• Pain Manag Nurs · Jun 2018

    Cognitive Dissonance and Pediatric Procedural Pain Management: A Concept Clarification.

    • April A Bice.
    • College of Health and Human Services, School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA. Electronic address: bicea@uncw.edu.
    • Pain Manag Nurs. 2018 Jun 1; 19 (3): 230-237.

    BackgroundPediatric nurses have often reported that pain management is a vital part of patient care. Evidence, however, suggests pediatric procedural pain treatments are often underused. Cognitive dissonance, the mental conflict leading to unpleasant thoughts and or feelings, may be related to this evidence-based gap found between what pediatric nurses claim about procedural pain management (that it is important) and what they actually do (underutilize pain treatments).ObjectiveThe purpose of this manuscript is to clarify and further develop the concept of cognitive dissonance in terms of its relationship to nurses' mental struggles with underutilization of pediatric procedural pain treatments. A more relevant and extended definition of cognitive dissonance is presented.DesignThe concept of cognitive dissonance was examined using Rodgers' evolutionary concept analysis approach/framework. Analysis Methods: Through a six-step process of concept identification, setting and sample identification, data collection, data analysis, and future implication discussion, a more accurate and representative definition of cognitive dissonance is described. Databases used included CINAHL, Google Scholar, PsycINFO, ERIC, and PubMed. Seminal, recent, and relevant works were included in the review to adequately develop and clarify the concept.ConclusionsProcedural pain management breech among pediatric nurses is proposed to occur before the mental conflict produced. The unpleasant mental conflict created after the breech is followed by the nurse's determination to reduce mental conflict through attitude change followed by cognition change, which more closely reflects his or her behavior.Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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