Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment

Ayşe Şener Taplak

doi:10.37989/gumussagbil.1095539

Araştırma Makalesi

Bilişsel Bozukluğu Olan Çocuklarda Ağrı Yönetimine İlişkin Pediatri Hemşirelerinin Bilgi ve Uygulamaları

Yıl 2023, Cilt: 12 Sayı: 4, 1807 - 1816, 26.12.2023

Ayşe Şener Taplak

https://doi.org/10.37989/gumussagbil.1095539

Öz

Bu kesitsel çalışma, pediatri hemşirelerinin bilişsel bozukluğu olan çocuklarda ağrı yönetimine ilişkin bilgi ve uygulamalarını belirlemek amacıyla yapıldı. Araştırmanın örneklemini bir ilde bulunan iki farklı hastanede görev yapan 65 pediatri hemşiresi oluşturdu. Kurum izinleri, etik kurul izni ve katılımcı onamının alınmasının ardından veriler tanıtıcı özellikler veri formu ile bilişsel bozukluğu olan çocuklarda ağrı yönetimine ilişkin bilgi ve uygulamaları belirlemeye yönelik bir anket formu kullanılarak toplandı. Verilerin analizinde tanımlayıcı istatistiksel analizler ve ki-kare testi kullanıldı.
Pediatri hemşirelerinin çoğunluğu, bilişsel bozukluğu olan çocuklarda ağrının değerlendirilmesinde kullanılan parametreleri, yüz ifadeleri ve davranışsal tepkiler olarak bildirdi. Hemşirelerin sadece %16.9'unun ağrıyı ölçek kullanarak değerlendirdiği saptandı. Bilişsel bozukluğu olan çocukların ağrısının giderilmesinde hemşirelerin çalıştıkları klinikte %55.4'ünün nonfarmakolojik, %35.4'ünün farmakolojik yöntemleri kullandıkları ve %9.2'sinde spesifik bir yöntem kullanılmadığı belirlendi. Hemşirelerce en sık kullanılan nonfarmakolojik yöntemlerin sırasıyla dikkati başa yöne çekme, masaj, soğuk uygulama olduğu belirlendi. Nonfarmakolojik yöntem kullanma ile hemşirelerin cinsiyeti ve daha önce ağrı yönetimi konusunda eğitim alma arasında anlamlı farklılık bulundu (p<0.05). Bilişsel bozukluğu olan çocuklarda ağrının değerlendirilmesi ve nonfarmakolojik ağrı giderme yöntemleri hakkında hemşirelere yönelik eğitimler düzenlenmesi, ayrıca kliniklerde ağrı değerlendirmesinde uygun ölçeklerin kullanımının yaygınlaştırılması önerilir.

