This study examined the impact of an educational intervention (booklet distribution and lectures) on Singaporean nurses' provision of guidance to parents on the use of non-pharmacological methods of pain relief for their child's postoperative pain. Using a quasi-experimental one-group pre- and post-test study design, 134 and 112 registered nurses completed the questionnaires pre- and post-test, respectively. More than 75% of the nurses "always" guided parents to use breathing techniques, relaxation, positioning, comforting/reassurance, helping with activities of daily living, and creating a comfortable environment in the pretest and touch, presence, and distraction in addition to the aforementioned methods in the post-test. The nurses' provision of guidance to parents on all non-pharmacological methods increased, but statistically significant increases only were found in relation to massage and positive reinforcement. The results suggested that the educational intervention had some impact on nurses' provision of guidance to parents on the use of non-pharmacological methods of pain relief for children's postoperative pain. Continuing education in pain management should be provided to nurses in order to equip them with the knowledge to improve their practice.

The purpose of this study was to examine nurses' use of nonpharmacological methods for school-age children's postoperative pain relief. A survey was conducted in 2008 with a convenience sample of 134 registered nurses from 7 pediatric wards in Singapore. Nurses who were younger, had less education, lower designation, less working experience, and no children of their own used nonpharmacological methods less frequently. Nurses need training and education on nonpharmacological pain relief methods, particularly on methods that have been shown to be effective in prior research but that were less often used by nurses in this study: massage, thermal regulation, imagery, and positive reinforcement.

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The aims of this study are to describe Chinese parents' perceptions of informational and emotional support received from nurses and their recommendations for improvement in the management of their child's postoperative pain. Data were collected using a questionnaire survey completed by 206 parents of 6- to 12-year-old child hospitalized in 12 wards in five provincial hospitals in Fujian Province, China, in 2004. Findings indicated that parents experienced negative feelings such as worry (91%) and anxiety (59%). Most of them reported they had received sufficient information on outcomes of surgical procedure (85%) and postoperative recovery process (84%), but fewer reported they had received sufficient information on pain medication (51%) and non-pharmacological pain-relieving methods (59%). Parents made some recommendations, which centred mainly on nurses' use of non-pharmacological methods. Findings suggest that parents need more information related to pain management and their understanding of the information should be ensured.

This study implemented pain education for Chinese nurses using a pre-post test design and compared their use of nonpharmacological methods in children's postoperative pain management. Results show that nurses' use of most of these methods for pain relief increased significantly, which helped to improve the quality of care for children. This study enriches nurses' knowledge in children's pain management and develops evidence for practice by demonstrating the need for hospitals to provide continuous pain education to nurses.

The purpose of this study was to reveal the 8-12-year-old children's perceptions on the use of methods for pediatric postoperative pain alleviation by themselves, their parents and nurses. Face-to-face structured interviews were conducted with 59 subjects who had undergone surgical procedures in three provincial hospitals in Fujian Province, China in 2004. Content analysis and descriptive statistics were used to analyse the data. According to the children's perceptions, they commonly used rest/sleeping, a physical method (positioning) and a strategy of emotional support (requiring presence of their parents); their parents frequently used helping with daily activities and all strategies of emotional support; the nurses mostly used a strategy of emotional support (comforting) and a physical method (positioning). Children's suggestions mainly concerned the application of non-pharmacological methods, especially presence of caregivers. In conclusion, pain-relieving methods were not sufficiently used although children suffered from intense postoperative pain, which calls for health-care providers' future attention.

Parental participation in paediatric postoperative care is common in China. However, the knowledge is limited on what methods parents use to relieve their children's postoperative pain in hospital. The purpose of this study was to describe what nonpharmacological methods parents use to relieve their children's postoperative pain and factors related to this. A previously validated Scandinavian questionnaire survey was conducted in five provincial hospitals in Fujian, China, in 2004. Parents (n = 206) whose children had undergone operation were asked to complete questionnaires concerning nonpharmacological methods for children's pain relief. The response rate was 88%. Results show that the most commonly used methods by parents were emotional support strategies, helping with daily activities, distraction and imagery. Breathing technique was the method used least frequently. Fathers and parents who were older, more educated, employed and with earlier hospitalization experience with their children used pain alleviation methods more frequently than mothers and parents without these characteristics. Moreover, parents used some methods more frequently with boys, younger children, as well as children admitted for selective operations, with longer duration of hospitalization and with moderate or severe pain. Parents utilized various nonpharmacological methods for children's pain relief, especially those easy to use. This study may serve to focus healthcare providers' efforts on educating parents with respect to various nonpharmacological pain alleviation methods available for postoperative pain. Furthermore, this study provides parents an opportunity to be aware of their role in their children's pain management.

