Paramedic attitudinal profiles regarding pediatric pain management: A latent class analysis in a standardized emergency medical services system
Lütfi Mert Güler1
, Yalcin Gölcük2, Ömer Faruk Karakoyun3, Fulden Cantaş Türkiş4, Halil Emre Koyuncuoğlu3, Pınar Çay5
1Muğla Provincial Ambulance Service, Muğla, Türkiye
2Department of Emergency Medicine, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Türkiye
3Emergency Medicine Service, Muğla Training and Research Hospital, Muğla, Türkiye
4Department of Biostatistics, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Türkiye
5Department of Pediatric Emergency Medicine, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Türkiye
Keywords: Analgesia, latent class analysis, paramedics, pediatric pain, prehospital care
Abstract
OBJECTIVES: Pediatric pain is frequently under recognized and undertreated in prehospital emergency care despite guideline based recommendations, and practice variation may persist even within standardized emergency medical services (EMS) systems.
METHODS: We conducted a prospective, cross sectional survey of paramedics working in a nationally standardized EMS system in Türkiye to identify latent attitudinal (self reported) profiles related to pediatric prehospital analgesia and to examine whether profile membership differed by demographic or professional characteristics. Attitudinal items underwent exploratory dimensionality assessment and were then modeled using latent class analysis.
RESULTS: Among 129 paramedics, two profiles were identified: proactive/system oriented (57.4%) and conservative/low engagement (42.6%). The proactive/system oriented profile reported higher endorsement of decision support tools (mobile drug dosing applications and in ambulance analgesia algorithms), more consistent self reported post analgesia vital sign monitoring, and greater self reported use of non pharmacologic adjuncts. The conservative/low engagement profile reported lower intended engagement with these self reported practices and greater reliance on perceived barriers. Profile membership was not associated with age, sex, years of EMS experience, or prior training.
CONCLUSİON: Distinct attitudinal (self reported) profiles regarding pediatric prehospital analgesia were identified; whether these profiles translate into objectively observed analgesia delivery requires validation using routine documentation and, where feasible, linked ED outcomes.
How to cite this article: Güler LM, Gölcük Y, Karakoyun ÖF, Türkiş FC, Koyuncuoğlu HE, Çay P. Paramedic attitudinal profiles regarding pediatric pain management: Alatent class analysis in a standardized emergency medical services system. Turk J Emerg Med 2026;26:321-9.