Caregivers' perceptions, knowledge, and perceived barriers to pediatric procedural pain management: a cross-sectional study.

Introduction: Pain from medical procedures can have negative effects on children and adolescents (eg, healthcare avoidance), and is often not adequately prevented and treated. Best practices emphasize the important role of caregivers in procedural pain management. Objectives: To investigate caregivers' perceptions, knowledge, and behaviours related to their children's procedural pain management and to describe the barriers perceived by caregivers encountered during the management of their child's procedural pain. Methods: This was a cross-sectional online survey of caregivers with children aged 0 to 17 years. Statistical analysis of closed-ended responses and inductive content analysis of open-ended responses were completed. Results: Among 104 caregivers (56.7% female, average child age = 8.9 years), 93% were present during their child's recent painful procedure, 62% reported participating in pain management, and 66% perceived their child's recent procedural pain was well-managed. The most used pain management strategies reported were psychological (eg, 59% used deep breathing). Caregivers reported seeking information about pain management from electronic sources (37%) and/or healthcare providers (35%), and 70% reported being satisfied with the information available to them. Caregivers reported their own lack of knowledge, their child's emotions, communication breakdowns, and healthcare professional attitudes as barriers to helping with pain management. Conclusions: Caregivers are often present during their children's painful procedures, but many reported not being involved in pain management. Despite significant progress in procedural pain management, there remain knowledge gaps among caregivers and barriers to their active engagement. Addressing these may help to improve pediatric procedural pain management implementation.