AIMS AND OBJECTIVES: The aim of the study was to describe parental guidance provided by Chinese nurses regarding non-pharmacological methods in children's surgical pain relief as well as factors related to this. BACKGROUND: Parental involvement in children's pain management has been acknowledged and encouraged in recent years. However, parents' lack of related information has been pointed out and little is known about how parents are guided to use non-pharmacological methods to relieve the pain. METHODS: A previously validated European questionnaire survey was conducted in 2002. Structured questionnaires were distributed to all 187 nurses working at 12 surgical wards in five hospitals of Fujian Province, China. The average response rate was 98%. RESULTS: The results show that nurses informed parents of the majority of cognitive information. The most commonly guided non-pharmacological methods were distraction, positive reinforcement, comforting/reassurance, positioning and relaxation. Nurses' background factors, including age, education, nursing position, professional work experience, number of their own children and experiences of earlier hospitalizations of their children, were significantly related to their perceptions regarding parental guidance. CONCLUSIONS: Chinese nurses provided much guidance to parents on non-pharmacological methods. However, the results show that sensory information and physical methods were poorly conveyed to parents, which needs future attention to reinforce parents' active role in pain management. RELEVANCE TO CLINICAL PRACTICE: This study provides new information on Chinese nurses' guiding parents to use non-pharmacological methods in pain alleviation, thereby contributing to the body of knowledge on this subject. Furthermore, the study makes the respondents aware of the importance of involving parents in their child's pain management.

AIM: This paper reports a study describing Chinese nurses' use of non-pharmacological methods for relieving 6- to 12-year-old children's postoperative pain and factors related to this. BACKGROUND: Non-pharmacological methods are stated to be effective in relieving children's postoperative pain when used independently or in conjunction with medication. However, little is known about the use of these methods by Chinese nurses. METHODS: A questionnaire survey was carried out in 2002 with a convenience sample of 187 nurses working at 12 surgical wards in five hospitals of Fujian Province, China. A Likert-type instrument was used, and the average response rate was 98%. Descriptive statistics and content analysis were used to analyse the data. RESULTS: The most commonly used non-pharmacological methods were giving preparatory information, comforting/reassurance, creating a comfortable environment, distraction, and positioning. Positive reinforcement and helping with daily activities were used less often, and transcutaneous electrical nerve stimulation was not used at all. Many nurse background factors were statistically significantly related to their use of pain alleviation methods. Furthermore, many factors limited their use of non-pharmacological methods, the most common being that there were too few nurses for the work that had to be done, followed by nurses' lack of knowledge about pain management. CONCLUSIONS: While Chinese nurses used versatile non-pharmacological methods in school-aged children's postoperative pain relief, there remains a need for more education about pain management and for more frequent use of these methods in clinical care.

Aims: The purpose of this study was to assess the effectiveness of an acute pain educational programme in improving nurses' knowledge, skills and attitudes around postoperative pain management. Background: Poor postoperative pain management is consistently reported as a problem for patients (Chung and Lui, 2003; Klopper et al, 2006; Bell and Duffy, 2009). This is often attributed to health professionals' lack of knowledge and access to training programmes, which have been cited as barriers to effective pain management (Wilkes et al, 2003; Dihle et al 2006). The Acute Pain Service (APS) team at HSE Mid-Western Regional Hospital, Limerick, and the Centre for Nurse and Midwifery Education developed a training programme for nurses in pain management based on the International Association for the Study of Pain (2005) curriculum for nurses. Methods: A convenience sample of 59 nurses attending an educational programme on acute pain management was studied. Validated questionnaires were completed before, immediately after and 6 weeks after the educational programme to assess knowledge and attitudes towards acute pain management. Nurses were also asked to rate their views on 18 statements on acute pain management. Results: The acute pain educational programme intervention improved nurses' knowledge and attitudes towards pain assessment and management (p<0.01). It was most effective immediately after the pain education programme. Conclusion: Continuing evidenced-based educational programmes in pain management can improve nurses' knowledge of pain. The results of this study could guide the development and implementation of continuing educational programmes for nursing staff in providing patients with evidence-based pain management.

