Pediatric pain practices: a national survey of health professionals
Child; Humans; United States; Pain Measurement; Physician's Practice Patterns; Questionnaires; Hospitals; Teaching; Pain/therapy
The purpose of this study was to examine how health-care providers in U.S. teaching hospitals assess and manage children's pain. A 59-item questionnaire was sent to institutions with pediatric residency programs listed in the 1992 National Residency Matching Program. Two hundred and twenty-seven questionnaires were sent and 113 were returned. Two-thirds were from nurses, one-third from physicians. Sixty percent of the respondents stated that they had standards of care or protocols for pain in their institutions, but only one-quarter reported that the standards were followed 80% or more of the time. Use of formal pain-assessment tools was reported by 73% of the sample. Respondents reported that the effectiveness of pain assessment and management was lower for infants and younger children. Only 35% of the sample indicated it was "likely" or "very likely" that parents would be involved in planning prior to a painful event. Several obstacles to adequate pain management were identified by the respondents: knowledge deficit, attitudes, and resources.
1996
Broome ME; Richtsmeier A; Maikler V; Alexander M
Journal Of Pain And Symptom Management
1996
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/0885-3924(95)00205-7" target="_blank" rel="noreferrer">10.1016/0885-3924(95)00205-7</a>
Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions
BACKGROUND: Adolescents living with incurable cancer require ongoing support to process grief, emotions, and information as disease progresses including treatment options (phase 1 clinical trials and/or hospice/palliative care). Little is known about how adolescents become ready for such discussions. OBJECTIVE: The purpose of this study was to explore the process of adolescent readiness for end-of-life preparedness discussions, generating a theoretical understanding for guiding clinical conversations when curative options are limited. METHODS: We explored 2 in-depth cases across time using case-study methodology. An a priori conceptual model based on current end-of-life research guided data collection and analysis. Multiple sources including in-depth adolescent interviews generated data collection on model constructs. Analysis followed a logical sequence establishing a chain of evidence linking raw data to study conclusions. Synthesis and data triangulation across cases and time led to theoretical generalizations. Initially, we proposed a linear process of readiness with 3 domains: a cognitive domain (awareness), an emotional domain (acceptance), and a behavioral domain (willingness), which preceded preparedness. RESULTS: Findings led to conceptual model refinement showing readiness is a dynamic internal process that interacts with preparedness. Current awareness context facilitates the type of preparedness discussions (cognitive or emotional). Furthermore, social constraint inhibits discussions. CONCLUSIONS: Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation. IMPLICATIONS FOR PRACTICE: Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.
Bell CJ; Zimet GD; Hinds PS; Broome ME; McDaniel AM; Mays RM; Champion VL
Cancer Nursing
2017
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/ncc.0000000000000465" target="_blank" rel="noreferrer">10.1097/ncc.0000000000000465</a>