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Background The highest incidence of preterm birth (18%) occurs in Africa but the causes are largely unknown. Some studies have reported adverse effects of maternal physical exertion on birth outcomes. A randomized controlled trial (RCT) is proposed to determine the effectiveness of an intervention reducing lifting and carrying in pregnant women in reducing preterm birth and low birthweight. Aims To test the feasibility and acceptability of the proposed lift-less intervention RCT. Methods We recruited pregnant women and midwives from antenatal clinics within the Greater Accra Region of Ghana. The midwives were trained to administer the intervention during a 5-week trial. Four intervention trial sessions were organized at weekly intervals. Results Seven pregnant women and six midwives participated. After piloting, we observed a reduction in participants' self-reported daily exposure to heavy lifting and carrying. The daily average frequency of lifting by a participant within the first seven days of the study was 3.5 (SD 1.7) with an estimated mean total weight of 41.1 kg (SD = 13.3 kg). This had decreased to 2.3 (SD = 1.0) and the amount to 13.4 kg (SD = 10.9) within the last seven days of the study. Conclusions The findings provide insight into the daily physical exertion experienced by pregnant women in Ghana. The lift-less intervention trial is feasible with modifications and has the potential to reduce excessive physical exertion among pregnant women in Ghana to improve birth outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To assess pain levels of hemodialysis (HD) patients and to report pain management techniques. Materials and methods: A quantitative descriptive study design with a summative approach to qualitative analysis was held, with a personal interview of the HD patients in a Southern European city hospital (n=70), using the Visual Analog Scales (VAS), the Wong-Baker Pain Scales (WBPS) and McGill Pain Questionnaire. People confused or in a coma, with hearing or reading problems and inability to communicate in the spoken language were excluded. Results: Renal patients under investigation were 69.72 ±12.45 years old, male (58.5%) and on HD for 35.5 ± 27.4 months. In the Wong Baker Scale, pain was rated as "hurts little more" 30.8%, (n=20) and in the VAS 30.8% (n=20) reported 6/10 the amount of pain experienced. Forty-six percent pinpointed internal pain in the legs. Pain experienced was characterized as sickening (70.8%), tiring (67.7%), burning (66.2%), rhythmic (86.2%), periodic (66.2%) and continuous (61.5%). The patients studied mainly manage pain either with warm towel/cloth (85.2% females and all male patients), with massage (84.2% and 88.9%, respectively) or painkillers (47.4% and 52.6%, respectively). In a correlation of gender and pain management techniques, statistical significance was found only with warm towel (p=0.038). Conclusions: As renal patients are an increasing group of healthcare service users, and pain is affecting their everyday life, it is essential to individualize pain evaluation and to provide further education to clinical nurses so that they can effectively manage pain. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine nurses' use of nonpharmacological methods for school-age children's postoperative pain relief. A survey was conducted in 2008 with a convenience sample of 134 registered nurses from 7 pediatric wards in Singapore. Nurses who were younger, had less education, lower designation, less working experience, and no children of their own used nonpharmacological methods less frequently. Nurses need training and education on nonpharmacological pain relief methods, particularly on methods that have been shown to be effective in prior research but that were less often used by nurses in this study: massage, thermal regulation, imagery, and positive reinforcement. [ABSTRACT FROM AUTHOR]

The aim of this study is to describe the benefits of video home training on families' health and interaction from the perspective of parents six months after the training. There is hardly any empirical knowledge of how a resource-enhancing approach could be used in nursing practice and how nursing in a home context affects the families' health outcomes and interaction. The study was designed as a descriptive qualitative service evaluation. Fifteen families with 66 family members participated in the study. The study material consisted of videotapes recorded at homes and family service plans produced during the process of the video home training. The data were analysed by qualitative content analysis and by the method of analysing photographs and videotapes. Video home training was found to bring about many positive effects on families' health and interaction. The families had reached their goals related to parenthood, relationship between the partners, childcare skills and child-rearing skills. The entire family benefited from the video home training. Video home training can be recommended in providing families with early support and anticipating and preventing family problems. Video home training is applicable to family nursing owing to the concrete and interactive nature of the method. It supports the realisation of family centredness and family orientation. [ABSTRACT FROM AUTHOR]

