In spite of advances over the past decade in pain assessment and pharmacological management, hospitalized children continue to report significant unrelieved pain. Untreated pain may delay recovery, prevent healing, prolong hospitalization, and even lead to death. Research has shown that pediatric nurses consistently administer less analgesia than available and recommended, and believe that children over-report their pain. Survey data of nurses' knowledge and attitudes have failed to predict pain assessment and management behaviors. Pilot data suggest that measurement of nurses' cognitive representations may be more sensitive than survey instruments to capture data that may explain and predict nurses' behaviors. The purpose of this study is to examine pediatric nurses' cognitive representations (CRs) of assessment and management of children's pain to identify and better understand influences on their assessment and management behaviors. The specific aims for this study are to: (1) determine pediatric nurses' CRs of assessment of children's pain, (2) determine pediatric nurses' CRs of management of children's pain, and (3) examine the degree of congruence between their CRs and their decisions about pain assessment and analgesic administration. A descriptive exploratory design addresses the study aims. Data currently are being collected from 100 registered nurses employed at a children's hospital. Nurses' CRs are measured with the Conceptual Content Cognitive Map (3CM) open-ended technique. This mapping method permits identification of the assumptions, beliefs, facts, and misconceptions most likely to influence behavior. Nurses also are asked to provide their responses to case studies about assessment and analgesia administration. Data analysis includes descriptive and content analyses and exploratory regression analysis to address the study aims. Once nurses' CRs are better understood, researchers will be able to develop interventions to improve nurses' practice and children's pain relief. This study is supported by the NIH NINR1 R03 NR009809-01.