Purposes: Venipuncture is one of the most painful and frequently performed invasive procedure for children by nurses. The purpose of this study was to investigate the effect of EMLA cream(eutectic mixture of local anesthetics: 2.5% lidocaine and 2.5% prilocaine) to decrease venipuncture related pain and anxiety in children. Methods: A randomized, double blinded, placebo-controlled study was conducted. Sixty children scheduled venipuncture were recruited, and randomly allocated to receive either EMLA or a placebo cream 1 hour before venipuncture. Venipuncture was carried out by one nurse investigator. Pain and anxiety was measured by parent, nurse investigator, and nurse observer. Results: Pain in the EMLA group was significantly lower than that of placebo group. However, there was no significant difference in anxiety score between the EMLA and placebo groups. Local side effect of EMLA cream were negligible. Conclusions: EMLA cream was found to be an effective local anesthetic for pediatric venipuncture pain. Further studies should continue to evaluate the facilitators and barriers of EMLA cream application in pediatric nursing practice.
Suk Min Hyun;Yoon Young Mi;Oh Won Ock;Park Eun Sook
Child Health Nursing Research
/
v.5
no.3
/
pp.262-280
/
1999
This study was Performed to understand Pediatric Pain management status and nurses' knowledge and attitudes toward it. In addition. it aimed to provide basic data in order to establish effective nursing intervention strategies by confirming the barriers of effective pain management in practice. The subjects were 195 nurses working in pediatric units(general pediatric unit. oncology unit, neonatal unit. neonatal ICU, Pediatric ICU) of 8 university hospitals and one general hospital. Data was collected by the questionnaire from the 3rd of August to the 20th of September in 1999. The instrument developed by Sanna(1999) to measure nurses' knowledge and their attitudes and the other tool by Cleeland(1984) to evaluate barriers in effective Pain management was used. Results of this study are summarized as follows 1. Most nurses learn about the pain management knowledges from through regular curriculum of nursing school(62.0%) And almost nurses(90.8%) don't used to utilize pain assessment tool, but the 'Faces Rating Scale' is the most frequently used by nurses. 2. The use of pain medication(65.6%) is most frequently taken by nurses as pain management and is followed by massage (55.9%) , distraction(27.7%). 3. Nurses' knowledge level is moderate (Mn=3.07). Nurses don't seem to understand pediatric Physical development (Mn = 2.86), psychological development(Mn=2.94) well, meanwhile they seem relatively Quite knowledgeable about the way pain emerges. 4. Nurses' attitudes toward pain is based on behavioral and physiological responses to Pain. They believe 'changes in behavior are a way of assessing pain in child' and 'acute pain increases the number of respiration' Nurses are ready to accept pediatric pain, but are not positive in adopting pain intervention in practice. 5. The barriers of effective pain management are inadequate assessment of pain and pain relief(81.5%), ineffective incorporation among health professionals(80%), and lack of equipment or skills(80.0%).
Purpose: The purpose of the study is to offer necessary data to develop nursing interventions to reduce intravenous injection pain and uneasiness among hospitalized children. Methods: A total of 200 patients aged 1-72 months were selected. Pain during intravenous cannulation was assessed using the Procedural Behavior Checklist (PBCL) and the Faces Pain Rating Scale (FPRS). Data were analyzed by t-test and ANOVA using the SPSS/WIN 12.0. Results: Younger patients showed higher pain response than older patients (F=33.87, p<.001). Children with respiratory diseases showed higher responses in FPRS and PBCL than children without respiratory disease (F=4.17, p=.017; F=25.31, p<.001, respectively). Children of preschool age showed higher pain response during IV cannulation than the comparison group (t=2.04, p=.045). Children who had previous experiences with hospitalization and injections showed higher response to pain than those without these experiences (t=2.05, p=.045). In regards to FPRS, patients who were recannulated showed more painful restarts compared with patients injected just once (t=-3.60, p<.001). In regards to PBCL, infants and toddlers (t=-4.88, p<.001) and preschoolers (t=-3.86, p<.001) showed high pain scores during recannulation. Conclusion: A sick child's response to pain may be worse as they feel more pain over time. These characteristics should be considered for development of nursing interventions.