The aim of this study is to describe current post-operative pain management practices for patients with dementia and hip fracture in Finland. Older adults with hip fracture are at high risk of under treatment for pain, especially if they also have a cognitive disorder at the stage of dementia. Previous studies have provided limited information about the quality of acute pain treatment for persons with dementia. In this study data concerning current pain management practices was collected by questionnaire from 333 nursing staff. They worked in surgical wards of seven universities and ten city-centre hospitals. The response rate to the questionnaire was 53%. The data was analysed using factor analysis and parametric methods. Half the respondents (53%) considered that post-operative pain management was sufficient for patients with dementia. Less than one third of respondent nurses reported that pain scales were in use on their unit: the most commonly used scale was VAS. The use of pain scales was significantly related to the respondents' opinion of the sufficiency of post-operative pain management in this patient group (p<0.001). The findings can be utilised in nursing practice and research when planning suitable complementary educational interventions for nursing staff of surgical wards. Further research is needed to explain the current situation of pain management practices from the viewpoint of patients with dementia.

A growing body of research on workplace bullying which addresses the detrimental consequences of bullying in nursing has emerged. This quasi-experimental pilot study was aimed at examining the effect of an educational program provided to nursing staff on workplace bullying. The development of an educational program and use of a registered nurse educator in a group setting is an effective method for addressing workplace bullying.

PURPOSE OF REVIEW To summarize developments in analgesic use in the older person. RECENT FINDINGS Observational studies, reviews and a few randomized trials dealing with analgesic use in the older person have been published during the past year. Recent trials examine also pharmacological/nonpharmacological interventions, and education of older patients as well as clinicians in pain management. SUMMARY Under-treatment of pain remains a major concern in community-dwelling or institutionalized older persons, especially with dementia. An increased awareness of pain and palliative pain management in the older person is present throughout the literature. Age-related factors affect the safety and efficacy of the analgesic treatment and pharmacological aspects are often underlined, especially when impaired cognition and frailty are present. The use of topical analgesics, well tolerated in older persons, allows reduction of concomitant treatments and of adverse events. Optimizing analgesic use in older patients is carried out by exploring motivations and attitudes of the patients, by analysing barriers and practices of clinicians and by setting up structured educational nursing interventions. Although a larger number of older persons are included in studies, prospective and large-scale trials are needed in this vulnerable population characterized by a high variability and heterogeneity.

BACKGROUND Continuing education for registered nurses is a component of safe, effective pain management in every clinical setting. METHODS Two hundred ninety-one registered nurses from seven counties in rural southwestern Virginia completed a 22-item survey that assessed their interest in pain management topics. RESULTS The mean interest score for all respondents was 4.04 (range = 1 to 5). Mean interest scores did not differ significantly between younger and older respondents (t = 1.034, p =.302) or between clinical settings (t = 0.479, p =.632). The mean interest scores for nurses with an associate's degree in nursing/diploma and those with a bachelor of science in nursing or higher were 4.19 and 3.88, respectively, and the difference was statistically significant (t = 3.535, p <.001). CONCLUSION Nearly 300 registered nurses from communities in the southwestern Virginia area of Appalachia indicated interest in a wide variety of pain management topics. Nurses with at most an associate's degree in nursing/diploma were significantly more interested in pain management education than those with a bachelor of science in nursing or higher degree. The overall interest scores were high, indicating that the respondents found the topics salient to their clinical practice.

AIMS This paper reports a quantitative systematic review of the effects of educational interventions on quality of life, pain intensity and pain interference in cancer patients. BACKGROUND Cancer pain has a marked negative impact on quality of life, and this has become an important issue in discussions of treatment options. Patient education seems to be effective in pain management, but no review has been published with quality of life as an outcome measure. DATA SOURCES Relevant publications from 2000 to 2010 were identified in six databases (Medline, CIHAHL, PubMed, EMBASE, PsycINFO and DARE) and by means of hand-searches. All randomized controlled trial studies of pain-education programmes for cancer patients were considered, and a quantitative review of effectiveness carried out. REVIEW METHODS Studies were critically appraised by three independent reviewers, and the Jadad score was used to assess the quality of those included. RESULTS Four studies meeting the inclusion criteria were used, after methodological quality assessment. Pain intensity and pain interference were significantly reduced after education, but statistical change in quality of life was not found in any of the studies. CONCLUSIONS Pain and quality of life are complex matters, and quality of life might not be a sensitive indicator of the effectiveness of pain education. To improve quality of life and reduce the severity of pain in cancer patients, individualized care, recognition of variations in patient experience, and a multi-disciplinary approach are required. Further research is recommended into patients' preferences of any educational intervention, and into the quality of existing education programmes and the expertise of the healthcare professionals concerned.

