Clinical practices and barriers for pain management induced by injection in children: a cross-sectional from Palestine
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Date
2021-08-29
Authors
Nihal Y. Azzam
Tala A. Jalamnah
Areen N. Zuhour
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Abstract
Background
An efficient pain control is needed to provide an effective and improved clinical practice in the pediatric field, which depends on good knowledge and practice of pain management strategies during injections. In this study, we focused on assessing the practices and the level of knowledge in correlation to managing pain induced by injection and determining the barriers to effective injection pain control among child patients that face nurses in Palestine.
Methods
A convenience sample of 250 nurses in private/public hospitals and primary health care centers in Northern West Bank was handled in a cross-sectional design. A questionnaire was developed to be distributed among those nurses to assess practices, knowledge, and barriers correlated with injection-induced pain control among the child and patients.
Results:
Totally, 250 questionnaires were filled by nurses with a response rate of 100%. The mean age of Participants’ was 31.5 years. In total, 65.5% of the respondents worked in governmental hospitals, 28% of them worked in private hospitals, the remnant of them were employed in both private and governmental departments. The rate of response that was answered correctly to questions that were planned to assess knowledge in correlation to the management of injection-induced pain was estimated, and then the mean of the knowledge score was found to be 7.78±1.95. The sample characteristics and knowledge score were linked in a relationship, which exhibited that the higher score was for males (p = 0.044), and the median score was 8 [7–9] and 8 [6.25–9] for males and females, respectively. It also showed that those nurses who are working in governmental hospitals scored significantly higher (p = .025) than those who are working in private hospitals or in both of them, with a median score of 8 [7-9], 8 [6-9] and 7 [5.5-8] for governmental hospitals workers, private hospitals workers and both of them, respectively. Inadequate staff (75.2%), restricted amount of several types of topical analgesia (68.8%), and time constraints (67.6%) were the most numerous mentioned barriers. Distraction strategies were frequently used and seemed to be the most familiar ones for managing injection-induced pain. Other techniques that were always used by approximately half of the respondents were using different anatomical sites (arms, legs, buttocks) and using different needle aspects (length, gauge, and angle of insertion) for each age group. However, topical analgesia and sweet solutions were not common methods to manage injection-induced pain in any age group.
Conclusions
This study helped us in recognizing the barriers and the knowledge deficits to effective management of injection-induced pain. However, the investigation has displayed a significant pain management strategies practiced by nurses in Palestine. The deficits in knowledge showed that more education about the importance and how to manage injection-induced pain is needed among nurses. In addition, adequate staff seems to play a crucial role in implementing many injection-induced pain management practices, as inadequate staff and time constraints were cited as the most perceived barriers by nurses.
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Keywords
Injection, Pain, Nurses, Knowledge, Management, Practice, Attitude, Children, Barriers.