Peirce Deborah, Corkish Victoria, Lane Margie, Wilson Sally
Princess Margaret Hospital for Children, Child and Adolescent Health Service, Perth, Western Australia; School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia.
Princess Margaret Hospital for Children, Child and Adolescent Health Service, Perth, Western Australia.
Pain Manag Nurs. 2018 Dec;19(6):707-717. doi: 10.1016/j.pmn.2018.03.002.
Despite clinical guidelines, suboptimal pediatric pain management persists. A local audit found poor guideline compliance. Inadequate knowledge is a recognized barrier to the delivery of evidence-based care. The aim of the study was to investigate nurses' knowledge and attitudes regarding pain management at an Australian tertiary pediatric hospital. Design, Setting, Participants and Method: A cross-sectional, descriptive study using the Pediatric Pain Knowledge and Attitudes Questionnaire (Revised) was distributed to 590 nurses in an Australian pediatric hospital.
The mean knowledge score (n = 201) was 77.56 out of 100 (range 49.82-94.16, standard deviation [SD] 8.55); mean attitude score (n = 229) was 72.46 out of 100 (range 33.33-93.33, SD 11.76). Significant differences in mean knowledge scores were found between nurses' designations (p = .018), with the greatest mean difference (MD) between clinical nurses and enrolled nurses (10.5; p = .002). Nurses with experience in critical care had significantly higher mean knowledge scores (MD 3.1; p = .012). Senior registered nurses had the most positive mean attitude score (82.4, SD 6.2), which was significantly higher than clinical nurses (73.77, SD 10.0), registered nurses (71.64, SD 12.6), and enrolled nurses (68.89, SD 8.8) (p < .05). Nurses with specialist pediatric qualifications had significantly more positive attitude scores (mean 75.65, SD 11.6) than those without (mean 70.86, SD 11.7; p = .005). However, 51% of respondents believed that children tolerate pain better than adults do.
Although nurses' overall knowledge and attitude toward pediatric pain were among the highest reported, areas for targeted education using in-service education and workshops were identified alongside a need for exploration of the impediments to providing best care.
尽管有临床指南,但儿科疼痛管理仍未达到最佳状态。一项本地审计发现指南依从性较差。知识不足是提供循证护理的公认障碍。本研究的目的是调查澳大利亚一家三级儿科医院护士对疼痛管理的知识和态度。设计、设置、参与者与方法:采用《儿科疼痛知识与态度问卷(修订版)》进行的一项横断面描述性研究,向澳大利亚一家儿科医院的590名护士发放问卷。
平均知识得分(n = 201)为100分中的77.56分(范围49.82 - 94.16,标准差[SD] 8.55);平均态度得分(n = 229)为100分中的72.46分(范围33.33 - 93.33,SD 11.76)。护士职称之间的平均知识得分存在显著差异(p = 0.018),临床护士与注册护士之间的平均差异最大(MD)(10.5;p = 0.002)。有重症监护经验的护士平均知识得分显著更高(MD 3.1;p = 0.012)。高级注册护士的平均态度得分最积极(82.4,SD 6.2),显著高于临床护士(73.77,SD 10.0)、注册护士(71.64,SD 12.6)和注册护士(68.89,SD 8.8)(p < 0.05)。具有儿科专业资质的护士态度得分明显更积极(平均75.65,SD 11.6),高于没有该资质的护士(平均70.86,SD 11.7;p = 0.005)。然而,51%的受访者认为儿童比成人更能耐受疼痛。
尽管护士对儿科疼痛的总体知识和态度在已报道的情况中处于较高水平,但通过在职教育和研讨会确定了需要有针对性教育的领域,同时需要探索提供最佳护理的障碍。