Anahtar Kelimeler

Ağrı, Bilişsel bozukluk, Çocuk, Hemşire

Kaynakça

1. Breau, LM, Camfield, CS, McGrath, PJ. and Finley, GA. (2003). “The Incidence of Pain in Children with Severe Cognitive Impairments”. Arch Pediatr Adolesc Med., 157(12), 1219-1226. doi:10.1001/archpedi.157.12.1219.
2. Massaro, M, Pastore, S, Ventura, A. and Barbi E. (2013). “Pain in Cognitively Impaired Children: A Focus for General Pediatricians”. Eur J Pediatr., 172(1), 9-14. doi:10.1007/s00431-012-1720-x.
3. Carter, B. and Simons, J. (2014). “Assessing and Managing Pain in a Child Who is Cognitively İmpaired: Grace’s story,” in Stories of Children’s Pain Linking Evidence to Practice, B. Carter and J. Simons, Eds., pp. 111–130, Sage Publications, London, UK. doi:10.4135/9781446288245.
4. American Psychiatric Association. (2013). “Diagnostic and Statistical Manual of Mental Disorders: DSM-5, Fifth Edition”. Vol 33-41.
5. Pizzinato, A, Liguoro, I, Pusiol, A, Cogo, P, Palese, A. and Vidal, E. (2022). “Detection and Assessment of Postoperative Pain in Children with Cognitive İmpairment: A Systematic Literature Review and Meta-Analysis”. European Journal of Pain (London, England), 26(5), 965–979. https://doi.org/10.1002/ejp.1936.
6. Carter, B, Simons, J, Bray, L. and Arnott J. (2016). “Navigating Uncertainty: Health Professionals' Knowledge, Skill, and Confidence in Assessing and Managing Pain in Children with Profound Cognitive Impairment”. Pain Res Manag., 2016, 8617182. doi:10.1155/2016/8617182.
7. Cascella, M, Bimonte, S, Saettini, F. and Muzio, MR. (2019). “The Challenge of Pain Assessment in Children with Cognitive Disabilities: Features and Clinical Applicability of Different Observational Tools”. J Paediatr Child Health, 55(2), 129-135. doi:10.1111/jpc.14230.
8. Zernikow, B, Wager, J, Hechler, T, Hasan, C, Rohr, U, Dobe, M, Meyer, A, Hübner-Möhler, B, Wamsler, C. and Blankenburg, M (2012). “Characteristics of Highly Impaired Children with Severe Chronic Pain: A 5-Year Retrospective Study on 2249 Pediatric Pain Patients”. BMC Pediatr, 12, 54. doi:10.1186/1471-2431-12-54.
9. Tedroff, K, Gyllensvärd, M. and Löwing, K. (2021). “Prevalence, Identification, and Interference of Pain in Young Children with Cerebral Palsy: A Population-Based Study”. Disabil Rehabil., 43(9), 1292-1298. doi:10.1080/09638288.2019.1665719.
10. Calver, J, Balogh, R. and Rudoler, D. (2021). “Incidence of Injury in Children and Adolescents with Intellectual and Developmental Disability”. J Safety Res., Jun;77, 56-60. doi: 10.1016/j.jsr.2021.02.003.
11. Newacheck, PW, Inkelas, M. and Kim, SE. (2004). “Health Services Use and Health Care Expenditures for Children with Disabilities”. Pediatrics, 114 (1), 79–85. doi:10.1542/peds.114.1.79.
12. Voepel-Lewis, T, Malviya, S. and Tait, AR. (2005). “Validity of Parent Ratings As Proxy Measures of Pain in Children with Cognitive İmpairment”. Pain Manag Nurs., Dec;6(4), 168-74. doi: 10.1016/j.pmn.2005.08.004. PMID: 16337564.
13. Stallard, P, Williams, L, Velleman, R, Lenton, S. and McGrath, PJ. (2002). “Brief Report: Behaviors Identified by Caregivers to Detect Pain in Noncommunicating Children”. J Pediatr Psychol., 27(2), 209-214. doi:10.1093/jpepsy/27.2.209.
14. Friedrichsdorf, SJ, Postier, A, Eull, D, Weidner, C, Foster, L, Gilbert, M. and Campbell, F. (2015). “Pain Outcomes in a US Children's Hospital: A Prospective Cross-Sectional Survey”. Hosp Pediatr., 5(1), 18-26. doi:10.1542/hpeds.2014-0084.
15. Birnie, KA, Chambers, CT, Fernandez, CV, Forgeron, PA, Latimer, MA, McGrath, PJ, Cummings, EA. and Finley, GA. (2014). “Hospitalized Children Continue to Report Undertreated and Preventable Pain”. Pain Res Manag, 19(4), 198-204. doi:10.1155/2014/614784.
16. Shomaker, K, Dutton, S. and Mark, M. (2015). “Pain Prevalence and Treatment Patterns in a US Children's Hospital”. Hosp Pediatr, 5(7), 363-370. doi:10.1542/hpeds.2014-0195.
17. Stallard, P, Williams, L, Velleman, R, Lenton, S, McGrath, PJ. and Taylor, G. (2002). “The Development and Evaluation of the Pain Indicator for Communicatively Impaired Children (PICIC)”. Pain, Jul;98(1-2), 145-149. doi: 10.1016/s0304-3959(02)00038-6.
