Brenna L. Quinn

Pain Assessment in Children With Special Needs A Review of the Literature

Challenges in assessing the pain of children with special needs are created by the differing abilities of these students to self-report pain presence and intensity. This article reports the results of a literature review examining methods of pain assessment for children with special needs. The authors note the need to foster partnerships with parents and educators when assessing pain in difficult-to-assess students, and identify research priorities, including: obtaining perspectives of school nurses and parents on child perception of pain and challenges encountered during the assessment process, including educators in research, identifying current assessment practices used by school-based caregivers, and including a broader population of children with special needs in pain assessment research.

'It's Not Easy': School Nurse Pain Assessment Practices for Students with Special Needs

Assessing pain in children with special needs presents unique challenges for school nurses, as no evidence-based or clinical standards to guide practices have been established for use in the school setting. Additionally, school nurse staffing has not kept pace with the growth in the population of children with special needs, which has increased by 60% since 2002. The aim of this study was to explore school nurses pain assessment practices for students with special needs. A cross-sectional study was conducted via the web. Participants/Subjects: Of 3,071 special needs school nurses invited, 27% participated (nxa0=xa0825). STATA13 was used to analyze descriptive statistics, while content analysis was performed in NVIVO 10. The majority of participants assessed pain in students with special needs using objective assessments (97.34%) and consultations with teachers (91.09%) and parents (88.64%). School nurses utilize pain assessment methods used previously in other practice areas, and rated pain assessment practices at the low benchmark of adequate. Overall, school nurses assess pain by selecting approaches that are best matched to the abilities of the student with special needs. When assessing students with special needs, nurses should utilize objective clinical assessments, teacher consultations, and parent input scales. In addition to continuing education, policies facilitating lower nurse-to-student ratios are needed to improve pain assessment practices in the school setting. Research to understand the perspectives of nurses, teachers, parents, and students is needed to support the creation of evidence-based policies and procedures.

Pediatric Pain Assessment by Drawn Faces Scales: A Review

Pediatric pain assessment is a significant issue yet the topic is understudied. Unique challenges, namely reporting biases, are present when assessing pain in children. The aim of this review of the literature is to increase awareness of biases when assessing pain in children, suggest changes in practice, and state priorities for future research. Five computerized databases were searched to identify original research pertaining to the use of drawn faces scales for pediatric pain assessment. Twelve studies met inclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines provided a framework for this review. Relevant articles were identified and data were extracted from the studies. Content analyses were then used to synthesize the findings. The age of a child being assessed contributed to biases in pain assessment. Drawn faces scales may provide inaccurate pain assessment results if a child has difficulty separating the feelings of pain and mood. Smiling faces on pain assessment scales may lead to overestimation of pain intensity. Nurses should consider biases when selecting and implementing a drawn faces pain assessment tool and when planning pain management interventions. An increase in the use of technology in pediatric pain assessment practices may provide opportunities to implement individualized pain assessment in practice. Further research is needed to determine the most reliable methods for pediatric pain assessment including the use of technology. Evidence would assist nurses in determining the best tool to assess each child based on cognitive abilities and developmental level.

Forming Focus Groups for Pediatric Pain Research in Nursing: A Review of Methods

Background: Within current priorities for pain research set by the American Society for Pain Management Nursing, there is a paucity of pediatric pain research. Qualitative approaches are helpful when researching topics about which little is known. Focus groups are one method of qualitative data collection and have been successfully implemented with children and parents. Aims: The purpose of this paper was to identify ideal conditions for nurse researchers to employ when using focus groups as a data collection method for studies aiming to investigate pain in children. The aims of this paper are to identify focus group conditions (1) facilitating adequate scientific rigor and trustworthiness and (2) eliciting the richest data from participants. Methods: A critique of research studies that used focus groups with children, parents/caregivers, or nurses in hospital or community settings was performed to achieve the stated aims. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines directed the process of selecting studies for inclusion in this review. Results: The final sample for critique included four studies. Methods such as transcription processes and approaches to analysis used in the four publications were appraised for scientific rigor and usefulness in pediatric pain research. Conclusions: Researchers investigating priority areas must consider trustworthiness and strategies to eliciting quality data when planning to employ focus groups as a data collection method. Nurses in the clinical setting can use findings of this report to strengthen pain assessment practices as well as evaluate qualitative work for inclusion in evidence‐based policies.

