A psychoeducational intervention for pediatric residents: Pediatric pain
Donnenfeld, Penny B.
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This study assessed the effectiveness of an experimental psychoeducational intervention designed to teach pediatric residents about behavioral and nonpharmacological methods for pediatric pain control. The need for effective training for pediatric residents on pediatric pain is demonstrated dramatically in the pretest data. Discussion of the difficulties in imparting psychobiological concepts within the realm of pediatric education and long-standing inconsistencies in treatment of pediatric pain conditions are reviewed.;Subjects were medical residents at two Metropolitan area hospitals. A total of 63 residents participated in some part of the study. The experimental intervention consisted of three one-hour sessions employing an interactive format and a video of a primary care pediatrician working with patients. The control intervention consisted of three hours of traditional lecture instruction covering the same material. The criterion measures included scales measuring: (1) attitude toward the use of behavioral and nonpharmacologic methods of pain control; (2) degree of personal discomfort with pediatric procedures and situations involving pain; and (3) knowledge of pediatric pain and pain management procedures.;It was hypothesized that on post test measure the residents in the experimental group, as compared to controls, would demonstrate: (1) greater mastery of the course material; (2) more positive attitudes toward nonpharmacologic techniques; (3) more prevalent use of training hand-outs; (4) more interest in further training, and (5) significantly less discomfort in behaviorally managing patient care in painful situations.;No significant effect was found due to treatment group. Some changes in scores on the criterion variables were observed. Overall, both groups showed more favorable attitudes after exposure to the course materials. Both groups showed comparable decreases in personal degree of discomfort in patient management.;The results are discussed with regard to: (1) the mechanics of teaching the courses, and (2) the range of behavioral responses to the material are reviewed. Also, specific limitations in the experimental design of the study are explored. It is emphasized that in order for biopsychosocial educational offerings on pediatric pain and pain control to be more successful, senior faculty role-models and overlearning or practice of strategies in clinical settings may be crucial.
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