Mothers’ experiences of managing their child's pain before and during attendance at the emergency department

Edmonds, Jenny; Twycross, Alison

doi:10.1111/jocn.14322

Cited by 5 publications

(3 citation statements)

References 42 publications

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“…Untreated pain contributes to the morbidity and mortality in surgical trauma (Verghese & Hannallah, ). For children requiring acute care, and their parents, pain is a significant concern (Edmonds & Twycross, ). Children and parent concerns are not unfounded, as we know from the literature that children are still experiencing unnecessary pain while in hospital (Birnie et al, ; Shrestha‐Ranjit & Manias, ; Simons, ; Walther‐Larsen et al, ).…”

Section: Introductionmentioning

confidence: 99%

Tokenism or true partnership: Parental involvement in a child’s acute pain care

Smith

Kirshbaum

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To explore parental involvement in the child's acute pain care and establish ways in which parental preferences for involvement in their child's care can be identified, facilitated and enhanced by nurses. Background Despite growing evidence supporting effective acute pain management in children and the availability of national and international practice guidelines, children still experience acute pain. Involving parents in their child's pain care has been identified as being a central tenet of pain management in children. Design and methods A qualitative study using an ethnographical approach with nonparticipant observation and follow‐up semi‐structured interviews was undertaken. Nurses (n = 14), parents (n = 41), grandparents (n = 2), other relative (n = 1) and children (n = 30) participated. The framework approach underpinned data analysis. Consolidated criteria for reporting qualitative research (COREQ) enabled comprehensive reporting of the study. Results Three concepts emerged from the data: “parents as advocates for their child,” “nurses promoting involvement and partnership” and “nurses unintentionally preventing involvement and partnership.” Variations in the way parents were involved in their child's pain care were identified. Despite family‐centred care being the dominant model of involving families in their child's care, evidence of this being implemented was limited. Parents attempted to advocate effective pain care for their child, whether or not they were supported by nurses. Conclusions Parental involvement in their child's acute pain care can improve the child's pain experience, reduce parental anxiety and increase parents’ satisfaction in care. Nurses aspired to involve parents in pain care, but did not always enact this in practice. Relevance for practice Children deserve optimum pain care, which includes parental involvement. Parental involvement underpinned by the principles of family‐centred care was poorly implemented. Parents attempted to be involved and advocate for their child's pain care whether or not they were supported by nurses. An alternative approach for supporting parents to advocate in their child's acute pain care is offered, the “Partnership in Pain Care Model.”

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Section: Introductionmentioning

confidence: 99%

Tokenism or true partnership: Parental involvement in a child’s acute pain care

Smith

Kirshbaum

et al. 2019

Journal of Clinical Nursing

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“…Moreover, it can prevent or limit medical staff from prescribing an adequate analgesia during painful procedures. Besides, parents can be affected by their children’s distress, or their stressful behaviour can increase distress and pain in their children [10,11].…”

Section: Introductionmentioning

confidence: 99%

Paediatric Pain Medicine: Pain Differences, Recognition and Coping Acute Procedural Pain in Paediatric Emergency Room

Pancekauskaitė

Jankauskaitė

2018

Medicina

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Paediatric pain and its assessment and management are challenging for medical professionals, especially in an urgent care environment. Patients in a paediatric emergency room (PER) often undergo painful procedures which are an additional source of distress, anxiety, and pain. Paediatric procedural pain is often underestimated and neglected because of various myths, beliefs, and difficulties in its evaluation and treatment. However, it is very different from other origins of pain as it can be preventable. It is known that neonates and children can feel pain and that it has long-term effects that last through childhood into adulthood. There are a variety of pain assessment tools for children and they should be chosen according to the patient’s age, developmental stage, communication skills, and medical condition. Psychological factors such as PER environment, preprocedural preparation, and parental involvement should also be considered. There are proven methods to reduce a patient’s pain and anxiety during different procedures in PER. Distraction techniques such as music, videogames, virtual reality, or simple talk about movies, friends, or hobbies as well as cutaneous stimulation, vibration, cooling sprays, or devices are effective to alleviate procedural pain and anxiety. A choice of distraction technique should be individualized, selecting children who could benefit from nonpharmacological pain treatment methods or tools. Nonpharmacological pain management may reduce dosage of pain medication or exclude pharmacological pain management. Most nonpharmacological treatment methods are cheap, easily accessible, and safe to use on every child, so it should always be a first choice when planning a patient’s care. The aim of this review is to provide a summary of paediatric pain features, along with their physiology, assessment, management, and to highlight the importance and efficacy of nonpharmacological pain management in an urgent paediatric care setting.

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“…Pain in children is different from that witch experienced in adult [10], variations are also noted in children according age; young children cannot verbalize their pain experience [12]. Besides, parents can be affected by their children pain and increase children's anxiety [13], [14].…”

Section: Discussionmentioning

confidence: 98%

Pain Management in Children with Cancer: National Surveys of Practices and Perceptions in Morocco

Khoubila

Bendari

Benmiloud

et al. 2020

Open Access Maced J Med Sci

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AIM: The aim of the study was to improve the quality of pain management in Moroccan pediatric oncology units, the Moroccan Society of Paediatric Haematology/Oncology initiated a national quality improvement project in 2014 with the support of the Lalla Salma Foundation for Prevention and Treatment of Cancer. METHODS: To assess the current situation of pain management in Moroccan pediatric oncology patients, two cross-sectional surveys were conducted, involving patient/parental proxies and health-care providers’. RESULTS: The first survey concerned 108 care providers from five institutions. The second survey covered 155 children with cancer from the five Moroccan pediatric oncology units. Among them, 145 reported suffering from pain, which patients/families attributed to the underlying cancer (n = 85), to procedures and treatment (n = 46), or to both the cancer and procedures/treatment (n = 19). Procedural pain was mainly related to lumbar puncture and bone marrow aspirate. The majority of patients/parents reported that pain negatively impacted their emotional, physical, and social functioning. The majority of parents requested further information and communication about pain management. CONCLUSION: Both health-care providers and families of children with cancer in Morocco report need for pain management improvement, including in institutional and educational practices. This current baseline data have informed the development of our ongoing project including continuing education, training, and practice policies development.

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Mothers’ experiences of managing their child's pain before and during attendance at the emergency department

Abstract: The results suggest that mothers need additional resources to enable them to manage their child's pain at home following an injury. The reasons mothers attend the emergency department rather than other healthcare providers need exploring in more depth.

Cited by 5 publications

References 42 publications

Tokenism or true partnership: Parental involvement in a child’s acute pain care

Tokenism or true partnership: Parental involvement in a child’s acute pain care

Paediatric Pain Medicine: Pain Differences, Recognition and Coping Acute Procedural Pain in Paediatric Emergency Room

Pain Management in Children with Cancer: National Surveys of Practices and Perceptions in Morocco

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