Transforming acute pain management in children: A concept analysis to develop a new model of nurse, child and parent partnership

JOURNAL OF CLINICAL NURSING(2023)

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摘要
ObjectivesTo identify the core components of acute pain management in children, re-conceptualise the process and update the existing model to inform nursing research and clinical practice. BackgroundAcute pain in hospitalised children remains suboptimal, despite extensive nursing research and education. Improvements require a patient-centred approach and a conceptual model which includes the role of parents and partnership. DesignUsing Rodgers' Evolutionary method, a concept analysis was conducted to define the core components for effective acute pain management in children. MethodsA scoping review of peer-reviewed literature from 1990 through 2020 was conducted using the terms "pain management," "pain control," "pain treatment," "multi modal," and "concept*". Abstracts from 85 articles were initially reviewed with 30 articles retained for analysis. Core concepts were identified, defined and synthesised. The PRISMA 2020 checklist was used. ResultsA new model was developed from a synthesis of past work which incorporates the role of parents, the complexity of the process and definitions for shared decision-making. Trust, safety, collaborative communication and genuine partnership were identified as the core components for effective pain management in children, with the triadic relationship of nurses, patients and parents in genuine partnership foundational to the nursing process. ConclusionThe new model for acute pain management in children transforms the nurse's role from gatekeeper to facilitator, shifting the process from nurse driven to patient-centred. The new collaborative model will promote shared decision-making for individualised pain assessments, interventions and evaluations. Relevance to clinical practiceEstablishing the nurse, child, parent partnership as an essential foundation to pain management has the potential to expand pain assessments, optimise treatment selections, advancing clinical practice, patient outcomes and nursing science.No Patient or Public Contributions were included in this paper as this was a concept analysis pulling from past works.
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关键词
acute pain management,children,conceptual model,paediatric,partner
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