This study describes the extent to which registered and practical mental health nurses support, and consider the support in the units on parental responsibility in adult psychiatry, with regard to clients who are parents of dependent children and the predictors for this. A questionnaire survey was carried out in 2005 with Finnish practical and registered mental health nurses. Most nurses claimed that they support the well-being of parent clients and discuss with them about their children. At the units there is offered a support for parents in the therapeutic milieu and with managing at home with their parental duties. Nurses' ability to support their clients as parents and to recognize the support at the units increases through personal experiences such as being parent, professional experience, and further professional education. Copyright © 2010 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 65-74 Are the children of the clients' visible or invisible for nurses in adult psychiatry? - a questionnaire survey Children in families affected by mental illness are at an increased risk for developing psychopathology, emotional and behavioural problems. Nurses have direct and frequent contact with patients and their families, and are in a unique position to evaluate the situation of these children before problems arise. The aim of this study is to describe the interaction that practical mental health nurses (MHNs) and registered mental health currently have with children of their clients and predictors of this interaction when a parent is receiving psychiatric care. This is a cross-sectional study. In 2005, questionnaires were sent to all registered (n = 373) and practical MHNs (n = 235) working in 45 adult psychiatric inpatient and outpatient units in five Finnish university hospitals. The total response rate was 51%, while 60% (n = 222) of registered MHNs and 36% (n = 88) of practical MHNs responded. Most of the nurses did not meet children of their clients regularly, although they reported that information about children of the clients were gathered regularly at the units, and discussed clients' children with them. The personal characteristics of nurses, such as gender, age, marital status and being a parent, were significantly related to the nurse's propensity to pay attention to the children of their clients in adult psychiatry. Nurses' professional experience, further family education and use of family-centred care at the unit increased their interaction with the children of their patients. These results indicate that clients' children are not entirely invisible for most of the nurses in adult psychiatry. Knowledge of the risks faced by these children and implementation of the preventive approach should be included in the basic education of nurses. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 49-55 Nurses' attitudes and perceptions of pain assessment in neonatal intensive care Background: Pain assessment of premature infants continue to be ineffective. The problem may be partly because of misconceptions or lack of knowledge in the assessment of pain in children. Aims: This paper reports a study to describe nurses' attitudes towards and perceptions of pain assessment in neonatal intensive care and the demographic factors related to these attitudes and perceptions of pain. Methods: The participants consisted of 257 Finnish nurses who were recruited from all five of the country's university hospitals caring for the premature infants receiving intensive care or monitoring. We collected data by using a Likert-type questionnaire in spring 2006. The response rate was 71% from the represented population. Findings: Almost all (97%) of the nurses agreed that pain assessment in premature infants is important. However, over half (60%) of the respondents agreed that they could assess the premature infants pain reliably without pain scores. The respondents' perceptions of the premature infants' ability to sense and express pain indicated rather good knowledge of the topic. Nevertheless, one-fourth of the participants was unaware that a premature infant could be more sensitive in sensing pain than a full term counterpart. Education, work experience and the working unit were the demographic factors that were significantly related to the respondents' attitudes and perceptions. Conclusions: On average nurses' attitudes were positive towards the pain assessment in neonatal intensive care. However, there were some gaps in the knowledge concerning the respondents' perceptions of the items, which is a challenge to nursing and nursing education. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe recent trends in the prevalence and risk factors of obstetric anal sphincter ruptures during between 1997 and 2007 in Finland. METHOD: We analyzed a population-based register of 514,741 women with singleton vaginal deliveries recorded in the Finnish Medical Birth Register. Primiparous (n=2315) and multiparous women (n=534) with anal rupture compared in terms of possible risk factors to primiparous (n=215,463) and multiparous (n=296,429) women without anal rupture, respectively, using stepwise logistic regression analysis. RESULTS: The occurrence of anal rupture increased from 0.5% in 1997-1999 to 1.8% in 2006-2007 among primiparous women, and from 0.1% in 1997-2001 to 0.3% in 2006-2007 among multiparous women. Over the study period, the likelihood of women having anal rupture in these groups increased by a factor of 3.28 (95% CI 2.86-3.76) and 2.83 (95% CI 2.19-3.67), respectively, after adjustments for