An Assessment of Newly Identified Barriers to and Enablers for Prehospital Pediatric Pain Management

Whitley, Daniel E.; Li, Timmy; Jones, Courtney Marie Cora; Cushman, Jeremy T.; Williams, David M.; Shah, Manish N.

doi:10.1097/pec.0000000000000514

“…It is essential that prehospital providers have access to the resources required to facilitate pain management. Although more than half of the respondents identified that pain management is important, the influence of EMS and emergency department culture and leadership support on pain prioritisation and the provision of pain care in the prehospital setting must not be underestimated or overlooked (19,20).…”

Section: Barriers and Enablersmentioning

confidence: 99%

Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey

Lourens

¹

,

Hodkinson

²

,

Parker

³

2020

Preprint

0

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Background: Acute pain is frequently encountered in the prehospital setting, and therefore, a fundamental aspect of quality emergency care. Research has shown a positive association between health care providers’ knowledge of, and attitudes towards pain and pain management practices. This study aimed to describe the knowledge, attitudes, and practices of emergency care providers regarding acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa. The specific objectives were to, identify gaps in pain knowledge; assess attitudes regarding pain assessment and management; describe pain assessment and management behaviours and practices; and identify barriers to and enablers of pain care. Methods: A web-based descriptive cross-sectional survey was conducted among emergency care providers of all qualifications, using a face-validated Knowledge, Attitudes and Practices of Pain survey. Results: Responses of 100 participants was included in the analysis. The survey response rate could not be calculated. The mean age of respondents was 34.74 (SD8.13) years and the mean years’ experience 10.02 (SD6.47). Most respondents were male (69%), employed in the public/government sector (93%) as operational practitioners (85%) with 54% of respondents having attended medical education on pain care in the last two years. The mean percentage for knowledge and attitudes regarding pain among emergency care providers was 58.01% (SD15.66) with gaps identified in various aspects of pain and pain care. Practitioners with higher qualifications, more years’ experience and those who did not attend medical education on pain, achieved higher scores. Alcohol and drug use by patients were the most selected barrier to pain care while the availability of higher qualified practitioners was the most selected enabler. When asked to record pain scores, practitioners were less inclined to assign scores which were self-reported by the patients in the case scenarios. The participant dropout rate was 35%. Conclusion: Our results suggest that there is suboptimal knowledge and attitudes regarding pain among emergency care providers in the Western Cape, South Africa. Further, gaps in pain knowledge, attitudes and practices were identified. Some barriers and enablers of pain care in the South African prehospital setting were identified but further research is indicated.

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“…It is essential that prehospital providers have access to the resources required to facilitate the management of pain. Although more than half of respondents identified that pain management is important, the influence that organisational culture, EMS leadership support and emergency department culture and pain prioritisation may have on the provision of pain care in the prehospital setting must not be underestimated or overlooked (19,20).…”

Section: Barriers and Enablersmentioning

confidence: 99%

Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey

Lourens

¹

,

Hodkinson

²

,

Parker

³

2019

Preprint

0

View full text Add to dashboard Cite

Background: Acute pain is frequently encountered in the prehospital setting, and therefore, is known to be a fundamental aspect of quality emergency care. Research has shown a positive association between pain management practices and health care providers’ knowledge of, and attitudes towards pain. This study aimed to describe the knowledge, attitudes, and practices of emergency care providers in relation to acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa. The specific objectives were to, identify gaps in pain knowledge; assess attitudes regarding pain assessment and management, describe pain assessment and management behaviours and practices and identify barriers to and enablers of pain care. Methods: A web-based descriptive cross-sectional survey was conducted among emergency care providers of all qualifications, using a face-validated Knowledge, Attitudes and Practices of Pain survey. Results: The mean age of respondents (n=100), was 34.74 (SD 8.13) years and the mean years’ experience 10.02 (SD 6.47). Most respondents were male (69%), employed in the public/government sector (93%) as operational emergency care providers (85%) with 54% of respondents having attended medical education on pain assessment and management in the last two years. The overall mean percentage for knowledge and attitudes regarding pain among emergency care providers was 58.01% (SD 15.66) with gaps identified in various aspects of pain and pain care. Practitioners with a higher qualification, more years’ experience and those who did not attend medical education on pain, achieved higher overall scores. Alcohol and drug use by patients were the most commonly selected barrier to pain care while the availability of higher qualified practitioners was the most frequently selected enabler. Practitioners did not assign pain scores as self-reported by patients while overall, limited pain relief was provided. Conclusion: Our results suggest that there is suboptimal knowledge and attitudes regarding pain among most emergency care providers. Further, gaps in pain knowledge, attitudes and practices were identified and can be addressed in undergraduate curricula and through tailored educational initiatives for qualified practitioners Some barriers and enablers of pain care in the South African prehospital setting were identified but further research is indicated to explore.

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“…Male prehospital practitioners express more enduring (stoic) viewpoints regarding the need for analgesia while older practitioners have more negative attitudes about assessing pain medication requirements (30). Moreover, prehospital providers from various high-income countries (HIC) still report that pain assessment and management during undergraduate studies receive limited focus (18,20,21) and that continuous pain education is lacking (22). Knowledge, attitudes, and practices (KAP) surveys can be conducted to, measure what is known about a health problem, develop a baseline understanding of beliefs and behaviours, and even to quantify change after health interventions (31,32).…”

Section: Introductionmentioning

confidence: 99%

Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey

Lourens

¹

,

Hodkinson

²

,

Parker

³

2020

Preprint

0

View full text Add to dashboard Cite

Background: Acute pain is frequently encountered in the prehospital setting, and therefore, a fundamental aspect of quality emergency care. Research has shown a positive association between health care providers’ knowledge of, and attitudes towards pain and pain management practices. This study aimed to describe the knowledge, attitudes, and practices of emergency care providers regarding acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa. The specific objectives were to, identify gaps in pain knowledge; assess attitudes regarding pain assessment and management; describe pain assessment and management behaviours and practices; and identify barriers to and enablers of pain care. Methods: A web-based descriptive cross-sectional survey was conducted among emergency care providers of all qualifications, using a face-validated Knowledge, Attitudes and Practices of Pain survey. Results: Responses of 100 participants was included in the analysis. The survey response rate could not be calculated. The mean age of respondents was 34.74 (SD8.13) years and the mean years’ experience 10.02 (SD6.47). Most respondents were male (69%), employed in the public/government sector (93%) as operational practitioners (85%) with 54% of respondents having attended medical education on pain care in the last two years. The mean percentage for knowledge and attitudes regarding pain among emergency care providers was 58.01% (SD15.66) with gaps identified in various aspects of pain and pain care. Practitioners with higher qualifications, more years’ experience and those who did not attend medical education on pain, achieved higher scores. Alcohol and drug use by patients were the most selected barrier to pain care while the availability of higher qualified practitioners was the most selected enabler. When asked to record pain scores, practitioners were less inclined to assign scores which were self-reported by the patients in the case scenarios. The participant dropout rate was 35%. Conclusion: Our results suggest that there is suboptimal knowledge and attitudes regarding pain among emergency care providers in the Western Cape, South Africa. Further, gaps in pain knowledge, attitudes and practices were identified. Some barriers and enablers of pain care in the South African prehospital setting were identified but further research is indicated.

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An Assessment of Newly Identified Barriers to and Enablers for Prehospital Pediatric Pain Management

Cited by 16 publications

References 26 publications

Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey

Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey

Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey

Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: A Knowledge, Attitudes and Practices Survey

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