First steps towards developing a multidisciplinary pediatric pain management program in Trentino

Introduction
Several countries have seen the development and expansion of pediatric pain management services within pediatric health care institutions through integrated research-based guidelines into clinical practice (1). As to our country, Italy’s national health service (Servizio Sanitario Nazionale – SSN), in 2001 had launched the “Pain-free hospitals” project, (“Ospedale senza dolore”), the first program in Italy for hospitals aimed at providing appropriate solutions for people with pain, with an agreement between the Ministry of Health and Regional Authorities. However, from the last available Report on the Health Status in Italy 2009-2010, “the program did not achieve the expected results and there is no information available on the number of Pain-free Hospital Committees established” (2, p.83). Today the situation is not too different, although the health care system of the Provincia Autonoma di Trento, with the local Project “Pain Free Hospital” have promoted training for doctors and nurses, through special training events focused on the clinical recognition and assessment of pain and also public awareness campaigns. Despite these good premises about efforts to identify the limits to effective pain management and attempts to modify the, through quality improvement programs, apparently the barriers to relieving pain remain unchanged, and still pain management in newborns and children is far from optimal (3). An important point to underline are the existing discrepancies between reported beliefs and knowledge among health professionals, influencing the treatment of children’s pain (1, 4, 5), not only in relation to treatment but also to prevention, of its consequences in the short or long term (6).