strong associations with many known risks. Changes in population characteristics and in the use of interventions were small, and these did not cause the increased anal rupture rate. The only exception was vacuum-assisted deliveries, which explained about 9% of the rising anal rupture risk. CONCLUSIONS: The current obstetric practice is not optimal for protecting the perineum and reflects the need to standardise obstetric care. Copyright © 2010 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to determine the possibility of performing colonoscopy without medication, elucidate the factors related to a painful colonoscopy experience and compare colonoscopy patients' reported pain assessment to nurses' and endoscopists' observations. Background. Sedation and pain medication are routinely administered for colonoscopies in many countries. However, medication-free colonoscopies have attracted attention because the use of medication requires a time commitment from patients and increases complications. Earlier studies show that, for instance, gender, age and pelvic operations may increase the risk of painful colonoscopy and those healthcare professionals and patients appear to assess pain differently. Method. A cross-sectional descriptive study was conducted in a Finnish university hospital using questionnaires developed for this study and analysed statistically. The sample of 138 colonoscopy patients, 11 nurses and 11 endoscopists was recruited in 2006. Results. Over three-quarters of patients reported mild pain or no pain at all. Patients' nervousness is a risk factor for experiencing pain during colonoscopy. Both nurses and endoscopists slightly underestimated the intensity of pain experienced by patients. Conclusion. It is possible to perform colonoscopy without medication with most patients and focus sedation and pain medication on at-risk patients, especially those who are nervous. Before the procedure, nurses must devote time to discovering which patients are nervous and at risk of having a painful colonoscopy to present them for sedation. To improve pain management for patients having colonoscopy, endoscopists and nurses should participate systematically in pain education and use pain scales. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to examine Estonian nurses\'02 thinking with regard to how they perceive their autonomy, control over practice, teamwork and organizational support in regional, central and general hospitals.Background: Despite the well-documented fact that there is a need to improve nurses' working environments in hospitals to promote safe patient care, in Europe broader studies on this topic have not received priority thus far.Methods: A nationally representative stratified random sample of 478 acute care hospital nurses was surveyed using the Nursing Work Index-Revised (NWI-R) instrument in 2005/2006.Results: Nurses perceived their autonomy, control over practice and organizational support remarkably lower than nurse--physician relationships. Age and tenure were highly related to the nurses' perceptions.Conclusions: The Estonian nurses' ambivalent perceptions of the organizational attributes reflected the effects ascribed to hospital reforms.Implications for nursing management: There is an urgent need for nurse managers to be particularly alert and attentive with regard to nurses who have been practising the profession for more than a decade. Support for their practice should be provided with the long-term goal of assuring the retention of those experienced nurses. Continuous monitoring of nurses' perceptions should be used systematically as a tool for staffing decisions at the hospital level. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to assess the relationship between patient-toregistered nurse (RN) ratios and nursing outcomes: job satisfaction and stress, nursing care quality, control of own practise, intent to leave, adequacy of material resources and attitudes towards technical equipment.Background: Although there is a growing body of evidence showing that higher levels of RN staffing are linked to better outcomes, it still is unclear how nurse staffing produces these effects.Method: A survey of data of RNs (n = 854) in 46 inpatient units at five university hospitals in Finland was used to create a Bayesian network (BN) model of connections between the variables.Results: A BN model constructed showed that the quality of nursing care is influenced by multifaceted work environment measures. RNs\'02 possibility to control their own practice and the quality of care are mediation between patient-to-RN ratio and other variables examined.Conclusions: New insight was given to the complex theme of the nursing practice environment and its connections to nursing outcomes.Implications for nursing management: Work environment should be developed with consideration of many factors, including adequate staffing levels and the ability for nurses to control their own work. This could increase nurses\'02 work satisfaction, retention and patient care quality outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine rheumatoid arthritis (RA) patients' knowledge of the disease and its treatments and their self-efficacy changed in a 6-month period. The data were collected from 223 RA patients during August 2004DSMarch 2005 using self-administered questionnaires. The main finding was that the patients' knowledge of exercise, joint protection and energy