title: Neonatal nurses' perceptions of pain management: survey of the United States and China.
abstract: Despite growing knowledge, neonatal pain remains unrecognized, undertreated, and generally challenging. A cross-sectional survey study was conducted to investigate neonatal nurses' perceptions, knowledge, and practice of infant pain in the United States and China, including 343 neonatal nurses (American nurses [n = 237]; Chinese nurses [n = 106]). Nurses' responses regarding neonatal pain reflected adequate knowledge in general pain concepts, but knowledge deficits related to several topics were found (e.g., preterm infants are more sensitive to pain and long-term consequences of pain). Most reported regular use of pain assessment tools, but fewer agreed that the tool used was appropriate and accurate. More American nurses (83%) than Chinese nurses (58%) felt confident in the use of pain medications, while more Chinese nurses (78%) than American nurses (61%) acknowledged the effectiveness of nonpharmacologic interventions. About half reported that pain in their units was well managed (American: 44.3%; Chinese: 55.7%), and less than half felt that pain guidelines/protocols were research-based (American: 42.6%; Chinese: 34.9%). Nurses' perceptions of well-managed pain in their units were significantly correlated with adequate education/training, use of accurate tools, and use of research-based protocols. Barriers to effective pain management included resistance to change, lack of knowledge, lack of time, fear of side effects of pain medication, and lack of trust in the tools. The survey reflects concerns that pain has not been well managed in many neonatal intensive care units in the United States and China. Further actions are needed to solve the issues of inadequate training, lack of clinically feasible pain tools, and absence of evidence-based guidelines/protocols.
authors: University of Connecticut School of Nursing, Storrs, CT. Electronic address: xiaomei.cong@uconn.edu.
authors: Xiaomei
authors: X
authors: Cong
authors: University of Connecticut School of Nursing, Storrs, CT.
authors: Jacqueline M
authors: JM
authors: McGrath
authors: University of Connecticut School of Nursing, Storrs, CT.
authors: Colleen
authors: C
authors: Delaney
authors: Peking University School of Nursing, Beijing, People's Republic of China.
authors: Hua
authors: H
authors: Chen
authors: Peking University School of Nursing, Beijing, People's Republic of China.
authors: Shuang
authors: S
authors: Liang
authors: University of Connecticut School of Nursing, Storrs, CT.
authors: Victoria
authors: V
authors: Vazquez
authors: University of Connecticut School of Nursing, Storrs, CT.
authors: Laura
authors: L
authors: Keating
authors: University of Connecticut School of Nursing, Storrs, CT.
authors: Kimberly
authors: K
authors: Chang
authors: University of Connecticut School of Nursing, Storrs, CT.
authors: Angela
authors: A
authors: Dejong
mesh_terms: D002681:China; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D015931:Intensive Care, Neonatal / Q000379:methods*; D017283:Neonatal Nursing / Q000379:methods*; D010146:Pain / Q000451:nursing*; D059408:Pain Management / Q000451:nursing*; D010147:Pain Measurement / Q000451:nursing*; D011795:Surveys and Questionnaires; D014481:United States