improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations]
Background Each year in England, 450,000 children and young people (CYP) under 18 years of age are transported by ambulance to emergency departments. Approximately 20% of these suffer acute pain caused by illness or injury. Pain is a highly complex sensory and emotional experience. The intersection...
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F1000 Research Ltd
2025-01-01
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| Online Access: | https://openresearch.nihr.ac.uk/articles/4-42/v3 |
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| author | Paul Leighton Georgette Eaton Georgie Nicholls Kacper Sumera Marishona Ortega Jessica Hodgson Michael Baliousis Aloysius Niroshan Siriwardena Despina Laparidou Bill Lord Sarah Redsell Gregory Adam Whitley Tatiana Bujor |
| author_facet | Paul Leighton Georgette Eaton Georgie Nicholls Kacper Sumera Marishona Ortega Jessica Hodgson Michael Baliousis Aloysius Niroshan Siriwardena Despina Laparidou Bill Lord Sarah Redsell Gregory Adam Whitley Tatiana Bujor |
| author_sort | Paul Leighton |
| collection | DOAJ |
| description | Background Each year in England, 450,000 children and young people (CYP) under 18 years of age are transported by ambulance to emergency departments. Approximately 20% of these suffer acute pain caused by illness or injury. Pain is a highly complex sensory and emotional experience. The intersection between acute pain, unwell CYP and the unpredictable pre-hospital environment is convoluted. Studies have shown that prehospital pain management in CYP is poor, with 61% of those suffering acute pain not achieving effective pain relief (abolition or reduction of pain score by 2 or more out of 10) when attended by ambulance. Consequences of poor acute pain management include altered pain perception, post-traumatic stress disorder and the development of chronic pain. This realist review will aim to understand how ambulance clinicians can provide improved prehospital acute pain management for CYP. Methods A realist review will be conducted in accordance with the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidance. A five-stage approach will be adopted; 1) Developing an Initial Programme Theory (IPT): develop an IPT with key stakeholder input and evidence from informal searching; 2) Searching and screening: conduct a thorough search of relevant research databases and other literature sources and perform screening in duplicate; 3) Relevance and rigour assessment: assess documents for relevance and rigour in duplicate; 4) Extracting and organising data: code relevant data into conceptual “buckets” using qualitative data analysis software; and 5) Synthesis and Programme Theory (PT) refinement: utilise a realist logic of analysis to generate context-mechanism-outcome configurations (CMOCs) within and across conceptual “buckets”, test and refine the IPT into a realist PT. Conclusion The realist PT will enhance our understanding of what works best to improve acute prehospital pain management in CYP, which will then be tested and refined within a realist evaluation. Registration PROSPERO Registration: CRD42024505978 |
| format | Article |
| id | doaj-art-6cd33772a6a94ea287b8e11b535c39e1 |
| institution | Kabale University |
| issn | 2633-4402 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | F1000 Research Ltd |
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| series | NIHR Open Research |
| spelling | doaj-art-6cd33772a6a94ea287b8e11b535c39e12025-01-31T01:00:00ZengF1000 Research LtdNIHR Open Research2633-44022025-01-01415093improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations]Paul Leighton0Georgette Eaton1Georgie Nicholls2https://orcid.org/0000-0002-3936-2389Kacper Sumera3Marishona Ortega4Jessica Hodgson5https://orcid.org/0000-0002-3198-890XMichael Baliousis6https://orcid.org/0000-0002-8253-2208Aloysius Niroshan Siriwardena7https://orcid.org/0000-0003-2484-8201Despina Laparidou8https://orcid.org/0000-0002-5427-7422Bill Lord9https://orcid.org/0000-0001-8821-5353Sarah Redsell10Gregory Adam Whitley11https://orcid.org/0000-0003-2586-6815Tatiana Bujor12Applied Health Research Building (Building 42), University of Nottingham, Nottingham, England, NG7 2RD, UKLondon Ambulance Service NHS Trust, London, England, SE1 8SD, UKCommunity and