conservation increased and their self-efficacy strengthened over the 6-month period. However, the RA patients' general knowledge of the disease (e.g. of its aetiology) decreased significantly. Weak relationships exist between the patients' self-efficacy and their knowledge of exercise, joint protection and energy conservation. The patients who had follow-up visits during the 6-month period had slightly better knowledge levels, but their pain and other symptoms self-efficacy was weaker. It is important that nurses encourage patients to seek clarification of any unclear issues concerning their disease, and concentrate on supporting those patients whose self-efficacy is weak. Key words: Arthritis Self-Efficacy Scale, patient education, Patient Knowledge Questionnaire, rheumatoid arthritis, self-efficacy. [ABSTRACT FROM AUTHOR]

This study evaluated the influence of parental use of Parents' Post-Operative Pain Measure (PPPM) on 1 to 2-year-old children's pharmacological pain alleviation at home. Fifty parents whose child had undergone day surgery in three University Hospitals in Finland between January 2006 and June 2007 completed questionnaires. Parents of the intervention group (n = 29) were provided with PPPM as an intervention to promote children's pain relief at home, while parents in the control group (n = 21) did not receive the PPPM. The use of PPPM had a positive effect on pain management; total dosing of analgesics was higher in the intervention group on all three study days. However, the difference was not statistically significant. Optimal dosing was provided only for 12% of the children in the intervention group, whereas no children in the control group received optimal dosing. The parents of the intervention group did not consider analgesics to be helpful more often than the parents in the control group. In conclusion, the use the PPPM may promote parents' management of their child's post-operative pain at home. Larger samples in further studies are needed to verify the findings of this study. [ABSTRACT FROM AUTHOR]

Aim and objective. The purpose of this paper is to describe the content of patient education as portrayed and evaluated by rheumatoid arthritis (RA) patients. Background. Rheumatology nurses have an important role in educating and supporting RA patients. However, there is a lack of knowledge of the RA patients' own perspective of patient education. Design. Survey. Method. Data for this study were collected from 173 RA patients from 11 hospitals and 23 health centers using open-ended questions. Fifty-seven percent (57%) of the patients described the content of patient education and eighty-one percent (81%) evaluated it expressing their experience and satisfaction with it. Data were analysed using descriptive and non-parametric statistical tests. Results. Rheumatology nurses mostly gave their RA patients information about how to use the anti-rheumatic drugs prescribed to them (26%). About half (51%) of the patients were satisfied with patient education. However, every fourth patient (24%) was not satisfied, the main reason for the dissatisfaction being that nurses did not focus on the patient's emotional support. The patients of over 57 years of age and those who had suffered from RA for over five years were more satisfied with their education than the others. Conclusions. It is important that rheumatology nurses, besides passing on medical treatment-related information, concentrate on RA patients' emotional well-being. Relevance to clinical practice. The results provide a useful insight into RA patient education. Nurses should avoid merely passing on information in a routine workmanlike way. It is important that they take time to discuss their patients' feelings and worries especially with newly diagnosed patients. RA patient education should balance patients' information needs with their need for emotional support. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study evaluating anxiety in patients prior to colonoscopy and identifying correlations between that anxiety, previous pain experience, non-drug interventions and pain intensity during colonoscopy. Background. Waiting for forthcoming procedures, such as colonoscopy, is stressful. However, a few studies have evaluated the influence of patients' anxiety, previous pain experience and non-drug interventions during colonoscopy. Design. A quantitative cross-sectional survey design was used. The data were collected from colonoscopy patients by using the Spielberger State Trait Anxiety Inventory and a questionnaire developed for the study. Methods. We assigned one hundred and thirty patients scheduled for diagnostic colonoscopy in a Finnish university hospital during 2006. Patients completed the State Trait Anxiety Inventory before and a questionnaire developed for the study after colonoscopy. Results. Most of the patients suffered from pain but they considered it to be tolerable. Women were more anxious before colonoscopy and experienced more pain and discomfort than men. Previous pain experiences and high state anxiety level decreased patients' perceptions of colonoscopy. Non-drug interventions, such as peaceful talk, explanation of the reason for pain and guidance helped both anxious and non-anxious patients to ease the pain. Conclusion. Awareness and understanding of previous pain experiences and anxiety levels in patients are essential and must be taken into account. Relevance to clinical practice. Colonoscopy patients' clinical education should be developed so as to be more individual. Furthermore, nurses should be better aware of the positive effects of non-drug interventions and should use them as an element of pain management for colonoscopy patients. [ABSTRACT FROM AUTHOR]

