Nurses' Beliefs Regarding Pain in Critically Ill Children: A Mixed-Methods Study.
The purpose of this study was to provide a current and comprehensive evaluation of nurses' beliefs regarding pain in critically ill children.


METHODS
A convergent parallel mixed-methods design was used. Nurse beliefs were captured via questionnaire and interview and then compared.


RESULTS
Forty nurses participated. Most beliefs reported via questionnaire were consistent with effective pain management practices. Common inaccurate beliefs included the need to verify pain reports with physical indicators and the pharmacokinetics of intravenous opioids. Beliefs commonly shared during interviews concerned the need to verify pain reports with observed behavior, the accuracy of pain reports, the need to respond to pain, concerns regarding opioid analgesics, and the need to "start low" with interventions. Convergent beliefs between the questionnaire and interview included the use of physical indicators to verify pain, the need to take the child's word when pain is described, and concerns regarding negative effects of analgesics. Divergent and conflicting findings were most often regarding the legitimacy of a child's pain report.


CONCLUSIONS
Findings from this study regarding the accuracy of nurses' pain beliefs for critically ill children are consistent with past research. The presence of divergent and conflicting responses suggests that nurses' pain beliefs are not static and may vary with patient characteristics.


CONCLUSIONS
While most nurses appreciate the risks of unrelieved pain in children, many are concerned about the potential adverse effects of opioid administration. Interventions are needed to guide nurses in minimizing both of these risks.
University of Illinois at Chicago, College of Nursing, Chicago, IL. Electronic address: cynthia-lafond@uiowa.edu.
Cynthia M
CM
LaFond
University of Illinois at Chicago, College of Nursing, Chicago, IL.
Catherine
C
Van Hulle Vincent
University of Illinois at Chicago, College of Nursing, Chicago, IL.
Kimberly
K
Oosterhouse
University of Illinois at Chicago, College of Nursing, Chicago, IL.
Diana J
DJ
Wilkie
D059787:Acute Pain / Q000451:nursing; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology; D010147:Pain Measurement / Q000451:nursing*; D010371:Pediatric Nursing / Q000379:methods*; D057184:Practice Patterns, Nurses'
Acute pain; Knowledge and attitudes; Knowledge use in pain care; Patient simulation; Pediatric intensive care; Pediatric nurse