Experience of nurses about barriers to pain management in pediatric units: A qualitative study

Context: Children's pain in hospital settings has not yet been managed well. Although nurses play an important role in pain management, its extent is limited with respect to clinical nurses in Iran.

Aims: This study was conducted to explore the experience of nurses' barriers to pain management in pediatric units.

Settings and Design: This qualitative study was conducted at two teaching hospitals in Amirkola Children's Hospital in Babol and Children's Medical Centers in Tehran, Iran. Data were collected from 19 nurses, using unstructured and deep interviews during 2014–2015.

Material and Methods: Sampling was purposeful with maximum variation. Data analyzed by conventional content analysis method simultaneously data collection based on five steps of Granheim and Lundman (2004). To ensure about the accuracy and reliability of data, four criteria namely credibility, confirmability, dependability, and transferability, were used according to Lincoln and Guba's criteria. Before the interviews, participants were ensured about the confidentiality of their information and voluntarily nature of the study. In addition, written informed consents of the nurses were obtained.

Results: Data analysis extracted five themes of barriers to pain management, including: Inappropriate organizational structure, interruption in pain relief activities, inadequate competency of the nurses, individual characteristics of child and parents, and inefficacy of companions. These themes indicated the barriers to pediatric pain management based on research conditions and experience of nurses in the pediatric ward.

Conclusions: Therefore, modification of organizational structure, elimination of causes of delay in pain relief measures, promotion of nursing competencies, paying attention to child and parents' characteristics, and improvement of companions' effectiveness should be prioritized to achieve an optimal pain management