Meta-synthesis of nurses' perspectives on pediatric pain management reveals key themes

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Frontiers in Medicine Published May 8, 2026 Medically reviewed May 8, 2026 DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Recognize that nurses' perspectives on pediatric pain management involve emotional, cultural, and practical challenges that require targeted support.

This systematic review and meta-synthesis of 9 studies qualitatively synthesized nurses' perspectives on managing pain in pediatric patients. The analysis identified five major themes: Being Defeated by Pain (emotional and professional struggles), Family Participation is a Necessity (caregiver involvement), Evidence-Based vs. Experience-Based Pain Assessment (tension between guidelines and judgment), Pharmacological vs. Non-Pharmacological Interventions (challenges in treatment selection), and Culture-Related Pain Management (cultural influences on assessment and intervention).

No pooled effect sizes were reported as this is a qualitative synthesis. The certainty of the evidence was assessed using GRADE-CERQual, with high confidence for the themes 'Being Defeated by Pain' and 'Pharmacological vs. Non-Pharmacological Interventions', and moderate confidence for the remaining three themes.

The review highlights that nurses face multifaceted challenges, including emotional burden, the need for family collaboration, and navigating cultural factors. The authors note that targeted, culturally sensitive strategies are needed to enhance nursing competence and quality of care. Limitations were not explicitly reported in the source.

For clinicians, this synthesis underscores the complex realities of pediatric pain management from the nursing perspective. It suggests that interventions should address emotional support for nurses, foster family partnerships, and integrate cultural awareness into pain assessment and treatment protocols.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundPain remains one of the most frequently misinterpreted, underdiagnosed, and inadequately managed clinical conditions in pediatric populations. An estimated 50%–70% of pediatric patients experience undertreated pain, which can have serious negative effects on their overall health and well-being. Our study aims to identify, appraise, and synthesize qualitative studies exploring nurses’ perspectives on pain management for pediatric patients to develop a conceptual understanding of facilitators and barriers from the nurses’ perspective.MethodsThis review was registered with PROSPERO (CRD420251034205). A comprehensive literature search was conducted across CINAHL, PubMed, and Nursing journals for English-language studies. The SPIDER framework was used to guide the selection of qualitative studies. Inclusion and exclusion criteria were applied following the PRISMA 2020 guidelines, resulting in the inclusion of nine studies in the final synthesis. Confidence in the synthesized findings was assessed using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach.ResultsAnalysis of nine qualitative studies identified five interconnected themes shaping nurses’ perceptions of pediatric pain management. Being Defeated by Pain reflected nurses’ emotional and professional struggles with persistent or poorly managed pain. Family Participation is a Necessity emphasized the vital role of caregivers in assessment and decision-making. Evidence-Based vs. Experience-Based Pain Assessment revealed tension between adherence to clinical guidelines and reliance on personal judgment. Pharmacological vs. Non-Pharmacological Interventions highlighted challenges in selecting appropriate treatment strategies within practical constraints. Culture-Related Pain Management illustrated how cultural beliefs influence both pain assessment and intervention. Collectively, these themes underscore the complex, multifaceted nature of pediatric pain care from the nursing perspective. The GRADE-CERQual assessment indicated high confidence in the findings for “Being Defeated by Pain” and “Pharmacological vs. Non-Pharmacological Interventions,” and moderate confidence for the remaining three themes.ConclusionsNurses face multifaceted challenges in pediatric pain management. Targeted, culturally sensitive strategies are needed to enhance nursing competence and quality of care.