals about strategies for assessing and managing pediatric pain in a public teaching hospital. The sample consisted of 92 health professionals who worked in pediatric wards, pediatric intensive care, and neonatal intensive care. The sample included 45 doctors, 18 nurses, 16 psychologists, eight physiotherapists, and five occupational therapists. Data were collected through a self-administered questionnaire that included 22 open questions on the following topics: pain assessment, pharmacological management, and non-pharmacological interventions. Each area was analyzed with regard to actions, resources, gaps, and needs. The questionnaire was developed based on the principles of Strategic Planning. Two trained researchers analyzed the thematic content of all of the responses. With regard to actions and resources, 33% of the respondents mentioned the use of instruments for pain assessment, 73% reported that they prescribed pharmacological treatments for symptoms of pain, and 26% reported the use of non-pharmacological interventions for the relief of pain. The professionals predominantly reported a lack of training for pain assessment and management, standardized protocols, and human and material resources. Consequently, 96% of the professionals reported the necessity for educational training and standardized implementation guidelines for pain assessment services. These findings provide a baseline of the health professional's opinions of pain issues, which are essential for implementing and increasing pain assessment and management policies institutionally.

Management of pain in children by paediatric nurses in Eastern Turkey

“…Healthcare professionals are important for the diagnosis and management of pain. The studies in the literature have shown that pain management applied by doctors and nurses in neonatal and paediatric patients is inadequate [2,16,17].There is no standard pain scale used in paediatric clinics in Turkey and the physician is the primary person responsible for the diagnosis and treatment of pain. Nurses have functioned passively concerning pain management in Turkey, although they should be much more effective.…”

Challenges and ways for pain assessment of children in the primary health care

“…Some of these include the face, leg, activity, cancelability, and cry (FLACC) scale which stands for face, leg, activity, cancelability, and cry, and have been validated by an Australian study that used this approach on 30 infants in the post anesthetics care unit. [41][42][43] It has been estimated that this scale has a sensitivity rate of 98% and a specificity rate of 88%. 42 Moreover, previous investigations indicated that this new approach should be used in future investigations as it possesses similar standards to other infantile, objective pain scale and the score of the post anesthetics care unit nurse's global pain rating.…”

Manejo da dor neonatal: influência de fatores psicológicos e organizacionais

“…Apesar do conhecimento atual, profissionais de saúde que atuam em unidades neonatais não têm adotado, com a frequência esperada, medidas de alívio de dor na realização de procedimentos invasivos de rotina, sejam farmacológicas ou não (Hall, 2012;Linhares et al, 2012Linhares et al, , 2014. A não adesão desses profissionais às medidas de manejo de dor pode estar relacionada às seguintes variáveis: (a) falta de informação sobre avaliação e consequências da dor no neonato (Aymar, Lima, Santos, Moreno, & Coutinho, 2014); (b) crenças sobre a falta de capacidade do RNPT para demonstrar comportamentos que expressam dor e sua sensibilidade aos procedimentos invasivos dolorosos (Anand, Stevens, & McGrath, 2007;Martins, Dias, Paula, & Enumo, 2013a;Ramos, Enumo, Paula, & Vicente, 2010); (c) cultura e clima organizacional caracterizados, por exemplo, pela falta de colaboração entre os profissionais na tomada de decisão sobre manejo de dor, limitação à autonomia profissional, entre outros (Martins, Cruzeiro, Paula, & Enumo, 2013b;Stevens et al, 2011a); (d) estressores do ambiente e da rotina, os quais repercutem diretamente na qualidade do cuidado neonatal, dificultando a adoção de medidas adequadas no alívio da dor (Theme Filha, Costa, & Guilam, 2013); e (e) estratégias de enfrentamento ou coping do profissional da UTIN, reconhecidos como ações ou reavaliações cognitivas (controle, esquiva ou manejo), que interagem com os estressores e afetam saúde e desempenho no trabalho (Silva & Marcolan, 2015).…”