PROVIDE SUCCINCT SUMMARY OF THE STATE OF EVIDENCE RELATED TO THE AREA OF INTEREST (I.E. HOW RIGOROUS THE STUDY WAS PERFORMED, QUALITY, AND EXTENT OF THE EVIDENCE, CONFIDENCE AND RATIONALE FOR CONFIDENCE IN THE GENERALIZATION OF THE COLLECTIVE FINDINGS OF THESE RESEARCH STUDIES.
Provide succinct summary of the state of evidence related to the area of interest (i.e. how rigorous the study was performed, quality, and extent of the evidence, confidence and rationale for confidence in the generalizability of the collective findings of these research studies.
Example of State of Evidence:
A focused review of nursing literature was conducted to
determine the state of the science with respect to nursing practice
and education in managing pain in pediatric patients. The
Cumulative Index for Nursing and Allied Health database was used to
identify research articles that pertain to nursing practice and
education in managing pain in pediatric patients. From this
database, 3 research articles that were written in English;
published in scholarly nursing journals between 2000 and 2012; and
that contained the words pediatric, pain management, and nursing in
the title and/or abstract and in which pediatric pain management
was a major term were analyzed.
George (2012) conducted a quantitative retrospective study to determine parent satisfaction with pain management of children following abdominal surgery. Kolcaba’s Comfort Theory was used as a framework. Pain was conceptually defined as “a sensation of discomfort with physiological changes in vital signs”. Two weeks following patient discharge, a convenience sample of 10 parents (five Caucasian, 3 African American, and 2 Hispanic) was invited to answer a 20 question survey named “The Pain Experience Survey”. The survey had content validity and no reliability data were reported. Parents rated each question on a 5 point Likert Scale with 5 being Strongly Agree, 4 Agree, 3 Neutral, 2 Disagree, 1 Strongly Disagree. The study was limited by the convenience sampling, small number of participants, reliance of subjects recalling events, and questionable rigor.
Calico and Miller (2012) conducted a quasi-experimental study…….
Weitkamp (2008), on the other hand, performed as qualitative study employing a phenomenological approach…
In summary, three research articles were reviewed on pain management in children. Each of the three studies reviewed had different methodological approaches. Two were quantitative design and the last by Weitkamp was qualitative. In all three studies, rigor was compromised due to the convenience sampling, small sample size, and few culturally diverse clients. Conceptual and operational definitions were clearly defined in Calico and Miller’s study, but not by George or Weitkamp. One study (George, 2012) included a theoretical framework by Neuman. Limitations of the studies were clearly delineated as small convenience samples and a lack of valid and reliable instruments. Nurses and other health care professionals affirm that pediatric pain assessment is inconsistent and that this inconsistency compromises the quality of care. In addition results of this review indicate that there are few valid and reliable instruments to measure pediatric pain and the administration of pain medication is frequently based on what the previous nurse administered, rather than on a timely nurse assessment (George, 2010; Calico & Miller, 2012; Gardner, 2008).
Pediatric pain management is salient to quality care, but there is a dearth of scholarly evidence to inform practice, to support change in practice, and adequately educate nurses. More research on pediatric pain management is recommended that includes interdisciplinary collaboration of experts in pain management, pediatric care, assessment and cultural diversity.
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