18. Findlay, B, Switzer, L, Narayanan, U, Chen, S. and Fehlings, D. (2016). “Investigating the Impact of Pain, Age, Gross Motor Function Classification System, and Sex on Health-Related Quality of Life in Children with Cerebral Palsy”. Dev Med Child Neurol., 58(3), 292-297. doi:10.1111/dmcn.12936.
19. Akdeniz Kudubeş, A, Bektaş, İ. and Bektaş, M. (2021). “Nursing Role in Children Pain Management”. J Educ Res Nurs., 18(1), 107-113. doi: 10.5152/jern.2021.91489.
20. Royal College of Nursing. (2009). Improving Practice, Improving Care: The Recognition and Assessment of Acute Pain in Children: Update of Full Guideline. London: RCN.
21. Fanurik, D, Koh, JL, Schmitz, ML, Harrison, RD, Roberson, PK. and Killebrew, P. (1999). “Pain Assessment and Treatment in Children with Cognitive Impairment: A Survey of Nurses' and Physicians' Beliefs”. Clin J Pain, 15(4), 304-312. doi:10.1097/00002508-199912000-00007.
22. Fanurik, D, Koh, JL, Schmitz, ML, Harrison, RD. and Conrad TM. (1999). “Children with Cognitive Impairment: Parent Report of Pain and Coping”. J Dev Behav Pediatr, 20(4), 228-234. doi:10.1097/00004703-199908000-00005.
23. McGrath, PJ, Rosmus, C, Canfield, C, Campbell, MA. and Hennigar, A. (1998). “Behaviours Caregivers Use to Determine Pain in Non-Verbal, Cognitively Impaired Individuals”. Dev Med Child Neurol, 40(5), 340-343.
24. Defrin, R, Lotan, M. and Pick, CG. (2006). “The Evaluation of Acute Pain in Individuals with Cognitive Impairment: A Differential Effect of The Level of Impairment”. Pain, 124(3), 312-320. doi:10.1016/j.pain.2006.04.031.
25. Carter, B, Arnott, J, Simons, J. and Bray, L. (2017). “Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers' Perspectives”. Pain Res Manag., 2017, 2514920. doi:10.1155/2017/2514920.
26. Hunt, A, Mastroyannopoulou, K, Goldman, A. and Seers, K. (2003). “Not Knowing--The Problem of Pain in Children with Severe Neurological Impairment”. Int J Nurs Stud., 40(2), 171-183. doi:10.1016/s0020-7489(02)00058-5.
27. Malviya, S, Voepel-Lewis, T, Merkel, S. and Tait AR. (2005). “Difficult Pain Assessment and Lack of Clinician Knowledge are Ongoing Barriers to Effective Pain Management in Children with Cognitive İmpairment”. Acute Pain, 7(1), 27–32. doı:10.1016/j.acpain.2005.01.002.
28. Hunt, A, Goldman, A, Seers, K, Crichton, N, Mastroyannopoulou, K, Moffat, V, Oulton, K. and Brady, M. (2004). “Clinical Validation of the Paediatric Pain Profile”. Dev Med Child Neurol., 46(1), 9-18. doi:10.1017/s0012162204000039.
29. Association of Paediatric Anaesthetists of Great Britain and Ireland. (2012). “Good Practice in Postoperative and Procedural Pain management, 2nd edition”. Paediatric Anaesthesia, 22 Suppl 1, 1–79. doi:10.1111/j.1460-9592.2012.03838.x
30. Malviya, S, Voepel-Lewis, T, Burke, C, Merkel, S. and Tait, AR. (2006). “The Revised FLACC Observational Pain Tool: Improved Reliability and Validity for Pain Assessment in Children with Cognitive Impairment”. Paediatr Anaesth, 16(3), 258-265. doi:10.1111/j.1460-9592.2005.01773.x.
31. Breau, LM, Finley, GA, McGrath, PJ. and Camfield, CS. (2002). “Validation of the Non-communicating Children's Pain Checklist-Postoperative Version”. Anesthesiology, 96(3), 528-535. doi:10.1097/00000542-200203000-00004.
32. Malviya, S, Voepel-Lewis, T, Tait, AR, Merkel, S, Lauer, A, Munro, H. and Farley, F. (2001). “Pain Management in Children with and without Cognitive Impairment Following Spine Fusion Surgery”. Paediatr Anaesth, 11(4), 453-458. doi:10.1046/j.1460-9592.2001.00686.x
33. Koh, JL, Fanurik, D, Dale Harrison, R, Schmitz, ML and Norvell, D. (2004). “Analgesia Following Surgery in Children with and without Cognitive Impairment”. Pain, 111(3), 239-244. doi:10.1016/j.pain.2004.07.005.
34. Schreiber, S, Cozzi, G, Rutigliano, R, Assandro, P, Tubaro, M, Cortellazzo Wiel, L, Ronfani, L. and Barbi, E. (2016). “Analgesia by Cooling Vibration During Venipuncture in Children with Cognitive Impairment”. Acta Paediatr, 105(1), e12-e16. doi:10.1111/apa.13224.
35. Zabalia, M. and Esquerré, F. (2009). “Prerequisite Abilities in the Use of Hypnosis for Pain in Children With Cognitive Impairment”. Journal of Pain Management, 2(1), 63-69.

Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment

Yıl 2023, Cilt: 12 Sayı: 4, 1807 - 1816, 26.12.2023

Ayşe Şener Taplak

https://doi.org/10.37989/gumussagbil.1095539

Öz

This study was conducted with a cross-sectional design to determine pediatric nurses' knowledge and practices related to pain management in children with cognitive impairment. The sample of the study consisted of 65 pediatric nurses working in two different hospitals in one city. After obtaining institutionals, ethics committee permissions, and written consent from participants, the data were collected using a ıntroductory characteristics form and a questionnaire to determine knowledge and practices regarding pain management in children with cognitive impairment. Descraiptive statistics and Chi-square tests were used for data analyses.
The majority of the pediatric nurses reported the parameters used to assess pain among children with cognitive impairment as facial expressions and behavioral responses. Only 16.9% of nurses evaluated pain using a scale. In terms of reducing the pain of children with cognitive impairment, 55.4%, 35.4% of nurses reported that they used nonpharmacological, pharmacological methods, respectively, and 9.2% no specific methods were used in the clinic where they worked. The commonly used nonpharmacological methods were distraction, massage, cold application, etc. A significant difference was found in the use of nonpharmacological methods with respect to gender and previous training on pain management (p<0.05). It is recommended to organize training for nurses on the assessment of pain in children with cognitive impairment and non-pharmacological pain relief methods, and to popularize the use of appropriate scales in pain assessment in clinics.

