Genik Lara M, McMurtry C Meghan, Breau Lynn M, Lewis Stephen P, Freedman-Kalchman Tamlyn
Department of Psychology, University of Guelph, Guelph.
Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton.
Clin J Pain. 2018 May;34(5):428-437. doi: 10.1097/AJP.0000000000000554.
Pain in children with intellectual disabilities (ID) is common and complex, yet there is no standard pain training for their secondary caregivers (ie, respite staff).
Determine perceived pain training needs/preferences of children's respite staff (phase 1) and, use this information combined with extant research and guidelines to develop and pilot a training (phase 2).
In phase 1, 22 participants responded to questionnaires and engaged in individual interviews/focus groups about their experiences with pain in children with ID, and perceived training needs/preferences. In phase 2, 50 participants completed knowledge measures and rated the feasibility of, and their own confidence and skill in, pain assessment and management for children with ID immediately before and after completing a pain training. They also completed a training evaluation.
Participants viewed pain training as beneficial. Their ideal training involved a half-day, multifaceted in-person program with a relatively small group of trainees incorporating a variety of learning activities, and an emphasis on active learning. Phase 2 results suggested that completion of the 3 to 3.5-hour pain training significantly increased respite workers' pain-related knowledge (effect sizes: r=0.81 to 0.88), as well as their ratings of the feasibility of, and their own confidence and skill in, pain assessment and management in children with ID (effect sizes: r=0.41 to 0.70). The training was rated favorably.
Training can positively impact respite workers' knowledge and perceptions about pain assessment and management. As such, they may be better equipped to care for children with ID in this area.
智障儿童的疼痛很常见且复杂,但对于他们的二级照料者(即临时照料人员)而言,尚无标准的疼痛培训。
确定儿童临时照料人员感知到的疼痛培训需求/偏好(第一阶段),并结合现有研究和指南,利用这些信息来开发并试行一项培训(第二阶段)。
在第一阶段,22名参与者回答了问卷,并就他们在智障儿童疼痛方面的经历以及感知到的培训需求/偏好进行了个人访谈/焦点小组讨论。在第二阶段,50名参与者完成了知识测评,并在完成疼痛培训之前和之后,立即对智障儿童疼痛评估和管理的可行性、自身信心及技能进行了评分。他们还完成了一项培训评估。
参与者认为疼痛培训有益。他们理想的培训是一个为期半天的、多方面的面对面培训项目,培训学员相对较少,包含各种学习活动,并强调主动学习。第二阶段的结果表明,完成3至3.5小时的疼痛培训显著增加了临时照料人员与疼痛相关的知识(效应量:r = 0.81至0.88),以及他们对智障儿童疼痛评估和管理的可行性、自身信心及技能的评分(效应量:r = 0.41至0.70)。该培训获得了好评。
培训可对临时照料人员关于疼痛评估和管理的知识及认知产生积极影响。因此,他们在这方面可能更有能力照料智障儿童。