Nurses' work environment and nursing outcomes: A survey study among Finnish university hospital registered nursesThe aim was to assess the interrelationships between nurses' work environment and nursing outcomes. A cross-sectional survey of 664 registered nurses (RN) on 34 acute care inpatient hospital wards was used to measure nurses' perceptions. Patient data (n = 4045) consisting of a total patient satisfaction indicator were collected simultaneously with the nurse data during year 2005. RN's assessments of staffing adequacy, respect and relationships were the most important factors of work environment having an influence on job-related stress, job satisfaction, patient satisfaction and adverse events to patients and nurses. Some 77% of the RN reported adverse nurse events and 96% reported adverse patient events during a 3 month retrospective period. Ensuring sufficient and suitably qualified nurses' availability in delivering nursing care is an important management issue. Nurses are concerned about the quality of care, and the concerns perceived by nurses can influence their clinical work. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this study is to describe nurses' evaluations of factors that are hindering implementation of child-focused family nursing (CF-FN) into adult psychiatric practice. In addition, it explains the nurses' evaluations of the hindering factors related to the hospital organizational structure, the individual nurse, nursing and family. Background. There is an increasing amount of families with dependent children in adult psychiatry. Although these families have long-term benefits from preventive family interventions, implementation of CF-FN is not routine mental health practice. Design and methods. Data were collected via a questionnaire-survey completed by Registered Psychiatric Nurses (n = 223) and practical Mental Health Nurses (n = 88) from 45 adult psychiatric units in five Finnish university hospitals. The response rate was 51%. Results. Family-related factors, such as families' fears and lack of time, were considered as 'most hindering' to CF-FN. Nurses who used a family-centred approach and had further family education considered most of the factors as 'less hindering' in comparison to other nurses. Conclusion. To meet the needs of the families in mental health services, it is essential to develop nursing intervention methods such as CF-FN. There is a need for further education and use of family-centred care to develop this preventive approach. Relevance to clinical practice. The results of this study could be considered when developing mental health services and family interventions for families with parental mental illness. [ABSTRACT FROM AUTHOR]

Aims and objectives. The purpose of this study is to describe the contents and methods used by rheumatology nurses when they educate their patients with rheumatoid arthritis. Background. Rheumatology nurses have an important role in educating patients with rheumatoid arthritis. However, there is a lack of knowledge on the content provided and the methods used by rheumatology nurses. Design and methods. The sample was drawn in using stratified random sampling and the data were collected from 80 rheumatology nurses with a questionnaire in 2003-2004 (response rate was 65.2%). The data were analysed using descriptive and non-parametric statistical tests. Results. Medical treatment was the most commonly taught issue, as 76% of rheumatology nurses gave information on anti-rheumatic drugs prescribed to the rheumatoid arthritis patients and blood tests (64%) which must be taken as follow-up controls. Only 45% of the nurses discussed self care at home. Individual oral patient education (88%) and written materials by the local hospitals or drug industries (71%), were the most commonly used methods. Patients with rheumatoid arthritis were educated mostly in special health care units. A rheumatology nursing course did not have an effect on the chosen contents or methods when educating rheumatoid arthritis patients. Conclusions. It is important that rheumatology nurses teach more self-care abilities to patients with rheumatoid arthritis and use also the other teaching methods than oral individual method such as group sessions, teleinformatics and internet. The contents of rheumatology nursing course should be developed further to stress the importance of appropriate teaching methods and to point out the importance of self care abilities for patients. Relevance to clinical practice. The results provided useful insight into education of patients with rheumatoid arthritis. Nurses should avoid the routine teaching programmes. They should take time to discuss with their patients and plan together the contents and methods, that education of patients with rheumatoid arthritis is based on patients' information needs and their individual learning capabilities. [ABSTRACT FROM AUTHOR]

This study investigated the perceptions of patients, nurses, physicians, and managers of the quality of care. While they all evaluated the quality of care to be good, the evaluations of patients and staff were different from each other's. Organizational factors such as values and work explained the quality of care evaluated by nursing staff and physicians compared to work and leadership by managers. No obvious relationship between quality and leadership could be found. [ABSTRACT FROM AUTHOR]