Anahtar Kelimeler

Child, Cognitive Impairment, Nurse, Pain

Kaynakça

1. Breau, LM, Camfield, CS, McGrath, PJ. and Finley, GA. (2003). “The Incidence of Pain in Children with Severe Cognitive Impairments”. Arch Pediatr Adolesc Med., 157(12), 1219-1226. doi:10.1001/archpedi.157.12.1219.
2. Massaro, M, Pastore, S, Ventura, A. and Barbi E. (2013). “Pain in Cognitively Impaired Children: A Focus for General Pediatricians”. Eur J Pediatr., 172(1), 9-14. doi:10.1007/s00431-012-1720-x.
3. Carter, B. and Simons, J. (2014). “Assessing and Managing Pain in a Child Who is Cognitively İmpaired: Grace’s story,” in Stories of Children’s Pain Linking Evidence to Practice, B. Carter and J. Simons, Eds., pp. 111–130, Sage Publications, London, UK. doi:10.4135/9781446288245.
4. American Psychiatric Association. (2013). “Diagnostic and Statistical Manual of Mental Disorders: DSM-5, Fifth Edition”. Vol 33-41.
5. Pizzinato, A, Liguoro, I, Pusiol, A, Cogo, P, Palese, A. and Vidal, E. (2022). “Detection and Assessment of Postoperative Pain in Children with Cognitive İmpairment: A Systematic Literature Review and Meta-Analysis”. European Journal of Pain (London, England), 26(5), 965–979. https://doi.org/10.1002/ejp.1936.
6. Carter, B, Simons, J, Bray, L. and Arnott J. (2016). “Navigating Uncertainty: Health Professionals' Knowledge, Skill, and Confidence in Assessing and Managing Pain in Children with Profound Cognitive Impairment”. Pain Res Manag., 2016, 8617182. doi:10.1155/2016/8617182.
7. Cascella, M, Bimonte, S, Saettini, F. and Muzio, MR. (2019). “The Challenge of Pain Assessment in Children with Cognitive Disabilities: Features and Clinical Applicability of Different Observational Tools”. J Paediatr Child Health, 55(2), 129-135. doi:10.1111/jpc.14230.
8. Zernikow, B, Wager, J, Hechler, T, Hasan, C, Rohr, U, Dobe, M, Meyer, A, Hübner-Möhler, B, Wamsler, C. and Blankenburg, M (2012). “Characteristics of Highly Impaired Children with Severe Chronic Pain: A 5-Year Retrospective Study on 2249 Pediatric Pain Patients”. BMC Pediatr, 12, 54. doi:10.1186/1471-2431-12-54.
9. Tedroff, K, Gyllensvärd, M. and Löwing, K. (2021). “Prevalence, Identification, and Interference of Pain in Young Children with Cerebral Palsy: A Population-Based Study”. Disabil Rehabil., 43(9), 1292-1298. doi:10.1080/09638288.2019.1665719.
10. Calver, J, Balogh, R. and Rudoler, D. (2021). “Incidence of Injury in Children and Adolescents with Intellectual and Developmental Disability”. J Safety Res., Jun;77, 56-60. doi: 10.1016/j.jsr.2021.02.003.
11. Newacheck, PW, Inkelas, M. and Kim, SE. (2004). “Health Services Use and Health Care Expenditures for Children with Disabilities”. Pediatrics, 114 (1), 79–85. doi:10.1542/peds.114.1.79.
12. Voepel-Lewis, T, Malviya, S. and Tait, AR. (2005). “Validity of Parent Ratings As Proxy Measures of Pain in Children with Cognitive İmpairment”. Pain Manag Nurs., Dec;6(4), 168-74. doi: 10.1016/j.pmn.2005.08.004. PMID: 16337564.
13. Stallard, P, Williams, L, Velleman, R, Lenton, S. and McGrath, PJ. (2002). “Brief Report: Behaviors Identified by Caregivers to Detect Pain in Noncommunicating Children”. J Pediatr Psychol., 27(2), 209-214. doi:10.1093/jpepsy/27.2.209.
14. Friedrichsdorf, SJ, Postier, A, Eull, D, Weidner, C, Foster, L, Gilbert, M. and Campbell, F. (2015). “Pain Outcomes in a US Children's Hospital: A Prospective Cross-Sectional Survey”. Hosp Pediatr., 5(1), 18-26. doi:10.1542/hpeds.2014-0084.
15. Birnie, KA, Chambers, CT, Fernandez, CV, Forgeron, PA, Latimer, MA, McGrath, PJ, Cummings, EA. and Finley, GA. (2014). “Hospitalized Children Continue to Report Undertreated and Preventable Pain”. Pain Res Manag, 19(4), 198-204. doi:10.1155/2014/614784.
16. Shomaker, K, Dutton, S. and Mark, M. (2015). “Pain Prevalence and Treatment Patterns in a US Children's Hospital”. Hosp Pediatr, 5(7), 363-370. doi:10.1542/hpeds.2014-0195.
17. Stallard, P, Williams, L, Velleman, R, Lenton, S, McGrath, PJ. and Taylor, G. (2002). “The Development and Evaluation of the Pain Indicator for Communicatively Impaired Children (PICIC)”. Pain, Jul;98(1-2), 145-149. doi: 10.1016/s0304-3959(02)00038-6.
