Pain Assessment and Use of Non-Pharmacological Interventions: A Survey of Paediatric Nurses
Main Article Content
Abstract
Background: Pain is recognized as the fifth vital sign, requiring routine assessment and effective management, particularly in children. Non-pharmacological interventions are vital in paediatric pain control. This study aimed to evaluate the knowledge and practice of pain assessment and the use of non-pharmacological strategies among paediatric nurses in Umuahia, Nigeria.
Methods: A descriptive cross-sectional study was conducted from January to February 2018 at Federal Medical Centre Umuahia. Forty-seven structured questionnaires were distributed to registered paediatric ward nurses after an educational programme in December 2017. A total of 26 responses were received (55.3% response rate). Data were analyzed using SPSS version 20 with Fisher’s exact test for statistical comparison.
Results: All nurses (100%) assessed pain during shifts but 42.3% were unaware of the need to assess pain in neonates. Nurses who participated in the educational programme demonstrated significantly better knowledge about neonatal pain assessment (68% versus 0%, P = 0.0221). Additionally, 26.9% of the respondents lacked knowledge of key non-pharmacological strategies, such as distraction and applying skin-to-skin contact. Nurses with over 10 years’ experience were more likely to recognize distraction as a useful intervention (P = 0.0261).
Conclusion: Gaps persist in pediatric nurses’ knowledge regarding pain assessment and non-pharmacological pain management strategies. Periodic educational programmes improve knowledge and may enhance pediatric pain management practices.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.
How to Cite
References
1. Okpara PN. Challenges of nursing of the paediatric surgical patient. Afr J Paediatr Surg. 2018; 15: 154 - 157
2. Anand KJ, Hickey PR. Pain and its effects in the human neonate and fetus. N Eng J Med. 1987; 317 (21): 1321 – 1329
3. Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2016; 7:CD001069
4. Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet. 1997; 349 (9052): 599 – 603
5. Walker SM. Long-term effects of neonatal pain. Semin Fetal Neonatal Med. 2019; 24 (4): 101005
6. Pillai RR, Racine N, Craig KD. Non-pharmacological management of procedural pain in infants and young children; An abbreviated Cochrane review. Pain Res Manag. 2011; 16(1): 33 – 37
7. McGrath PA. Non-drug programmes for pediatric pain. Pain Res Manag. 1995; 1 (1): 33 – 37
8. World Health Organization (WHO). Guidelines on the management of chronic pain in children. 2020.
9. International Association for the Study of Pain (IASP). IASP guidelines on pain in infants, children, and adolescents. 2020.
10. Eke GK, Ide LEY. Non-pharmacological management of procedural pain in children: Health worker’s approach at a tertiary health facility, Southern Nigeria. J Adv Med Res. 2020; 32: 97 – 103
11. Harrison D, Laroque C, Bueno M, Stokes Y, Turner L, Hutton B et al. Sweet solutions to reduce procedural pain in neonates: A meta-analysis. Pediatrics. 2017; 139 (1): e20160955.
12. Taddio A, McMurty CM, Shah V, Riddell RP, Chambers CT, Noel M WT et al. Reducing pain during vaccine injections. CMAJ. 2015; 187 (13); 975 - 182
13. Shah PS, Torgalkar R, Shah VS. Breastfeeding or breastmilk for procedural pain in neonates. Cochrane Database Syst Rev. 2023; 12:CD004950
14. Ibitoye BM, Oyewale TM, Olubiyi KS, Onasoga OA. The use of distraction as a pain management technique among nurses in a North-central in Nigeria. Int J Afr Nurs Sci. 2019; 11: 100158
15. Umar NJ, Nuhu LA, Olubiyi SK, Rejuaro FA, Ibraheem AA, Onasoga OO et al. Practice and perceived effectiveness of non-pharmacological strategies used for pain management among nurses in University of Maiduguri Teaching Hospital. Trop J Health Sci. 2017; 24: 1 – 4
16. Koller D, Goldman RD. Distraction techniques for children undergoing procedures: A critical review of pediatric research. J Ped Nurs. 2012; 27(6): 652 - 681
17. Sonmez MO, Nazik F, Erol L. Management of pain in children by paeditric nurses in Eastern Turkey. 2018; 20: 250 – 254
18. Arif-Rahu M, Fisher D, Matsuda Y. Biobehavioural measures for pain in the pediatric patient. Pain Manag Nurs. 2012; 13 (3): 157 – 168
19. Wuni A, Salia SM, Ibrahim MM, Iddriss I, Nyarko BA, Seini SN et al. Evaluating knowledge, practices, and barriers of paediatric pain management among nurses in a tertiary health facility in the northern region of Ghana: A descriptive cross-sectional study. Pain Res Manag. 2020; 8846599
20. Federal Ministry of Health, Nigeria. Guidelines for pain management in Nigeria. 2019.
21. Alotaibi K, Higgins I, Chan S. Paediatric pain management: knowledge, attitudes, barriers and facilitators among nurses – integrated review. Int Nurs Rev. 2018; 65(4): 524 -533
22. Grunau RE, Holsti L, Peters JW. Long-term pain consequences in human neonates. Semin Fetal Neonatal Med. 2006; 11 (4): 268 – 275
23. Carter BS, Brunkhorst J. Neonatal pain management. Clin perinatal. 2017; 44 (3): 503 – 515
24. Twycross A. Nurses’ about the barriers and facilitators to effective management of pediatric pain. Pain Manag Nurs. 2013; 14(4): e164 – e172