Atefeh Shamsi
Nursing Care Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
BMC Anesthesiol. 2025 Apr 1;25(1):148. doi: 10.1186/s12871-025-02941-2.
Effective pain management in pediatric care is essential to safeguarding the well-being and recovery of children; however, numerous barriers impede optimal pain relief. Identifying and understanding these barriers, along with facilitators that enhance care, is crucial for advancing clinical practices and patient outcomes. This study presented a comprehensive scoping review of the barriers and facilitators to pediatric pain management, synthesizing findings from research published between 2014 and 2024 to inform evidence-based clinical strategies. A systematic search was conducted using key terms such as "pain management," "children," "barriers," and "facilitators" across PubMed, ProQuest, Web of Science, and Scopus databases, focusing on English-language articles.The review identified several key barriers to effective pediatric pain management, including deficits in provider knowledge and training, organizational and structural limitations, medication and prescription challenges, environmental and situational constraints, communication gaps, technological barriers, parental factors, policy and systemic issues, logistical difficulties, and context-specific limitations. Conversely, facilitators emerged as essential components for improvement, including professional initiatives by healthcare providers, structural and organizational enhancements, family engagement, targeted educational and training interventions, technological innovations, procedural improvements, remote and virtual care adaptations, policy enhancements, and supportive interprofessional relationships.Addressing these multifaceted barriers requires a holistic approach that integrates enhanced education, organizational support, technological development, and active family involvement. Implementing these facilitators has the potential to significantly improve pain management practices, promoting a higher standard of care and quality of life for pediatric patients.
在儿科护理中进行有效的疼痛管理对于保障儿童的福祉和康复至关重要;然而,众多障碍阻碍了最佳疼痛缓解。识别并理解这些障碍以及促进护理的因素,对于推进临床实践和改善患者预后至关重要。本研究对儿科疼痛管理的障碍和促进因素进行了全面的范围综述,综合了2014年至2024年发表的研究结果,以为循证临床策略提供信息。使用“疼痛管理”、“儿童”、“障碍”和“促进因素”等关键词在PubMed、ProQuest、Web of Science和Scopus数据库中进行了系统检索,重点关注英文文章。该综述确定了有效儿科疼痛管理的几个关键障碍,包括提供者知识和培训的不足、组织和结构限制、药物和处方挑战、环境和情境限制、沟通差距、技术障碍、家长因素、政策和系统问题、后勤困难以及特定情境限制。相反,促进因素成为改善的重要组成部分,包括医疗保健提供者的专业举措、结构和组织的改进、家庭参与、有针对性的教育和培训干预、技术创新、程序改进、远程和虚拟护理适应、政策改进以及支持性的跨专业关系。应对这些多方面的障碍需要一种整体方法,将强化教育、组织支持、技术发展和家庭积极参与整合起来。实施这些促进因素有可能显著改善疼痛管理实践,为儿科患者提升护理标准和生活质量。