Purpose: The purpose of this study was to review pain alleviation intervention for Korean pediatric inpatients with reference to Kolcaba's Theory of Comfort. Methods: Whittemore and Knafl's integrative review methods were used. Articles published in Korean or English were identified through electronic search engines and scholarly web sites. Scientific, peer-reviewed articles published between 2006 and 2019 were included in this review. Twenty-seven articles that met the inclusion criteria were analyzed. Results: Among the 27 selected studies, three were descriptive, while 24 were interventional studies related to pain alleviation interventions. Pain alleviation interventions showed three attributes: identifying pain triggers and the child's response to pain, effective strategies for pain relief, and nurses' competence in pain management. Conclusion: The three attributes of pain alleviation interventions using the theory of comfort shown in this study were identified as important factors for obtaining evidence-based data on how to enhance the comfort of hospitalized pediatric patients. In addition, the attributes of pain alleviation interventions should be considered for hospitalized pediatric patients and their family members.
Purpose: This study was to investigate nursing students' knowledge, experience and self-efficacy regarding children's pain management. Methods: A descriptive research design was used. The participants in this study were 167 senior nursing students who understood purpose of this study and accepted to participate in. The Pediatric Nurses' Knowledge and Attitude Survey regarding Pain (PNKAS) was used to measure knowledge toward children's pain management. Data were collected from December 15 to December 30, 2012. Results: The overall percentage of correct answer was 56%. The pain assessment scale and non-pharmacological pain intervention which senior nursing students used in most were face pain rating scale (94.6%, n=158/167) and emotional support (93.4%, n=156/167). Significant differences were found in self-efficacy scores between above-average group of knowledge score. Conclusion: This study showed that undergraduate nursing students had a lack of knowledge for children's pain management. There is a need for more detailed educational program in the area of children's pain management.
Purpose: The purposes of this study were to explore knowledge, barriers, and self-efficacy in relation to pain management practice, and to identify factors influencing pain management practice in pediatric nurses. Methods: A descriptive correlational study was conducted. The participants were 237 pediatric nurses from a metropolitan city. Data were analyzed using t-test or analysis of variance and Pearson correlation and multiple regression analyses. Results: The mean percentage of correct answers on the children's pain management knowledge scale was 58.8%. Child and parent related factors were the main barriers for pain management. Self-efficacy to assess children's pain across developmental stages was particularly low. Pain management practices for assessing pain and non-pharmacological interventions were relatively low. Factors significantly affecting children's pain management practice were current conditions of work department and self-efficacy in pain management, and these factors accounted for 37.5% of the variance in pain management practice. Conclusion: The results suggest that an integrative education program needs to be developed to improve self-efficacy in children's pain management practice. Moreover, good communication, building cooperative relationships with children and parents, and a more active role by pediatric nurses are required to carry out more effective pain management.
Purpose: The purpose of this study was to investigate the effect on pain of distraction with an operating doll in preschool children(3-6 years old) during an IV catheter insertion. Method: The research design was a nonequivalent control group posttest design, and the participants were 22 children in the experimental group, and 23 children in the control group. The children were hospitalized for enteritis and pharyngitis in a university hospital. The subjective pain was measured using FACES Pain Rating Scale by self report, and the pain behavior responses were scored using Procedure Behavior Check List by observing a film of the entire procedure, and changes in pulse and oxygen saturation as the physiological pain responses were measured by pulse oximeter. Data were analyzed with the SPSS Win 10.0 program. Result: The degree of subjective pain, pain behavior responses, and changes in pulse during IV catheter insertion were significantly lower in the experimental group. But there was no significant difference in $O_2$ saturation between the two groups. Conclusion: Distraction using an operating doll was effective in decreasing pain during inserting the IV catheter in preschool children.