Aim. This paper is a discussion of the use of unstructured diaries and their benefits and limitations as primary research data in a study of family caregivers of people with Alzheimer's disease. Background. Caregivers' diaries have rarely been used to study family caregivers' subjective knowledge of life with a family member with Alzheimer's disease. Method. Family caregivers wrote unstructured diaries for 2 weeks during the period 2002-2004, starting within 6 months after the diagnosis of Alzheimer's disease in a family member. The family caregivers (n = 83) were voluntary participants in an ongoing intervention study (patients n = 241 and caregivers n = 241). The diaries were analysed using content analysis. Findings. The diary data were categorized into the following four different types: meagre, reporting, descriptive and reflective. They described the family caregivers' experiential world and the changes taking place in it. Family caregivers found diarywriting a therapeutic and pleasant experience. The use of written diaries involves some limitations concerning high dependency on writers, and data solely in written form. An effort to confirm the quality of data should be made by personal contacts. Conclusion. Diaries can be used as a primary method of data collection in nursing research, as they produce subjective knowledge of the experiences, emotions and meanings associated with caregiving. Their use can result in a high level of motivation, and ability to reflect on life promotes successful writing. [ABSTRACT FROM AUTHOR]

AIM: This study aimed to describe the knowledge and skills of nurses in managing pain during colonoscopy procedures. BACKGROUND: Colonoscopy is a procedure to diagnose diseases of the intestine, and patients consider it even painful. However, few studies have described patients' pain management during the colonoscopy procedure. DESIGN: A quantitative survey design was used. The data were collected from colonoscopy nurses with a self-completed semi-structured questionnaire developed for the study. METHODS: The hospitals performing colonoscopies in Finland, with the exception of the ones where the questionnaire was pilot-tested, were included in the study (n = 12). The optional sample was drawn by mailing questionnaires (n = 147) to endoscopy units to be filled in by three colonoscopy nurses during 2002. The response rate was 79% (n = 116). RESULTS: The majority of nurses used versatile non-pharmacological methods of managing pain and had practice-based knowledge of pain management during the colonoscopy procedure, but pain education and the acquisition of new professional knowledge were rarely reported. Pain scales were not in use and ethical conversation was lacking among the endoscopy staff in most (95%) hospitals. CONCLUSION: The study showed that colonoscopy nurses used numerous non-pharmacological methods, but only rarely acquired professional knowledge. There was a lack of pain scales and ethical conversation in the participating endoscopy units. RELEVANCE TO CLINICAL PRACTICE: The results can be used to improve the treatment of pain during colonoscopy procedures and endoscopy nurses' education. Nurses should be motivated by education and ethical conversation. Future studies should aim to analyse patients' own evaluation of pain during the colonoscopy procedure. The applicability of the existing pain scales and non-pharmacological methods should be tested in practice. [ABSTRACT FROM AUTHOR]

Parental participation in paediatric postoperative care is common in China. However, the knowledge is limited on what methods parents use to relieve their children's postoperative pain in hospital. The purpose of this study was to describe what nonpharmacological methods parents use to relieve their children's postoperative pain and factors related to this. A previously validated Scandinavian questionnaire survey was conducted in five provincial hospitals in Fujian, China, in 2004. Parents (n = 206) whose children had undergone operation were asked to complete questionnaires concerning nonpharmacological methods for children's pain relief. The response rate was 88%. Results show that the most commonly used methods by parents were emotional support strategies, helping with daily activities, distraction and imagery. Breathing technique was the method used least frequently. Fathers and parents who were older, more educated, employed and with earlier hospitalization experience with their children used pain alleviation methods more frequently than mothers and parents without these characteristics. Moreover, parents used some methods more frequently with boys, younger children, as well as children admitted for selective operations, with longer duration of hospitalization and with moderate or severe pain. Parents utilized various nonpharmacological methods for children's pain relief, especially those easy to use. This study may serve to focus healthcare providers' efforts on educating parents with respect to various nonpharmacological pain alleviation methods available for postoperative pain. Furthermore, this study provides parents an opportunity to be aware of their role in their children's pain management. [ABSTRACT FROM AUTHOR]