Pain Management Strategies in Hospitalized Children: The Role of Paediatric Nurses

Abstract

Pain remains one of the most distressing experiences for hospitalized children, influencing not only their physical comfort but also their psychological well-being, developmental outcomes, and trust in healthcare systems. Despite advances in pediatric care, under-assessment and inadequate management of pain continue to be reported globally, often due to misconceptions about children’s pain perception, communication barriers, and resource limitations. Pediatric nurses, who spend the most time with children during hospitalization, play a crucial role in pain recognition, assessment, intervention, and evaluation. Their role extends beyond direct clinical care to encompass advocacy, family education, emotional support, and collaboration with interdisciplinary teams to ensure holistic pain management.

This review synthesizes current evidence on pharmacological and non-pharmacological pain management strategies in hospitalized children and highlights the pivotal role of pediatric nurses in implementing these interventions. The study aimed to identify best practices in pediatric pain management, evaluate the effectiveness of nurse-led interventions, and explore the challenges and opportunities in improving pain outcomes among children. A narrative review design was adopted, with integrative elements, analyzing 25 peer-reviewed studies, systematic reviews, and clinical guidelines published between 2015 and 2025. The evidence was grouped thematically into four categories: pharmacological approaches, non-pharmacological interventions, family-centered strategies, and the professional role of pediatric nurses.

Results revealed that multimodal approaches yield the best outcomes in reducing pain intensity and distress. Pharmacological management, primarily involving opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and acetaminophen, remains central to acute and procedural pain relief, though nurses must monitor dosing, side effects, and safe administration. Non-pharmacological methods, such as distraction, play therapy, guided imagery, music therapy, and cognitive-behavioral techniques, were shown to significantly reduce anxiety and perceived pain, particularly in younger children. Family-centered care, which empowers parents to actively participate in pain management, was associated with improved child cooperation, reduced anxiety, and enhanced satisfaction. Pediatric nurses were found to be instrumental in all these dimensions, with their roles encompassing pain assessment using validated pediatric scales, individualized intervention planning, education, and continuous evaluation of outcomes.

The review concludes that effective pain management in hospitalized children requires a holistic, evidence-based, and family-centered approach. Pediatric nurses, through their unique position at the bedside and ongoing interactions with both children and families, are essential in bridging clinical evidence with compassionate care. Strengthening nurse education, institutional support, and interdisciplinary collaboration can significantly improve pediatric pain outcomes and ensure children’s right to optimal pain relief.