Health Research Unit, University of Lincoln, Lincoln, England, LN6 7FS, UKEast Midlands Ambulance Service NHS Trust, Nottingham, England, NG8 6PY, UKLibraries and Learning Skills, University of Lincoln, Lincoln, England, LN6 7TS, UKSchool of Medicine, University of Nottingham, Nottingham, England, NG7 2RD, UKSchool of Psychology, University of Lincoln, Lincoln, England, LN5 7TS, UKCommunity and Health Research Unit, University of Lincoln, Lincoln, England, LN6 7FS, UKCommunity and Health Research Unit, University of Lincoln, Lincoln, England, LN6 7FS, UKMonash University, Clayton, Victoria, AustraliaFaculty of Medicine & Health Sciences, University of Nottingham, Nottingham, England, NG7 2UH, UKCommunity and Health Research Unit, University of Lincoln, Lincoln, England, LN6 7FS, UKThe Medical School, Newcastle University, Newcastle upon Tyne, England, NE2 4HH, UKBackground Each year in England, 450,000 children and young people (CYP) under 18 years of age are transported by ambulance to emergency departments. Approximately 20% of these suffer acute pain caused by illness or injury. Pain is a highly complex sensory and emotional experience. The intersection between acute pain, unwell CYP and the unpredictable pre-hospital environment is convoluted. Studies have shown that prehospital pain management in CYP is poor, with 61% of those suffering acute pain not achieving effective pain relief (abolition or reduction of pain score by 2 or more out of 10) when attended by ambulance. Consequences of poor acute pain management include altered pain perception, post-traumatic stress disorder and the development of chronic pain. This realist review will aim to understand how ambulance clinicians can provide improved prehospital acute pain management for CYP. Methods A realist review will be conducted in accordance with the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidance. A five-stage approach will be adopted; 1) Developing an Initial Programme Theory (IPT): develop an IPT with key stakeholder input and evidence from informal searching; 2) Searching and screening: conduct a thorough search of relevant research databases and other literature sources and perform screening in duplicate; 3) Relevance and rigour assessment: assess documents for relevance and rigour in duplicate; 4) Extracting and organising data: code relevant data into conceptual “buckets” using qualitative data analysis software; and 5) Synthesis and Programme Theory (PT) refinement: utilise a realist logic of analysis to generate context-mechanism-outcome configurations (CMOCs) within and across conceptual “buckets”, test and refine the IPT into a realist PT. Conclusion The realist PT will enhance our understanding of what works best to improve acute prehospital pain management in CYP, which will then be tested and refined within a realist evaluation. Registration PROSPERO Registration: CRD42024505978https://openresearch.nihr.ac.uk/articles/4-42/v3Acute Pain Analgesia Child Emergency Medical Services Paramedics Paediatricseng |
| spellingShingle | Paul Leighton Georgette Eaton Georgie Nicholls Kacper Sumera Marishona Ortega Jessica Hodgson Michael Baliousis Aloysius Niroshan Siriwardena Despina Laparidou Bill Lord Sarah Redsell Gregory Adam Whitley Tatiana Bujor improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations] NIHR Open Research Acute Pain Analgesia Child Emergency Medical Services Paramedics Paediatrics eng |
| title | improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations] |
| title_full | improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations] |
| title_fullStr | improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations] |
| title_full_unstemmed | improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations] |
| title_short | improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): protocol for a realist review. [version 3; peer review: 2 approved, 1 approved with reservations] |
| title_sort | improving pain management for children and young people attended by ambulance panda protocol for a realist review version 3 peer review 2 approved 1 approved with reservations |
| topic | Acute Pain Analgesia Child Emergency Medical Services Paramedics Paediatrics eng |
| url | https://openresearch.nihr.ac.uk/articles/4-42/v3 |
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