Purpose: The purpose of this study was to investigate effect of distraction by use of a cellular phone on pain and fear during venipuncture procedure for hospitalized preschool children. Method: Fifty four preschool children aged 3-6 were recruited from one university affiliated hospital in Daegu. Participants were assigned to the control(n=27) to receive usual care or intervention group(n=27) to receive distraction plus usual care. For the assessment of children's pain, FACE scale and mothers' perceptions of their own children's pain, visual analogue scale(VAS) were used. For the assessment of fear, Procedure Behavioral checklist developed by Lebaron and Zeltzer was used. Results: Results showed that intervention group demonstrated significantly less pain scores on FACE(t=2.19, p<.03) as rated by children and on VAS(t=2.78, p<.01) as rated by their mothers. Intervention group showed also significantly less fear scores(t=2.30, p<.02) as rated by the researcher. Conclusion: Distraction with cell phone for relieving pain and fear during venipuncture procedure was effective for the hospitalized preschool children.
Purpose: The purpose of this study was to examine the nurses' knowledge and attitude to pain management in children and explore the status of pain management in clinical practice. Method: The subjects were 131 nurses enrolled in 3 university affiliated hospitals. Questionnaire method was utilized for data collection. Data was analyzed by SPSS statistical program. Result: The result was as follows: 1. The overall mean score of the pain knowledge was 16.88 (58.2%). The percentages of correct response in test subsections were pain assessment 45.5, choice of medication and drug action 48.7, and pain statement 79.6 respectively. 2. 70.3% of the nurses agreed or strongly agreed that the procedural pain should always be eliminated. And, 44.3% of the nurses agreed or strongly agreed that post-operative treatment of pain in children should always aim at eliminating the pain completely. 3. There was a significant relationship between pain attitude and knowledge related facts about pain(r=.217, p<.01). 4. When asked to identify the point of self-reported pain on a 0-10 scale at which the nurse would give medication, point 7 was mostly identified (29%). 5. Only 19.8% of the nurses utilized pain rating scale to assess children's pain. 6. The nonpharmacologic interventions nurses used most were position change, emotional support, and massage. 7. 68.7% of the nurses indicated that they learned about pain management from their current working environment. Also, Mostly helpful resource identified in increasing their pain management knowledge and skills was the continuing education program. Conclusion: The findings showed that there was a need to develop educational program for adequate pain management for children. Further research study is recommended to examine the effectiveness of the intervention methods for children's pain.
The purpose of this study was to evaluate the effect of informational intervention on postoperative pain following tonsillectomy in children. This study was performed on 30 children, aged 5-15 years, undergoing tonsillectomy and their parents by providing informational intervention with colored figure; operation procedure and information. Pain assessment was done by Pain Questionnaire. The results from this study were as follows : 1. Children in experimental group with mean 16.07 had lower pain scores than control group with mean 14.87 at 4th hours after operation(p<0.05). It showed 'significant difference' and first hypothesis was adopted. 2. Children in experimental group with mean 20.60 had lower pain scores than control group with mean 17.27 at 8th hours after operation(p<0.05). It showed 'significant difference' and second hypothesis was adopted. 3. Children in experimental group with mean 28.80 had lower pain scores than control group with mean 25.70 at 24th hours after operation(p<0.05). It showed 'significant difference' and third hypothesis was adopted. 4. When we analyzed the time difference and difference between two groups simultaneously by repeated measure ANOVA, the significant difference was not found. And so 'the experiential group with operation-related information will show the lower pain sense than the control group just as the time flows after operation', fourth hypothesis was rejected. Generally, it was found that providing information about operation to children and their parents reduced effectively postoperative pain in children, but in clinical settings there are minimum preoperative information-providing because of insufficient time and inconvenience although nursing staffs and patients know its needs. Conclusionally providing preoperative information should help children and their parents cope with Pre, Peri and Post operative events effectively.
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