Strategies to Reduce Nursing Student Test Anxiety: A Literature Review

BACKGROUNDnNursing students are plagued by test anxiety. Chronic stress, heavy academic workloads, and rigorous progression standards are antecedents of test anxiety in nursing students. The purpose of this article is to identify helpful interventions to decrease test anxiety in prelicensure nursing students.nnnMETHODnThis systematic review was completed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Four electronic databases were searched using the terms nurs*, anxiety, test, NCLEX, strategies, and exam*.nnnRESULTSnSeven articles were identified for inclusion in this review. Following analysis, two categories of test anxiety interventions for nursing students were identified: environmental adjustments and student behavior modifications.nnnCONCLUSIONnFaculty members should consider using the test anxiety reduction interventions described in this article. Priorities for future research include studying the effects of test anxiety reduction interventions on examination grades. [J Nurs Educ. 2017;56(3):145-151.].

Improving School Nurse Pain Assessment Practices for Students With Intellectual Disability

School nurses are afforded minimal resources related to assessing pain in students with intellectual disability (ID) and have called for continuing education. The purpose of this study was to measure the effectiveness of an education program regarding best practices for assessing pain in students with ID. Educational sessions were presented to 248 school nurses. Pre-, post-, and follow-up surveys measured (1) difficulty school nurses face when assessing pain, (2) knowledge and use of pain assessment methods, and (3) intent to change and actual changes to professional practices. Participants experienced less difficulty assessing pain following the educational program. Almost all participants intended to change pain assessment practices, but large caseloads limited new practice adoption. Policy makers must consider population size and acuity when determining school nurse staffing. Trainings and other resources should be made available to school nurses in order to make pain assessments for students with ID more thorough and efficient.

Toward total student health: A qualitative pilot study

Abstract Objective: Colleges should aim to cultivate healthy behaviors among students by addressing alterations in wellness students view as important. The purpose of this study was to determine the self-perceived wellness-related concerns and behaviors of college students. Participants: Thirty-seven undergraduate students participated in this study between January and March 2017. Methods: Focus groups served as a data collection method. Groups were recorded and transcribed verbatim. Directed and conventional approaches to data analyses were employed. Results: Participants expressed concern regarding four campus wellness topics: nutrition, economics, mental health, and campus safety. Participants offered solutions for improving campus wellness, representing a fifth theme. Conclusions: Health concerns for college students and realistic solutions to address concerns were identified across focus groups. Overall, students cared about their own health, as well as the well-being of other students. Future directions include conducting a Web-based survey among students to assess prevalence and impact of select health and wellness topics.

School nurses are able to support adolescents experiencing pain secondary to stress and unhealthy lifestyle choices

Commentaryxa0on: Hoie M, Haraldstad K, Rohde G, et al . How school nurses experience and understand everyday pain among adolescents. BMC Nurs 2017;16:53.nnnnPain in school children is a topic receiving increased attention from researchers, clinicians and parents. The impact of pain in school children stems beyond discomfort: children in pain may miss school, are unable to focus on curricular activities, forego social opportunities, and may rely on or misuse analgesic medications.1–3 Pain is a biopsychosocial experience for all, but psychosocial influences are particularly prevalent among adolescents. As …

Educators’ Experiences Identifying Pain Among Students in Special Education Settings:

If special educators cannot identify pain in students with intellectual disability (ID), students cannot be referred to the school nurse for assessment and management. The purpose of this study was to examine how special educators identify pain in the school setting. Twenty-four special educators participated in focus groups aiming to (1) identify educators’ observations and perceptions of pain in students with ID and (2) determine the decision-making processes educators use to determine the need for student presentation or referral to the health office. Overall, special educators know students well enough to differentiate pain-related behaviors from normal well-child behaviors, prioritize student safety, and draw on personal experiences with pain when addressing pain in students with ID. Special educators welcome opportunities to learn more about pain in children with ID. Teachers, nurses, and other professionals should share knowledge about and experiences of working with students in pain to improve practices.

Using Theory Integration to Explore Complex Health Problems.

Although nursing leaders call for theory utilization in research, use remains low within the discipline. The purpose of this article is to explore the application of interdisciplinary integration of models and theories to nursing research. An example of theory integration for the purposes of guiding a study relevant to school nursing is described. A conceptual-theoretical-empirical structure based on the Neumans systems model, a nursing theory, integrated with the social communication model of pain, a psychology model, was developed to guide the study to examine pain assessment for schoolchildren with intellectual and developmental disabilities.