Experiences of Teaching and Learning Pediatric Pain Management in Ghana.

BACKGROUND: The literature has revealed gaps in knowledge and attitudes regarding pediatric pain management among Ghanaian nurses and nursing students that can be attributed to inadequate education in the area. Consequently, nursing tutors teaching pain management might not have the appropriate knowledge to transfer to their students. PURPOSE: To explore nursing tutors' experiences of teaching pediatric pain management as well as their students' learning experiences before and after the tutors' training workshop. DESIGN: A descriptive qualitative design was employed for the conduct of the study. METHODS: Data were collected via focus groups from 32 tutors and 24 students before and after an educational workshop. Data analysis drew on Braun and Clarke's thematic analysis. FINDINGS: Pre-workshop themes revealed knowledge deficits regarding pediatric pain management in both tutors and students due to learning having occurred in bits and pieces. Furthermore, lack of accessibility to books and pain scales perpetuated this bits-and-pieces approach to learning. Post-workshop findings revealed gains in tutors' knowledge and skills. Consequently, students gained new insights into pediatric pain management. CONCLUSION: Tutors and student nurses had a knowledge deficit regarding pediatric pain management. The educational workshop and the provision of learning materials resulted in enhanced knowledge and attitudes that subsequently improved tutors' ability to effectively teach the topic to their students, with a clear implication for improvements in clinical practice. CLINICAL IMPLICATION: Educating nursing tutors about pediatric pain is imperative to enable students and thus future nurses to be equipped with the necessary evidence-based knowledge of how to manage pediatric pain.

Factors Contributing to Malnutrition among Children Under 5 Years at St. Elizabeth Catholic Hospital, Ahafo Hwidiem.

Background: Nutrition among children under 5 plays an important role in the overall development of children physically and psychologically. Nutritional deficiencies and malnutrition generally affect children. In this study, we estimate the prevalence of 3 malnutrition indicators underweight, stunting and wasting and to assess factors associated with them. Objective: The main objective of the study was to assess the factors contributing to malnutrition among children under 5 years old. Design: The study employed a descriptive cross-sectional study design to assess the factors contributing to malnutrition among children under 5 years of age. Methods: This is quantitative cross-sectional facility-based study of 245 children aged 11 to 49 months. A structured questionnaire was used, and anthropometric measurements were taken to collect data. The Pearson chi-square test was used to assess the bivariate association between the outcomes and the characteristics. The binary logistic regression model was employed to estimate the crude and adjusted odds of malnutrition indicators among the characteristics observed in the study. Results: The prevalence of underweight, stunting, and wasting were 35.9, 13.9, and 33.9%, respectively. Underweight was significantly higher among females compared to males (42.0% vs. 24.1%) and highest among children aged 11 to 23 months (53.6%). Female children had 3 times more odds of being underweight (AOR: 3.09, 95% CI: 1.56-6.12). Compared to children aged 11 to 23 months, the odds of being underweight were less among children aged 24 to 35 months (AOR: 0.26, 95% CI: 0.13-0.51, P < .001), and 36 to 47 months (AOR: 0.9, 95% CI: 0.03-0.29, P < .001). Wasting was less prevalent among children aged 11 to 23 months (4.8%). Also, wasting was high among children aged 24 to 35 months (AOR: 27.41, 95% CI: 9.12-82.37, P < .001), 36 to 47 months (AOR: 28.23, 95% CI: 7.59-104.94, P < .001), and 48 to 59 months (AOR: 18.10, 95% CI: 3.04-107.76, P < .001). None of the observed factors were associated with stunting in the study. Conclusion: This study concludes that child malnutrition was high among under-five children. Promoting the use of healthy complementary feeding, preventing diarrheal diseases, and vaccinating children integrated with access to nutrition education programs are vital interventions to improve the nutritional status of children.

A Qualitative Study on Frontline Nurses' Experiences and Challenges in Providing Care for COVID-19 Patients in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention.

Since the outbreak of COVID-19, studies related to the COVID-19 pandemic have been published widely. However, there are limited qualitative studies in Ghana that explored and shed light on frontline nurses' experiences and challenges in caring for patients diagnosed with COVID-19. This study aimed to explore frontline nurses' experiences and challenges of providing care for COVID-19 patients in the Volta Region of Ghana. This study adopted a descriptive qualitative research design to collect data. We conducted the study among frontline nurses who provided nursing care for COVID-19 patients in the Treatment Centre for COVID-19 cases in the Volta Region of Ghana. A purposive sampling method was used to select fifteen (15) participants for this study. We collected data through individual in-depth interviews facilitated by a semi-structured interview guide. The content analysis approach was used to analyse the data. The results showed: frontline nurses received inadequate information and training during the initial stages of the pandemic; stress and burnout because of inadequate staffing; logistical challenges; stigmatisation by family members and friends; frontline nurses displeased with the decision to exclude other nurses as frontline workers; participants made some recommendations towards supporting frontline nurses for effective management of patients during pandemics. This study revealed an in-depth understanding of the experiences of frontline nurses who provided nursing care to COVID-19 patients during the pandemic. Our study concludes that the frontline nurses experienced both physical and psychological problems while caring for COVID-19 patients at the treatment centre. Some challenges frontline nurses encountered were inadequate information on COVID-19 prevention and management in the early stages of the pandemic, logistical inadequacies, and stigmatisation in providing care for COVID-19 patients during the pandemic, all of which affected the quality of nursing care, work productivity, and efficiency. Therefore, nurse managers need to provide support to frontline nurses providing care for patients with COVID-19.

