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Int J Nurs Pract. 2018 Dec;24(6):e12695. doi: 10.1111/ijn.12695. Epub 2018 Sep 24.

The state of the science in paediatric pain management practices in low-middle income countries: An integrative review.

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University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Division of Anesthesiology and Critical Care Medicine/Critical Care Nursing, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.



Examine the state of the science for pain management in children living in low-middle income countries (LMIC).


Significant challenges exist in pain management for children living in LMIC.


An integrative review was conducted using PRISMA guidelines for quality of reporting. Literature searches were completed using Medline, PubMed, Scopus, and CINAHL databases for publications between January 2006 and August 2016 using MeSH and primary search terms pain and LMIC. Full text publications were evaluated using GRADE criterion and methodology specific evaluation tools.


Of 1510 publications identified, 31 met the criteria for inclusion. Data were categorized into three broad themes: (1) magnitude of the pain problem with subthemes describing the burden of and resources for paediatric pain management; (2) perceptions, experience, and practices for managing pain in children residing in LMIC with subthemes addressing health care providers, parent/caregiver and children, respectively; and (3) pain management practices with pain assessment and treatment strategies as subthemes.


Current data on paediatric pain management in LMIC are limited with respect to describing the burden of pain, children's pain perceptions and experiences, and pain management practices. Rigorous investigations are needed to expand knowledge and address the pervasive problem of pain for children in LMIC.


integrative review; low-middle income countries (LMIC); nursing; paediatric pain; pain; pain management

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