Parental Postoperative Pain Management: Attitudes, Assessment, and Management

Author:

Rony Rachel Yaffa Zisk1,Fortier Michelle A.23,Chorney Jill MacLaren2,Perret Danielle2,Kain Zeev N.2345

Affiliation:

1. Department of Family Medicine, University of Wisconsin-Madison, Madison, Wisconsin;

2. Departments of Anesthesiology and Perioperative Care,

3. Department of Psychology, Children's Hospital of Orange County, Orange, California

4. Pediatrics, and

5. Psychiatry and Human Behavior, University of California-Irvine, Irvine, California; and

Abstract

OBJECTIVES: Previous studies suggested that parents frequently do not adequately treat postoperative pain that is experienced at home. Reasons for these parental practices have not been extensively studied. Aims of this study were to examine parental postoperative pain assessment and management practices at home as well potential attitudinal barriers to such pain practices. METHODS: This was a longitudinal study involving 132 parents of children who were aged 2 to 12 years and undergoing elective outpatient surgery. Parental attitudes about pain assessment and management were assessed preoperatively, and children's pain severity and analgesic administration were assessed postoperatively for the first 48 hours after discharge. RESULTS: Although postoperative parental ratings indicated significant pain, parents provided a median of only 1 dose of analgesics (range: 0–3) during the first 48 hours after surgery. In the attitudinal survey, parents' responses have indicated significant barriers. For example, 52% of parents indicated that analgesics are addictive, and 73% reported worries concerning adverse effects. Also, 37% of parents thought that “the less often children receive analgesics, the better they work.” Regression analysis demonstrated that, overall, more preoperative attitudinal barriers to pain management were significantly associated with provision of fewer doses of analgesics by parents (P < .05). CONCLUSIONS: Parents detected pain in their children yet provided few doses of analgesics. Parents may benefit from interventions that provide them with information that addresses individual barriers regarding assessing and treating pain.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference21 articles.

1. Centers for Disease Control and Prevention. National Survey of Ambulatory Surgery. Available at: www.cdc.gov/nchs/nsas.htm. Accessed January 15, 2009

2. Parents' management of children's pain following ‘minor’ surgery;Finley;Pain,1996

3. Children's pain at home following (adeno) tonsillectomy;Hamers;Eur J Pain,2002

4. Parents' perceptions and use of analgesics at home after children's day surgery;Kankkunen;Paediatr Anaesth,2003

5. Pain relief in children following outpatient surgery;Munro;J Clin Anesth,1999

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