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Original Article|Articles in Press

Time for Action: Understanding Health Care Professionals Views on Pain and Pain Management in a Pediatric Hospital

Published:November 14, 2022DOI:https://doi.org/10.1016/j.pmn.2022.10.002

      Background

      Children admitted to the hospital experience pain. ChildKind International (CKI) is an organization dedicated to improving the quality of pediatric pain care worldwide. In 2019, BC Children hospital (BCCH) clinicians set out to achieve this certification. A qualitative study was performed in order to fully comprehend the current state of pain assessment and management at BCCH.

      Aim

      The objective of this study is to characterize the perceptions of health care professionals (HCPs) about pediatric pain and pain management in a pediatric hospital.

      Methods

      We choose a quantitative methodology as it allows us to delve more deeply into the HCPs’ personal experience with pain and pain management of children in the hospital. We interviewed 31 pediatric healthcare professionals (N = 31).

      Results

      HCPs believe there is a significant lack of resources, especially educational resources, to adequately assess and treat pain in children. There is a lack of time to evaluate each patient appropriately and use pain tools consistently for both verbal and non-verbal children. HCPs varied in their opinions as to whether a procedure is painful or uncomfortable, and this opinion often differs from the perception of the child. Additionally, staff recognize that cultural diversity of both staff and patients can influence pain assessment and management in children. Therefore, there is a need for increased cultural diversity training for staff.

      Conclusions

      Pain management and treatment of children in the hospital remain inconsistent and inadequate. ChildKind certification will help hospitals to address this gap in their clinical practice.
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      References

        • Birnie K.
        • Chambers C.
        • Chorney J.
        • Fernandez C.
        • McGrath P.J.
        Dyadic analysis of child and parent trait and state pain catastrophizing in the process of children's pain communication.
        Pain. 2016; 157: 938-948
        • Bombard Y.
        • Baker G.R.
        • Orlando E.
        • Fancott C.
        • Bhatia P.
        • Casalino S.
        • Onate K.
        • Denis J.L.
        • Pomey M.P.
        Engaging patients to improve quality of care: A systematic review.
        Implementation Science. 2018; 13: 98
        • Borsook D.
        • Youssef A.M.
        • Simons L.
        • Elman I.
        • Eccleston C.
        When pain gets stuck: the evolution of pain chronification and treatment resistance.
        Pain. 2018; 159: 2421-2436
        • Butler R.
        • Monsalve M.
        • Thomas G.W.
        • Herman T.
        • Segre A.M.
        • Polgreen P.M.
        • Suneja M.
        Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network.
        American Journal of Medicine. 2018; 131 (972.e979-972.e915)
        • Chiu I.M.
        Infection, pain, and itch.
        Neuroscience Bulletin. 2018; 34: 109-119
        • Earp B.D.
        • Monrad J.T.
        • LaFrance M.
        • Bargh J.A.
        • Cohen L.L.
        • Richeson J.A.
        Featured article: Gender bias in pediatric pain assessment.
        Journal of Pediatric Psychology. 2019; 44: 403-414
        • Eccleston C.
        • Fisher E.
        • Law E.
        • Bartlett J.
        • Palermo T.M.
        Psychological interventions for parents of children and adolescents with chronic illness.
        Cochrane Database of Systematic Reviews. 2015; 4CD009660
        • Edwards C.L.
        • Fillingim R.B.
        • Keefe F.
        Race, ethnicity and pain.
        Pain. 2001; 94: 133-137
        • FitzGerald C.
        • Hurst S.
        Implicit bias in healthcare professionals: A systematic review.
        BMC Medical Ethics. 2017; 18: 19
        • Hall W.J.
        • Chapman M.V.
        • Lee K.M.
        • Merino Y.M.
        • Thomas T.W.
        • Payne B.K.
        • Coyne-Beasley T.
        Implicit Racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review.
        American Journal of Public Health. 2015; 105: e60-e76
        • Homer C.
        • Wilson A.
        • Davis D.
        Editorial: Words matter; language matters.
        Women Birth. 2020; 33: 105-106
        • Hurley-Wallace A.
        • Wood C.
        • Franck L.S.
        • Howard R.F.
        • Liossi C.
        Paediatric pain education for health care professionals.
        Pain Reports. 2019; 4: e701
        • Kieft R.
        • de Brouwer B.
        • Francke A.L.
        • Delnoij D.
        How nurses and their work environment affect patient experiences of the quality of care: A qualitative study.
        BMC Health Services Research. 2014; 14: 249
        • Linhares M.
        • Doca F.
        • Martinez F.E.
        • Carlotti A.
        • Cassiano R.
        • Pfeifer L.
        • Finley G.A.
        Pediatric pain: Prevalence, assessment, and management in a teaching hospital.
        Brazilian Journal of Medical and Biological Research = Revista Brasileira de Pesquisas Medicas e Biologicas. 2012; 45: 1287-1294
        • McGrath P.J.
        Science is not enough: The modern history of pediatric pain.
        Pain. 2011; 152: 2457-2459
        • McLean M.A.
        • Niknafs N.
        • Scoten O.C.
        • Chau C.M.Y.
        • MacKay M.
        • Weinberg J.
        • Grunau R.E.
        Sensory processing and cortisol at age 4 years: Procedural pain-related stress in children born very preterm.
        Development Psychobiology. 2021; 63: 915-930
        • McMurtry C.M.
        • Pillai Riddell R.
        • Taddio A.
        • Racine N.
        • Asmundson G.J.
        • Noel M.
        • Shah V.
        Far from "Just a Poke": Common painful needle procedures and the development of needle fear.
        Clinical Jurnal of Pain. 2015; 31: S3-11
        • Noel M.
        • McMurtry C.M.
        • Pavlova M.
        • Taddio A.
        Brief clinical report: A systematic review and meta-analysis of pain memory-reframing interventions for children's needle procedures.
        Pain Practice. 2018; 18: 123-129
        • Page G.G.
        Are there long-term consequences of pain in newborn or very young infants?.
        Journal of Perinatal Education. 2004; 13: 10-17
        • Palermo T.M.
        • Chambers C.T.
        Parent and family factors in pediatric chronic pain and disability: An integrative approach.
        Pain. 2005; 119: 1-4
        • Peacock P.J.
        • Zengeya S.T.
        • Cochrane L.
        • Sleath M.
        Neonatal outcomes following delivery water: Evaluation of safety in a district general hospital.
        Cureus. 2018; 10: e2208
        • Raja S.N.
        • Carr D.B.
        • Cohen M.
        • Finnerup N.B.
        • Flor H.
        • Gibson S.
        • Keefe F.J.
        • Mogil J.S.
        • Ringkamp M.
        • Sluka K.A.
        • Song S.J.
        • Stevens B.
        • Sullivan M.D.
        • Tutelman P.R.
        • Ushida T.
        • Vader K.
        The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises.
        Pain. 2020; 161: 1976-1982
        • Sabin J.A.
        • Greenwald A.G.
        The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: Pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma.
        American Journal of Public Health. 2012; 102: 988-995
        • Simons L.E.
        • Basch M.C.
        State of the art in biobehavioral approaches to the management of chronic pain in childhood.
        Pain Management. 2016; 6: 49-61
        • Simons L.E.
        • Sieberg C.B.
        • Claar R.L.
        Anxiety and functional disability in a large sample of children and adolescents with chronic pain.
        Pain Research & Management. 2012; 17: 93-97
      1. St-Laurent-Gagnon, T., Bernard-Bonnin, A., & Villeneuve, E. (1999). Pain evaluation in preschool children and by their parents. 88(4), 422-427.

