Original Article Review of Pain Content in Three-Year Preregistration Pediatric Nursing Courses in the United Kingdom ---
-
From the Faculty of Health and Social Care Sciences, Kingston University and St George’s University of London, London, United Kingdom. Address correspondence to Alison Twycross, PhD, Faculty of Health and Social Care Sciences, Kingston University and St George’s University of London, Grosvenor Wing, Cranmer Terrace, London, SW17 0RE UK. E-mail: a.twycross@ sgul.kingston.ac.uk Received November 22, 2010; Revised May 10, 2011; Accepted May 10, 2011. 1524-9042/$36.00 Ó 2013 by the American Society for Pain Management Nursing http://dx.doi.org/10.1016/ j.pmn.2011.05.002
Alison Twycross, PhD, and Lynda Roderique, PhD
ABSTRACT:
The results of several studies suggest that gaps remain in nurses’ knowledge about pain in children, and particularly regarding pain assessment, analgesic drugs, and nondrug methods, suggesting a need to explore the pain content of preregistration nursing curricula. Over the past decade, the way nurse education is delivered has changed with the advent of the internet and the use of virtual learning environments. This study, therefore, explored the depth and breadth of pain content in 3-year preregistration pediatric nursing courses across the U.K. as well as ascertaining how this content is delivered. The leads for pediatric nursing at all 56 U.K. higher education institutions running the 3-year preregistration pediatric nursing course were e-mailed a questionnaire. Participants were asked to indicate whether topics are covered in the program, and if so how it was delivered. Results suggest that preregistration pediatric nursing courses in the U.K. do not always equip students to manage pain effectively in clinical practice. There appears to be limited content on pain in nursing curricula, with several institutions not covering key topics. Most teaching is delivered face to face with limited workbooks and virtual learning activities. Further research is needed in this area to ascertain the impact of this on the quality of care provided. Ó 2013 by the American Society for Pain Management Nursing The evidence to guide nurses’ pain management practices is readily available. However, pediatric nurses’ pain management practices continue to be suboptimal and fall short of the ideal (Polkki, Pietila, & Vehvilamen-Julkunen, 2003; Twycross, 2007a; Vincent & Denyes, 2004) with children experiencing moderate to severe unrelieved pain (Johnston, Gagnon, Pepler, & Bourgault, 2005; Taylor, Boyer, & Campbell, 2008; Vincent & Denyes, 2004). Insufficient knowledge about managing pain in children has been suggested as one reason that nurses do not manage pain effectively. Seven studies have examined pediatric nurses’ theoretic knowledge about pain management in children. A study carried out with pediatric oncology nurses (n ¼ 106) in the U.S. found a lack of understanding of the basic pharmacologic Pain Management Nursing, Vol 14, No 4 (December), 2013: pp 247-258
248
Twycross and Roderique
principles regarding analgesic drugs, such as the effects and side effects (Schmidt, Eland, & Weller, 1994). In Salantera, Lauri, Salmi, and Helenius’ (1999) study on pain management, a knowledge questionnaire was completed by pediatric nurses (n ¼ 265) in Finland; gaps were found in nurses’ knowledge about managing pain in children regarding analgesic drugs and nondrug methods of pain relief. Final-year student nurses (n ¼ 73) also completed the questionnaire and demonstrated knowledge deficits regarding analgesic drugs and pain assessment (Salantera & Lauri, 2000). Twycross (2004) used a modified version of Salantera’s questionnaire (n ¼ 12) and found that English nurses had gaps in their knowledge; these were particularly noticeable regarding analgesic drugs and nondrug methods for relieving pain, as well as the physiology, psychology, and sociology of pain. The Pediatric Nurses’ Knowledge and Attitudes Regarding Pain Survey was completed by nurses in the United States (n ¼ 274) in Manworren’s (2000) study. The mean score for the questionnaire was only 66%, with knowledge deficits apparent in many areas, including pain assessment, the pharmacology of analgesic drugs, the use of analgesic drugs, and nondrug methods. Nurses (n ¼ 67) completed an adapted version of the Nurses’ Knowledge and Attitudes Regarding Pain Survey in Vincent’s (2005) study undertaken in the U.S. Pediatric nurses had knowledge deficits regarding nondrug methods of pain relief, analgesic drugs, and the incidence of respiratory depression. Rieman and Gordon (2007) surveyed pediatric nurses (n ¼ 295) working in Shriners’ Hospitals in the U.S. with the use of a revised version of the Pediatric Nurses’ Knowledge and Attitudes Regarding Pain Survey. The mean survey score was 74%. The ten questions answered incorrectly by most participants related to pharmacology and its relationship to the incidence of respiratory depression. The results of these studies suggest that gaps remain in nurses’ knowledge about pain in children, particularly regarding pain assessment, analgesic drugs, and nondrug methods. These gaps in knowledge suggest that there is a need to explore the pain content of preregistration nursing curricula. Three earlier studies have explored this. A review of pain content in preregistration diploma courses in England found that most pediatric nursing curricula included