Communication, information, involvement and decision making: A systematic scoping review of child-parent-nurse relationships during postoperative pain management.

AIMS: To examine the existing literature on child-parent-nurse relationships (in relation to communication, information, and involvement and decision-making) during postoperative pain management. BACKGROUND: Pain in children is under-reported and under-treated in hospitals and research has continued to report high rates of pain among hospitalised children worldwide. The role of child-parent-nurse relationships may be a factor and to date, no review has been identified that focus on these relationships during postoperative pain management. DESIGN: A systematic scoping review following Arksey and O'Malley with further adaptations based on JBI. METHODS: A systematic search for published primary studies was conducted using the Medline, CINAHL, British Nursing Index, ASSIA, PsycINFO, Science Direct and Web of Science in English from 2000 to 2022. Two reviewers independently carried out data screening and extraction and any differences were resolved with the assistance of a third reviewer. The data were analysed using thematic analysis and presented descriptively. This study followed the PRISMA-ScR Checklist. RESULTS: A total of 37 studies met the inclusion criteria. The findings mainly demonstrated a focus on the perspectives of parents and nurses with less on children's perspectives and none of the studies explored child-nurse relationships. The findings were categorised under three themes: communication, information, and involvement and decision making. CONCLUSION: A prevailing deficiency in child-parent-nurse relationships significantly contributed to suboptimal postoperative pain care, causing prolonged and untreated postoperative pain in children. Children's hesitation in communicating with nurses, the limited communication skills of nurses, and the weak communication position of parents in a hospital setting all hindered the development of strong relationships between children, parents, and nurses. The unclear definition of the roles of children and parents in postoperative pain management resulted in confusion for both parents and nurses. This was exacerbated by parents' lack of knowledge and inadequate guidance from nurses, ultimately leading to a decreased level of parental involvement in their child's postoperative pain management while in the hospital. Unattended requests for pain management caused children to experience prolonged pain and led to a deterioration in the relationship between parents and nurses, as well as a reduction in the parents' ability to provide pain care to their child. RELEVANCE TO CLINICAL PRACTICE: This study highlights the reasons behind the suboptimal management of postoperative pain in children. The importance of the relationship between children, parents, and nurses in pain management must be acknowledged, and the results of this study may be used to inform improvements in nursing pain management practices. NO PATIENT OR PUBLIC CONTRIBUTION: Patient or public contribution is not a necessary stage in a systematic scoping review following Arksey and O'Malley's framework.

Does Education Improve Nurses' Knowledge, Attitudes, Skills, and Practice in Relation to Pain Management? An Integrative Review.

BACKGROUND: Pain is undertreated in both adults and children and a major factor linked to this is nurses' lack of knowledge as evidenced by studies undertaken globally. OBJECTIVE: This review sought to explore the effects educational interventions can have on nurses' knowledge, attitudes, skills, and practice regarding pain management. DESIGN: An integrative review DATA SOURCES: Systematic search of CINAHL, MEDLINE, AMED, EMBASE, and Psych INFO. REVIEW/ANALYSIS METHODS: Five major databases were systematically searched from the year 2000-December 2019 with a total of 33 studies included in the final review. RESULTS: The literature revealed that many nurses had inadequate knowledge and a poor attitude towards pain at baseline, which may be improved through educational intervention. However, misconceptions remained at post-intervention, particularly regarding pharmacological pain management. CONCLUSIONS: Education is a possible means to enhance nurses' knowledge and improve attitudes and practices in pain management. However, there was some evidence that this may decline over time, and continuous professional updates are likely required.

The impact of education on the knowledge and attitudes of Ghanaian nurse tutors towards the assessment and management of pain in children: A quantitative study.

BACKGROUND: Undertreatment of pain in children is an international problem as many children reports unresolved moderate to severe pain. One key factor which may contribute to under treatment of pain in children by nurses is lack of knowledge. In Ghana opportunities for nurses to learn about pediatric pain have been limited due to gaps in the undergraduate curriculum and inadequate continuing professional education post qualification. OBJECTIVE: To assess tutors' knowledge and attitudes to pediatric pain management before and after an educational workshop. DESIGN: Single group pre-test-post-test design. SETTING: One Ghanaian Nursing Training College. PARTICIPANTS: All (37) nursing tutors in the college. METHOD: Total population sampling was used to access 37 tutors, data were collected using the Knowledge and Attitude Survey Regarding Pain at 3 stages; pre-intervention, immediately after the train-the-trainer based Pediatric Pain Educational Workshop and at 3-months follow-up. Data from the survey were analyzed using descriptive and inferential statistics. RESULTS: Results at pre-intervention showed low scores in the survey. However, post-intervention results at both the immediate and 3-months follow-up stages revealed a significant increase from pre-intervention: Mean (SD) of 20.35 (4.56), to immediate follow-up Mean (SD) 26.93 (5.02), and 3-months follow-up Mean (SD) 25.19 (5.80) and a p-value of <0.001. CONCLUSION: The results suggest tutors' knowledge and attitudes regarding pediatric pain management can be directly improved through a nurse tutor focused educational program. However, knowledge declines with time and as such there is the need for regular update through Continuing Professional Development activities.