title: The opinion of clinical staff regarding painfulness of procedures in pediatric hematology-oncology: an Italian survey.
abstract: BACKGROUND
  Beliefs of caregivers about patient's pain have been shown to influence assessment and treatment of children's pain, now considered an essential part of cancer treatment. Painful procedures in hematology-oncology are frequently referred by children as the most painful experiences during illness. Aim of this study was to evaluate professionals' beliefs about painfulness of invasive procedures repeatedly performed in Pediatric Hemato-Oncology Units.
  
  
  METHODS
  Physicians, nurses, psychologists and directors working in Hemato-Oncology Units of the Italian Association of Pediatric Hematology-Oncology (AIEOP) were involved in a wide-nation survey. The survey was based on an anonymous questionnaire investigating beliefs of operators about painfulness of invasive procedures (lumbar puncture, bone marrow aspirate and bone marrow biopsy) and level of pain management.
  
  
  RESULTS
  Twenty-four directors, 120 physicians, 248 nurses and 22 psychologists responded to the questionnaire. The score assigned to the procedural pain on a 0-10 scale was higher than 5 in 77% of the operators for lumbar puncture, 97.5% for bone marrow aspiration, and 99.5% for bone marrow biopsy. The scores assigned by nurses differed statistically from those of the physicians and directors for the pain caused by lumbar puncture and bone marrow aspiration. Measures adopted for procedural pain control were generally considered good.
  
  
  CONCLUSIONS
  Invasive diagnostic-therapeutic procedures performed in Italian Pediatric Hemato-Oncology Units are considered painful by all the caregivers involved. Pain management is generally considered good. Aprioristically opinions about pain depend on invasiveness of the procedure and on the professional role.
authors.affiliation: Pediatric Pain and Palliative Care Service, Department of Pediatrics, University of Padua, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Po'
authors.forename: Franca
authors.initials: F
authors.lastname: Benini
authors.forename: Laura
authors.initials: L
authors.lastname: Sainati
authors.forename: Anna C
authors.initials: AC
authors.lastname: Frigo
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.forename: Maria I
authors.initials: MI
authors.lastname: Farina
authors.forename: Caterina
authors.initials: C
authors.lastname: Agosto
mesh_terms: D000700:Analgesics / Q000494:pharmacology*; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D019937:Diagnostic Techniques and Procedures / Q000009:adverse effects*; D019337:Hematologic Neoplasms / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008495:Medical Oncology / Q000379:methods*; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D011795:Surveys and Questionnaires
chemical_list: D000700:Analgesics