-
From the Faculty of Health and Social Care Sciences, Kingston University and St George’s University of London, London, United Kingdom. Address correspondence to Alison Twycross, PhD, Faculty of Health and Social Care Sciences, Kingston University and St George’s University of London, Grosvenor Wing, Cranmer Terrace, London, SW17 0RE UK. E-mail: a.twycross@ sgul.kingston.ac.uk Received November 22, 2010; Revised May 10, 2011; Accepted May 10, 2011. 1524-9042/$36.00 Ó 2013 by the American Society for Pain Management Nursing http://dx.doi.org/10.1016/ j.pmn.2011.05.002
Alison Twycross, PhD, and Lynda Roderique, PhD
ABSTRACT:
The results of several studies suggest that gaps remain in nurses’ knowledge about pain in children, and particularly regarding pain assessment, analgesic drugs, and nondrug methods, suggesting a need to explore the pain content of preregistration nursing curricula. Over the past decade, the way nurse education is delivered has changed with the advent of the internet and the use of virtual learning environments. This study, therefore, explored the depth and breadth of pain content in 3-year preregistration pediatric nursing courses across the U.K. as well as ascertaining how this content is delivered. The leads for pediatric nursing at all 56 U.K. higher education institutions running the 3-year preregistration pediatric nursing course were e-mailed a questionnaire. Participants were asked to indicate whether topics are covered in the program, and if so how it was delivered. Results suggest that preregistration pediatric nursing courses in the U.K. do not always equip students to manage pain effectively in clinical practice. There appears to be limited content on pain in nursing curricula, with several institutions not covering key topics. Most teaching is delivered face to face with limited workbooks and virtual learning activities. Further research is needed in this area to ascertain the impact of this on the quality of care provided. Ó 2013 by the American Society for Pain Management Nursing The evidence to guide nurses’ pain management practices is readily available. However, pediatric nurses’ pain management practices continue to be suboptimal and fall short of the ideal (Polkki, Pietila, & Vehvilamen-Julkunen, 2003; Twycross, 2007a; Vincent & Denyes, 2004) with children experiencing moderate to severe unrelieved pain (Johnston, Gagnon, Pepler, & Bourgault, 2005; Taylor, Boyer, & Campbell, 2008; Vincent & Denyes, 2004). Insufficient knowledge about managing pain in children has been suggested as one reason that nurses do not manage pain effectively. Seven studies have examined pediatric nurses’ theoretic knowledge about pain management in children. A study carried out with pediatric oncology nurses (n ¼ 106) in the U.S. found a lack of understanding of the basic pharmacologic Pain Management Nursing, Vol 14, No 4 (December), 2013: pp 247-258
248
Twycross and Roderique
principles regarding analgesic drugs, such as the effects and side effects (Schmidt, Eland, & Weller, 1994). In Salantera, Lauri, Salmi, and Helenius’ (1999) study on pain management, a knowledge questionnaire was completed by pediatric nurses (n ¼ 265) in Finland; gaps were found in nurses’ knowledge about managing pain in children regarding analgesic drugs and nondrug methods of pain relief. Final-year student nurses (n ¼ 73) also completed the questionnaire and demonstrated knowledge deficits regarding analgesic drugs and pain assessment (Salantera & Lauri, 2000). Twycross (2004) used a modified version of Salantera’s questionnaire (n ¼ 12) and found that English nurses had gaps in their knowledge; these were particularly noticeable regarding analgesic drugs and nondrug methods for relieving pain, as well as the physiology, psychology, and sociology of pain. The Pediatric Nurses’ Knowledge and Attitudes Regarding Pain Survey was completed by nurses in the United States (n ¼ 274) in Manworren’s (2000) study. The mean score for the questionnaire was only 66%, with knowledge deficits apparent in many areas, including pain assessment, the pharmacology of analgesic drugs, the use of analgesic drugs, and nondrug methods. Nurses (n ¼ 67) completed an adapted version of the Nurses’ Knowledge and Attitudes Regarding Pain Survey in Vincent’s (2005) study undertaken in the U.S. Pediatric nurses had knowledge deficits regarding nondrug methods of pain relief, analgesic drugs, and the incidence of respiratory depression. Rieman and Gordon (2007) surveyed pediatric nurses (n ¼ 295) working in Shriners’ Hospitals in the U.S. with the use of a revised version of the Pediatric Nurses’ Knowledge and Attitudes Regarding Pain Survey. The mean survey score was 74%. The ten questions answered incorrectly by most participants related to pharmacology and its relationship to the incidence of respiratory depression. The results of these studies suggest that gaps remain in nurses’ knowledge about pain in children, particularly regarding pain assessment, analgesic drugs, and nondrug methods. These gaps in knowledge suggest that there is a need to explore the pain content of preregistration nursing curricula. Three earlier studies have explored this. A review of pain content in preregistration diploma courses in England found that most pediatric nursing curricula included
