Journal of pediatric nursing
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A telephone interview with the parents of 84 children who underwent tonsillectomy was conducted within 24 hours after discharge from an ambulatory surgery center. Parents were asked to rate the intensity of their child's pain and data were collected on the type, dose, and amount of analgesics administered, and the types of side effects the children experienced. The mean age of the children was 7 years (SD = 2.31), with an equal number of boys and girls. ⋯ Twenty-six percent of the children had one or more episodes of emesis. Our data suggest that children experience a significant amount of pain in the first 24 hours after tonsillectomy and that parents administer analgesics less frequently than the drugs are prescribed. In addition, children experience significant deleterious effects (i.e., poor oral fluid intake, sleep disturbance, behavioral changes, and emesis) associated with the undertreatment of pain, the analgesic administered, or the surgery itself.
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This study examined (1) the influence of continuing education and length of pediatric nursing experience on infant pain assessments, (2) length of pediatric nursing experience on the cues used in making these assessments, and (3) the relationships between cues and assessed levels of pain. The convenience sample consisted of 20 nurses with less than 1 year of pediatric nursing experience, 20 nurses with more than 1 year of pediatric nursing experience but less than 5 years, and 24 nurses with more than 5 years pediatric nursing experience. All had at least a Bachelor of Science in Nursing degree. ⋯ Results fit with, and provide some quantitative illustration for, the model of clinical nursing development as described by Benner and coworkers. More experienced nurse participants agreed more with the expert panel on levels of assessed pain than the other nurse participants. Similarities and differences in the relationship between key cues and level of assessed pain among nurse participants with differing lengths of pediatric nursing experience are presented and discussed.
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Resilience is relevant to nurses because of its implications for health. Research on the resilience of children and adolescents has proliferated over the past five years. ⋯ Furthermore, few intervention studies have been conducted. This article describes resilience and factors that influence resilience of children, examines the relationship between resilience and health, identifies interventions that foster children's resilience and health, reviews research focusing on children's resilience, and suggests the relevance of resilience to nursing of children.
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The components of the assessment process are identified and compared from an ethnography of the methods used by 65 pediatric nurses to assess the level of pain in a sample of infants younger than 1 year of age. Nine different modes of thought, feeling, and action were referenced in reaching judgments about pain levels. ⋯ Nurses demonstrated a wider "repertoire" of knowledge about how to assess pain than they customarily used: the selection of particular repertoire items varied by nurses' initial estimates, experience level, and personal assessment style. Findings support the proposition that an understanding of the infant pain assessment process must include nurses' selection and customary use of knowledge and data available to them, as well as the intrinsic nature of that information.
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Randomized Controlled Trial Clinical Trial
Postoperative use of pediatric pain scales: children's self-report versus nurse assessment of pain intensity and affect.
The purpose was to examine nurses' use of pediatric pain scales and to compare their estimate of the child's pain intensity and affect with the child's self-report. The Analog Chromatic Continuous Scale (ACCS) was used for pain intensity and the McGrath Affective Faces Scale (MAFS) for pain affect. Self-report of pain was obtained from 124 hospitalized postoperative children aged 5 to 17 years and compared with estimates of 44 pediatric nurses randomly assigned to either an experimental or control group. ⋯ Findings revealed that only 36% of the nurses had at any time used a pediatric pain scale. Correlations between the experimental nurses' ratings and the child's self-report were significantly higher than the control nurses' estimates and the child's self-report. The correlation between the child's self-report of pain intensity on the ACCS and of affect on the MAFS was r = .612, suggesting that nurses' use of both an intensity and affect pediatric pain scale would more accurately reflect the child's pain experience.