Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto;
Can J Infect Dis Med Microbiol. 2011 Summer;22(2):43-8. doi: 10.1155/2011/381864.
Despite the availability of a variety of evidence-based interventions, it has previously been reported that the majority of infants and children undergo vaccine injections without the benefit of analgesia. Nurses in public health administer a substantial number of injections; however, their attitudes and practices surrounding acute pain during vaccine injections have not been previously explored.
A focus-group interview was conducted in Toronto, Ontario, with 10 nurses who immunize children. Participants reported their perceptions and practices with regard to vaccine injection pain and pain management.
THREE KEY THEMES EMERGED: environmental and process factors, perceptions regarding the effectiveness of different analgesic interventions, and perceptions regarding pain and fear. Participants reported a lack of control over their environment, resulting in fear and discomfort for children. They recommended increased support from external partners such as school teachers and administrators. Participants reported that pharmacological interventions, such as topical local anesthetics, were not used; however, psychological and physical interventions were commonly used. Nurses questioned the effectiveness of topical anesthetics, and indicated that more education was required regarding effective analgesic interventions. Needle pain was reported to be the most prominent concern for children undergoing vaccine injections, and children were described as being fearful.
Nurses reported vaccination setting, analgesic effectiveness and relative importance given to pain as important factors for pain and pain management during vaccine injections. Future studies should explore whether additional perspectives are present in vaccinators in other geographical regions. The effectiveness of educational resources and pain management programs aimed at improving current practices should be investigated.
尽管有各种基于证据的干预措施，但此前有报道称，大多数婴儿和儿童在接受疫苗注射时并未受益于镇痛。公共卫生护士接种了大量疫苗；然而，他们在疫苗接种过程中对急性疼痛的态度和做法尚未得到探索。
在安大略省多伦多市对 10 名为儿童接种疫苗的护士进行了焦点小组访谈。参与者报告了他们对疫苗注射疼痛和疼痛管理的看法和做法。
出现了三个关键主题：环境和过程因素、对不同镇痛干预措施效果的看法以及对疼痛和恐惧的看法。参与者报告说他们对环境缺乏控制，导致儿童感到恐惧和不适。他们建议增加来自学校教师和管理人员等外部合作伙伴的支持。参与者报告说，未使用局部麻醉剂等药物干预措施；然而，心理和身体干预措施通常被使用。护士质疑局部麻醉剂的有效性，并表示需要更多关于有效镇痛干预措施的教育。针刺痛被报告为儿童接受疫苗注射时最突出的关注点，并且描述了儿童感到恐惧。
护士报告了疫苗接种环境、镇痛效果以及对疼痛的相对重视，这些是疫苗接种过程中疼痛和疼痛管理的重要因素。未来的研究应探讨在其他地理区域的接种者中是否存在其他观点。应研究旨在改善当前实践的教育资源和疼痛管理计划的有效性。