This study describes strategies used by the Joint Clinical Practice Council of Children's Hospital of Wisconsin to identify barriers perceived as interfering with nurses'(RNs) ability to provide optimal pain management. A survey was used to ascertain how nurses described optimal pain management and how much nurses perceived potential barriers as interfering with their ability to provide that level of care. The survey,"Barriers to Optimal Pain management"(adapted from Van Hulle Vincent & Denyes, 2004), was distributed to all RNs working in all patient care settings. Two hundred seventy-two surveys were returned. The five most significant barriers identified were insufficient physician (MD) orders, insufficient MD orders before procedures, insufficient time to premedicate patients before procedures, the perception of a low priority given to pain management by medical staff, and parents' reluctance to have patients receive pain medication. Additional barriers were identified through narrative comments. Information regarding the impact of the Acute Pain Service on patient care, RNs' ability to overcome barriers, and RNs' perception of current pain management practices is included, as are several specific interventions aimed at improving or ultimately eliminating identified barriers.

This study examined the impact of an educational intervention (booklet distribution and lectures) on Singaporean nurses' provision of guidance to parents on the use of non-pharmacological methods of pain relief for their child's postoperative pain. Using a quasi-experimental one-group pre- and post-test study design, 134 and 112 registered nurses completed the questionnaires pre- and post-test, respectively. More than 75% of the nurses "always" guided parents to use breathing techniques, relaxation, positioning, comforting/reassurance, helping with activities of daily living, and creating a comfortable environment in the pretest and touch, presence, and distraction in addition to the aforementioned methods in the post-test. The nurses' provision of guidance to parents on all non-pharmacological methods increased, but statistically significant increases only were found in relation to massage and positive reinforcement. The results suggested that the educational intervention had some impact on nurses' provision of guidance to parents on the use of non-pharmacological methods of pain relief for children's postoperative pain. Continuing education in pain management should be provided to nurses in order to equip them with the knowledge to improve their practice.

Schoolchildren reported their parents' use of aversive control and positive reinforcement contingencies in their educational interventions, as well as parental non-responsiveness to their requests for educational assistance. They also reported their own levels of six dimensions of anxiety disorder-related phenomena. Both parental use of aversive control and non-responsiveness were directly related to overall levels of child anxiety disorder-related behavior; these correlations were more robust than those observed in previous investigations of more diffuse dimensions of parenting style and trait anxiety. Panic disorder/agoraphobia and Generalized anxiety disorder were the dimensions most strongly correlated with both parental aversive control and non-responsiveness, while Compulsive behavior was uniquely uncorrelated with parental non-responsiveness and uniquely correlated with parental use of positive reinforcement contingencies. Differences in the magnitudes of correlations between anxiety disorder-related dimensions and parental educational practices are interpreted in terms of the probable differential effectiveness of their constituent behaviors in terminating parent-mediated negative reinforcers.

What is the meaning of advocacy, and how does it relate to the nurse who wants patients to experience optimum pain management? This question and the lack of empirical data provided the stimulus for the American Society for Pain Management Nursing (ASPMN) Research Committee to explore ASPMN members' beliefs, knowledge, and skills regarding pain management advocacy activities. The specific aim of the study was to determine the educational needs for and barriers of advocacy for nurses working with patients experiencing pain. An ASPMN Advocacy Survey Instrument was developed to gather data about advocacy activities and interventions. The sample consisted of 188 ASPMN nurses (20% of the membership) who responded via the internet. Study findings revealed that the majority of nurse respondents were active in personal advocacy, serving as guardians of the patient. They confronted physicians as necessary and assisted patients to evaluate their pain management. Regarding making the public aware of pain management-related issues (i.e., public awareness advocacy), the respondents were not as active. Respondents were knowledgeable about pain management and best practices/best evidence, with the exceptions of legislative issues and media training. These two areas need support and educational intervention. Additional areas in need of education and training, as identified by respondents, are social and political advocacy interventions."Lack of time" was identified as the barrier to advocacy experienced by the greatest number of nurses.