Nursing Attitude and Intervention for Cancer Related Pain in Children

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The purpose of this project is to establish the effective nursing intervention for cancer pain in children in Japan. The research findings from 1995 to 1997 studies are follows :1. In 1995, extensive literature review was carried out. There were discrepancy between how nurses and physician had perceive about children's pain and what they intervene for the pain of children. Passive use of analgesia, lack of enough information sharing, incorrect knowledge of pain relief are some of indications for inadequate pain relief for children. The needs for more detailed survey study to clarify the condition of care setting for children in pain.2. In 1996, the survey was conducted. As the results, 20% to 50% of nurses had misunderstanding of the nature of children's behavior in pain and use of morphine. The use of analgesia and morphine was found to be passive and considerable response indicated that strong analgesia and/or narcotics were considered as last resort for pain alleviation. Inadequate pain relief in children's pain condition were indicated.3. In 1997, in order to grasp what is happening in the care situation for children in pain, interview was conducted. The nurse who has been working in the leading hospital for children's pain relief. From the results, the process of how the nurses makes clinical judgment about the need of pain intervention was constructed. The process has two dimensions : judgment about the nature of pain and judgment to determine effective intervention. The nurses were feeling inadequate about outcome of these judgement. Recommendation for approach to children in pain which include the necessary assessment process and items, the list of environmental factors to be improve, the need of clarifying value and belief about pain experience among people involved in the care, the support from organizational system, and others were proposed.