18. Findlay, B, Switzer, L, Narayanan, U, Chen, S. and Fehlings, D. (2016). “Investigating the Impact of Pain, Age, Gross Motor Function Classification System, and Sex on Health-Related Quality of Life in Children with Cerebral Palsy”. Dev Med Child Neurol., 58(3), 292-297. doi:10.1111/dmcn.12936.
19. Akdeniz Kudubeş, A, Bektaş, İ. and Bektaş, M. (2021). “Nursing Role in Children Pain Management”. J Educ Res Nurs., 18(1), 107-113. doi: 10.5152/jern.2021.91489.
20. Royal College of Nursing. (2009). Improving Practice, Improving Care: The Recognition and Assessment of Acute Pain in Children: Update of Full Guideline. London: RCN.
21. Fanurik, D, Koh, JL, Schmitz, ML, Harrison, RD, Roberson, PK. and Killebrew, P. (1999). “Pain Assessment and Treatment in Children with Cognitive Impairment: A Survey of Nurses' and Physicians' Beliefs”. Clin J Pain, 15(4), 304-312. doi:10.1097/00002508-199912000-00007.
22. Fanurik, D, Koh, JL, Schmitz, ML, Harrison, RD. and Conrad TM. (1999). “Children with Cognitive Impairment: Parent Report of Pain and Coping”. J Dev Behav Pediatr, 20(4), 228-234. doi:10.1097/00004703-199908000-00005.
23. McGrath, PJ, Rosmus, C, Canfield, C, Campbell, MA. and Hennigar, A. (1998). “Behaviours Caregivers Use to Determine Pain in Non-Verbal, Cognitively Impaired Individuals”. Dev Med Child Neurol, 40(5), 340-343.
24. Defrin, R, Lotan, M. and Pick, CG. (2006). “The Evaluation of Acute Pain in Individuals with Cognitive Impairment: A Differential Effect of The Level of Impairment”. Pain, 124(3), 312-320. doi:10.1016/j.pain.2006.04.031.
25. Carter, B, Arnott, J, Simons, J. and Bray, L. (2017). “Developing a Sense of Knowing and Acquiring the Skills to Manage Pain in Children with Profound Cognitive Impairments: Mothers' Perspectives”. Pain Res Manag., 2017, 2514920. doi:10.1155/2017/2514920.
26. Hunt, A, Mastroyannopoulou, K, Goldman, A. and Seers, K. (2003). “Not Knowing--The Problem of Pain in Children with Severe Neurological Impairment”. Int J Nurs Stud., 40(2), 171-183. doi:10.1016/s0020-7489(02)00058-5.
27. Malviya, S, Voepel-Lewis, T, Merkel, S. and Tait AR. (2005). “Difficult Pain Assessment and Lack of Clinician Knowledge are Ongoing Barriers to Effective Pain Management in Children with Cognitive İmpairment”. Acute Pain, 7(1), 27–32. doı:10.1016/j.acpain.2005.01.002.
28. Hunt, A, Goldman, A, Seers, K, Crichton, N, Mastroyannopoulou, K, Moffat, V, Oulton, K. and Brady, M. (2004). “Clinical Validation of the Paediatric Pain Profile”. Dev Med Child Neurol., 46(1), 9-18. doi:10.1017/s0012162204000039.
29. Association of Paediatric Anaesthetists of Great Britain and Ireland. (2012). “Good Practice in Postoperative and Procedural Pain management, 2nd edition”. Paediatric Anaesthesia, 22 Suppl 1, 1–79. doi:10.1111/j.1460-9592.2012.03838.x
30. Malviya, S, Voepel-Lewis, T, Burke, C, Merkel, S. and Tait, AR. (2006). “The Revised FLACC Observational Pain Tool: Improved Reliability and Validity for Pain Assessment in Children with Cognitive Impairment”. Paediatr Anaesth, 16(3), 258-265. doi:10.1111/j.1460-9592.2005.01773.x.
31. Breau, LM, Finley, GA, McGrath, PJ. and Camfield, CS. (2002). “Validation of the Non-communicating Children's Pain Checklist-Postoperative Version”. Anesthesiology, 96(3), 528-535. doi:10.1097/00000542-200203000-00004.
32. Malviya, S, Voepel-Lewis, T, Tait, AR, Merkel, S, Lauer, A, Munro, H. and Farley, F. (2001). “Pain Management in Children with and without Cognitive Impairment Following Spine Fusion Surgery”. Paediatr Anaesth, 11(4), 453-458. doi:10.1046/j.1460-9592.2001.00686.x
33. Koh, JL, Fanurik, D, Dale Harrison, R, Schmitz, ML and Norvell, D. (2004). “Analgesia Following Surgery in Children with and without Cognitive Impairment”. Pain, 111(3), 239-244. doi:10.1016/j.pain.2004.07.005.
34. Schreiber, S, Cozzi, G, Rutigliano, R, Assandro, P, Tubaro, M, Cortellazzo Wiel, L, Ronfani, L. and Barbi, E. (2016). “Analgesia by Cooling Vibration During Venipuncture in Children with Cognitive Impairment”. Acta Paediatr, 105(1), e12-e16. doi:10.1111/apa.13224.
35. Zabalia, M. and Esquerré, F. (2009). “Prerequisite Abilities in the Use of Hypnosis for Pain in Children With Cognitive Impairment”. Journal of Pain Management, 2(1), 63-69.

Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Çocuk Sağlığı ve Hastalıkları Hemşireliği
Bölüm	Araştırma Makaleleri
Yazarlar	Ayşe Şener Taplak 0000-0002-4229-038X
Yayımlanma Tarihi	26 Aralık 2023
Yayımlandığı Sayı	Yıl 2023 Cilt: 12 Sayı: 4

Kaynak Göster

APA	Şener Taplak, A. (2023). Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 12(4), 1807-1816. https://doi.org/10.37989/gumussagbil.1095539
AMA	Şener Taplak A. Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. Aralık 2023;12(4):1807-1816. doi:10.37989/gumussagbil.1095539
Chicago	Şener Taplak, Ayşe. “Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children With Cognitive Impairment”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 12, sy. 4 (Aralık 2023): 1807-16. https://doi.org/10.37989/gumussagbil.1095539.
EndNote	Şener Taplak A (01 Aralık 2023) Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 12 4 1807–1816.
IEEE	A. Şener Taplak, “Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment”, Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 12, sy. 4, ss. 1807–1816, 2023, doi: 10.37989/gumussagbil.1095539.
ISNAD	Şener Taplak, Ayşe. “Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children With Cognitive Impairment”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 12/4 (Aralık 2023), 1807-1816. https://doi.org/10.37989/gumussagbil.1095539.
JAMA	Şener Taplak A. Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2023;12:1807–1816.
MLA	Şener Taplak, Ayşe. “Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children With Cognitive Impairment”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 12, sy. 4, 2023, ss. 1807-16, doi:10.37989/gumussagbil.1095539.
Vancouver	Şener Taplak A. Pediatric Nurses’ Knowledge and Practices Related Pain Management in Children with Cognitive Impairment. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2023;12(4):1807-16.

Kapak Resmi İndir

Makale Dosyaları

Tam Metin