Aydin, BahiseBektas, IlknurBektas, Murat2026-01-252026-01-2520251472-6955https://doi.org/10.1186/s12912-025-04119-0https://hdl.handle.net/20.500.14365/8597Aydın, Bahise/0000-0001-9815-2843Background Pediatric pain is a complex and often undertreated issue. Nurses' knowledge and self-efficacy in pediatric pain management are essential to improving pain outcomes. Undergraduate nursing education plays a critical role in developing these competencies, yet the relationship between knowledge and self-efficacy in this area remains underexplored. Purpose This study aimed to predict the pediatric pain management knowledge levels of nursing students based on their self-efficacy. Methods This descriptive and correlational study included 227 third- and fourth-year nursing students enrolled in the Child Health and Disease Nursing course at a state university in T & uuml;rkiye. Data were collected using a sociodemographic data form, the Pediatric Pain Management Knowledge Scale, and the Pediatric Pain Management Self-Efficacy Scale. Descriptive statistics, correlation, and linear regression analysis were performed. Results Participants' mean age was 21.40 +/- 1.38 years; 59% were female, and 51.1% had prior education on pain management. Knowledge scores for "Barriers", "Pain Diagnosis," and "Pain Assessment" significantly predicted the "Decision-Making" subdimension of the self-efficacy scale. Additionally, the "Pain Pathophysiology" subdimension significantly predicted the "Planning and Management" subdimension scores (p < 0.05). The knowledge subdimensions explained 87.4% of the variance in "Decision-Making" and 14.8% in "Planning and Management". Conclusions Nursing students' overall knowledge levels of pediatric pain management did not predict their self-efficacy. However, a strong and statistically significant relationship was found between the subdimensions of "Pain Awareness," "Pathophysiology," "Barriers," "Assessment," and "Pain Control" knowledge and the "Decision-Making" subdimension of self-efficacy. These findings highlight the importance of targeted education on pediatric pain content to strengthen students' self-efficacy in clinical practice. Trial registration Not applicable.eninfo:eu-repo/semantics/openAccessNursingStudentPain ManagementKnowledgeSelf-EfficacyArticle10.1186/s12912-025-04119-02-s2.0-105025811695