Establishiment And Application Of An Evidence-based Pain Management Training Program For Children

Pain can bring a series of short-term and long-term adverse effects,but it is inevitable that hospitalized children will suffer from various kinds of pain stimulation.A survey shows that the ability of pediatric nurses in evidence-based pain management has problems in theory and practice.In order to improve the pediatric health care workers’ ability of evidence-based pain management,we will construct an evidence-based pain training program to promote the attention of medical staff to children’s pain,and to ease pain of hospitalized children.Objectives:(1)To investigate the knowledge and attitude of medical staff in pain and evidence-based practice,and to provide guidance for the formulation of evidence-based pain training program.(2)To construct an evidence-based pain training program for children.(3)To implement the evidence-based pain training program and evaluate the training effect.Methods:(1)Questionnaire survey was conducted to investigate the pain and evidence-based practice knowledge and attitude of doctors and nurses in 4 wards with different characteristics(acute,chronic pain and pain of children in different ages): intensive care unit(ICU),orthopaedic department,neonatal department and hematological oncology department.The questionnaire consists of three parts: the generally information,the evidence-base practice questionnaire(EBPQ),and the pediatric nurses’ knowledge and attitude survey regarding pain(PNKAS).(2)Based on the content analysis of clinical practice guidelines on pediatric pain management results,the framework of training program was formed.The relevant literature on children’s pain was comprehensively searched and analyzed,and the framework was supplemented and improved.Then,the evidencebased pain training program for children was formed through focus group interviews.According to the standard process of test paper preparation,the test paper is constructed for training effect evaluation.(3)Subjects were assigned into an experimental group and a control group.Before the training,the experimental group and the control group were issued with A version of examination paper.The training group participated in the whole training,while the control group did not.After the training,the experimental group and the control group were issued with B version of examination paper.Results:(1)For medical staff,the average score of the EBPQ was 4.18 + 1.27,of the evidence-based behavior dimension was 4.09±1.37,of the evidence-based attitude dimension was 4.54±1.26,and of the evidence-based knowledge dimension was 4.09±1.19.The score of PNKAS was 17.78±3.53,and the correct rate was 42%.The correct rate of the concept of pain,pain assessment,analgesic and analgesic measures dimensions were 50%,18%,43% and 37%,respectively.(2)The pain training program trains doctors and nurses.The training includes five modules: overview of children’s pain,evaluation of children’s pain,non-drug intervention of children’s pain,drug intervention of children’s pain and evidence-based basic knowledge.The training method is a combination of multimedia teaching and case discussion.Five courses were set up to teach five modules of the training content.The training effect was evaluated by using the self-made evidence-based pain knowledge test paper for children and the training course satisfaction evaluation questionnaire.(3)The score of the experimental group before the training were 60.87±10.56,and those of the control group were 60.49±8.82.There was no statistically significant difference in the scores of the training group and the control group(t=0.414,p > 0.05).After the training,the score of the experimental group were xx,and those of the control group were 83.73±14.97.The difference in scores between the experimental group and the control group was statistically significant(t=18.416,p=0.000).Paired t test results showed that the test paper scores of the training group before and after the training were statistically significant(t=19.935,p=0.000),and so did the control group(t=2.433,p=0.016).The t-test of independent samples was used to compare the differences value of test scores between the two groups before and after the training,and the results showed that the differences were statistically significant(t=12.01,p=0.000).Conclusion:(1)The doctors and nurses are lack of pain and evidencebased practice knowledge and attitude.Training courses are needed to improve the evidence-based pain management ability of the medical staff.(2)The evidence-based pain training program for children can be used for healthcare workers.(3)The evidence-based pain training program can effectively improve medical staff’s pain and evidence-based knowledge.