        • Taylor-Stokes G.
        • Lobosco S.
        • Pike J.
        • Sadosky A.B.
        • Ross E.
        Relationship between patient-reported chronic low back pain severity and medication resources.
        Clinical Therapeutics. 2011; 33: 1739-1748
        • Thorne S.
        • Kirkham S.R.
        • MacDonald-Emes J.
        Interpretive description: A noncategorical qualitative alternative for developing nursing knowledge.
        Research in Nursing & Health. 1997; 20: 169-177
        • Thorne S.
        • Kirkham S.R.
        • O'Flynn-Magee K
        the analytic challenge in interpretive description.
        International journal of qualitative methods. 2004; 3: 1-11
        • Thorne S.E.
        Interpretive description: Qualitative research for applied practice.
        2nd ed. Routledge, Oxfordshire2016
        • Victoria N.C.
        • Murphy A.Z.
        Exposure to early life pain: Long term consequences and contributing mechanisms.
        Current Opinions in Behavioral Sciences. 2016; 7: 61-68
        • von Baeyer C.L.
        • Spagrud L.J.
        Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years.
        Pain. 2007; 127: 140-150
      2. World Health Organization (WHO), (2012). WHO Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses. Retrieved Month XX, XXXX, from https://www.ncbi.nlm.nih.gov/books/NBK138354/.

        • Woo B.F.Y.
        • Lee J.X.Y.
        • Tam W.W.S.
        The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review.
        Human Resources for Health. 2017; 15 (63-63)
        • Wressle E.
        • Samuelsson K.
        High job demands and lack of time: A future challenge in occupational therapy.
        Scandinavian Journal of Occupational Therapy. 2014; 21: 421-428