Children’s Nurses’ Knowledge and Attitudes on Paediatric Pain: A Descriptive Cross-Sectional Survey in a Developing Country

Abstract

Background: Children’s nurses’ knowledge of pain affects their pain management practices. Even though poor knowledge and attitudes have been reported in several studies, most were carried out in developed settings. However, little has been reported on the management of paediatric pain by nurses in resource-limited settings such as in sub-Saharan Africa.Purpose: This study sought to assess the knowledge and perceptions of children’s nurses regarding paediatric pain in a Ghanaian context.Methodology: A descriptive cross-sectional survey was carried out among 65 nurses at eight hospitals at various levels of healthcare in Ghana. Over three months, participants’ demographic data and responses on the Pediatric Nurses Knowledge and Attitude Survey Regarding Pain (PNKAS) instrument were collected. Data were analyzed and presented using descriptive and inferential statistics.Results: Participants’ average (SD) knowledge and attitudes regarding paeditric pain was 36.7% (6.9%) and ranged from 21.4% to 57.1%. Pediatric pain knowledge and attitudes (PPKA) of the nurses differed based on working years in the children’s unit and the hospital type they worked in (p<0.05). Nevertheless, the type of hospital facility was the only independent predictor of their PPKA (R2=0.181, p<0.001).Conclusion: Children nurses in this setting generally had insufficient knowledge and attitudes on paediatric pain. They should be motivated to undertake self-directed learning and regular continuing professional education to update their knowledge, attitude and skills on evidence-based pediatric pain assessment and management.

Educational Intervention to Strengthen Pediatric Postoperative Pain Management: A Cluster Randomized Trial

“…The total PNKAS-N mean score at T1 in the present study was lower than a few other PNKAS studies (12, 14, 79, 94, 99), but slightly higher than most previous studies (13, 15, 76, 78, 80, 81, 83-88, 95-98, 148), however, it did not reach an acceptable level of knowledge (84).The present study revealed PACU nurses' knowledge gaps in essential areas, especially regarding pharmacological management. These knowledge gaps concur with the other more recent studies using PNKAS, such as useful drugs for treatment of pain in children (83), risk of addiction (83,(85)(86)(87)96) and respiratory depressions (83,86,96). Healthcare professionals' knowledge is essential in pediatric pain management.…”

“…Results from PNKAS studies of nurses conducted in the Kingdom of Saudi Arabia (83), Ghana (84,85), Turkey (76), Mexico (13,87), Egypt (97), China (88), Mongolia (95) and Iran (98) showed low total mean scores, with < 50% correct answers. Studies conducted in the USA (12, 78-80, 96, 99), Canada (14,15,94), Norway (77), Spain (86) and Germany (81) showed higher total mean scores, with 56-82% correct answers.…”

“…Previous studies have shown that nurses have poor knowledge about and attitudes toward basic pediatric pain assessment and management principles (9). Nurses' knowledge and attitudes regarding pediatric pain management have been identified using the Pediatric Nurses' Knowledge and Attitude Survey Regarding Pain (PNKAS) in several previous studies (76)(77)(78)(79)(80)(81), conducted on nursing students (82), used in intervention studies (12)(13)(14)(15), and in more recent studies (83)(84)(85)(86)(87)(88) on nursing students (89)(90)(91)(92)(93), and in intervention studies (94)(95)(96)(97)(98)(99).…”

“…Findings from these studies demonstrated knowledge deficits in pharmacological issues, such as useful drugs for pain treatment in children (12,(76)(77)(78)(79)(80)83), risk of addiction (76,77,80,81,83,(85)(86)(87)96), risk of respiratory depression (12, 76-81, 83, 86, 96), conversion of morphine doses from intravenous to oral administration (12, 76-79, 84, 85, 96) and other items, including that children may sleep in spite of severe pain (77,83,86) and that children overreport pain (76-78, 80, 83-85, 96).…”