Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Norway; Institute of Health and Society, University of Oslo, Norway.
Children and Young People's Nursing School of Health, The Open University, UK.
Pain Manag Nurs. 2022 Aug;23(4):430-442. doi: 10.1016/j.pmn.2021.09.007. Epub 2021 Nov 23.
Pediatric postoperative pain is still undertreated.
To assess whether educational intervention increases nurses' knowledge and improves pediatric postoperative pain management.
Cluster randomized controlled trial with three measurement points (baseline T1, 1 month after intervention T2, and 6 months after intervention T3).
PARTICIPANTS/SUBJECTS: The study was conducted in postanesthesia care units at six hospitals in Norway. Nurses working with children in the included units and children who were undergoing surgery were invited to participate in this study.
Nurses were cluster randomized by units to an intervention (n = 129) or a control group (n = 129). This allocation was blinded for participants at baseline. Data were collected using "The Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain: Norwegian Version" (primary outcome), observations of nurses' clinical practice, and interviews with children. The intervention included an educational day, clinical supervision, and reminders.
At baseline 193 nurses completed the survey (75% response rate), 143 responded at T2, and 107 at T3. Observations of nurses' (n = 138) clinical practice included 588 children, and 38 children were interviewed. The knowledge level increased from T1 to T3 in both groups, but there was no statistically significant difference between the groups. In the intervention group, there was an improvement between T1 and T2 in the total PNKAS-N score (70% vs. 83%), observed increase use of pain assessment tools (17% vs. 39%), and children experienced less moderate-to-severe pain.
No significant difference was observed between the groups after intervention, but a positive change in knowledge and practice was revealed in both groups. Additional studies are needed to explore the most potent variables to strengthen pediatric postoperative pain management.
儿科术后疼痛仍未得到充分治疗。
评估教育干预是否能提高护士的知识水平并改善儿科术后疼痛管理。
三测点（基线 T1、干预后 1 个月 T2 和干预后 6 个月 T3）的群组随机对照试验。
参与者/受试者：本研究在挪威六家医院的麻醉后护理病房进行。邀请参与该研究的包括在纳入单位工作的儿童护理护士和正在接受手术的儿童。
根据单位，护士被群组随机分配到干预组（n=129）或对照组（n=129）。在基线时，参与者对分组情况不知情。数据收集采用“挪威版儿科护士疼痛知识和态度调查”（主要结局）、护士临床实践观察和儿童访谈。干预包括教育日、临床监督和提醒。
基线时 193 名护士完成了调查（75%的应答率），143 名护士在 T2 时回复，107 名护士在 T3 时回复。对护士（n=138）临床实践的观察包括 588 名儿童，有 38 名儿童接受了访谈。两组护士的知识水平均从 T1 提高到 T3，但组间无统计学差异。在干预组，T1 到 T2 时，PNKAS-N 总分（70% vs. 83%）、观察到疼痛评估工具的使用增加（17% vs. 39%）以及儿童经历的中重度疼痛减少，均有显著改善。
干预后两组之间没有观察到显著差异，但两组的知识和实践都有积极变化。需要进一步研究以探索增强儿科术后疼痛管理的最有效变量。
