Prediction of Children's Postoperative Pain: The Role of Presurgical Expectations and Anticipatory Emotions (original) (raw)
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Investigating The Effect of Psychological Variables On Postoperative Pain In Children
2021
Background and Purpose: Despite the progress of pain management in children, the prevalence of postoperative pain remains a caring challenge. Given the multidimensional nature of pain and the effect of various factors on pain, the need to identify risk factors in preventing postoperative pain is felt. The purpose of this study was therefore to investigate the effect of psychological variables on postoperative pain in childrenMethods: This study was conducted following a descriptive-correlational study design. The samples of the study were 171 children aged 6-13 years who were conveniently selected from the selected children's hospital in Tehran according to the inclusion criteria. Data were collected using the “demographic questionnaire”, “Child Pain Anxiety Symptoms Scale (CPASS)”, the Spielberger’s State-Trait Anxiety Inventory (STAI), and “Coping Strategies Questionnaire (CSQ)” and analyzed using SPSS21 software.Results: Most of the 171 children participated were boys (65.5%)...
Journal of Pediatric Nursing, 2020
Purpose: Postoperative pain (POP) is a common outcome of surgical interventions among children. Identifying POP contributing factors can help identify children who are at risk for POP and facilitate POP management. The aim of the study was to determine the predictors of POP based on the Theory of Unpleasant Symptoms. Design and methods: This descriptive-correlational study was conducted in 2018-2019 on 153 children purposively recruited. Data were collected using a personal characteristics questionnaire, the Coping Strategies Questionnaire, the Child Pain Anxiety Symptoms Scale, and a Visual Analogue Scale for Pain. The SPSS software (v. 21.0) was used for data analysis. Results: Twelve participants were excluded and final data analysis was done on the data obtained from 141 participants. Most of participants were male (65.2%), underwent abdominal surgery (53.2%), and experienced POP (86.5%). Their age mean was 8.58±2.23. Linear regression analysis revealed that the physiological factors of heart rate, preoperative pain, and surgery duration as well as the psychological factors of anxiety and coping strategies were significant predictors of POP among children. All these factors collectively explained 34% of the total variance of POP. Situational factors (such as age, gender, and ethnicity) had no significant effects on POP. Conclusions: Heart rate, preoperative pain, surgery duration, anxiety and coping as predictive factors of POP can be considered when designing effective POP management strategies. Practice implications: The findings provide a better understanding about the predictors of POP and can be used to develop pain management among children.
Construct Validity of the Parents' Postoperative Pain Measure
The Clinical Journal of Pain, 2003
Objectives: Pain assessment can be a challenging task for parents, who increasingly provide the care for their children after surgery. This research provides evidence of the construct validity of the Parents' Postoperative Pain Measure (PPPM), a 15-item behavioral scale. Methods: Study 1 examined the ability of scores on the PPPM to discriminate between pain and anxiety in a sample of 75 children (30 girls) between the ages of 7 and 12 years undergoing day surgery. Study 2 examined the sensitivity of scores on the PPPM to analgesic intervention among a sample of 28 children (7 girls) between the ages of 7 and 12 years undergoing day surgery. Results: In Study 1, scores on the PPPM closely followed the pattern of children's self-reported pain intensity and not state-related anxiety. Results from Study 2 showed that scores on the PPPM, like children's self-reported pain intensity ratings, were sensitive to analgesic intervention. Discussion: The results of these studies provide further support for the construct validity of the PPPM and confirm that the measure is a valid pain assessment tool for use by parents at home following children's surgeries.
Pain-related psychological correlates of pediatric acute post-surgical pain
Journal of Pain Research, 2012
Background: Post-surgical pain is prevalent in children, yet is significantly understudied. The goals of this study were to examine gender differences in pain outcomes and pain-related psychological constructs postoperatively and to identify pain-related psychological correlates of acute post-surgical pain (APSP) and predictors of functional disability 2 weeks after hospital discharge. Methods: Eighty-three children aged 8-18 (mean 13.8 ± 2.4) years who underwent major orthopedic or general surgery completed pain and pain-related psychological measures 48-72 hours and 2 weeks after surgery. Results: Girls reported higher levels of acute postoperative anxiety and pain unpleasantness compared with boys. In addition, pain anxiety was significantly associated with APSP intensity and functional disability 2 weeks after discharge, whereas pain catastrophizing was associated with APSP unpleasantness. Conclusion: These results highlight the important role played by pain-related psychological factors in the experience of pediatric APSP by children and adolescents.
International journal of nursing practice, 2007
The purpose of this study was to reveal the 8-12-year-old children's perceptions on the use of methods for pediatric postoperative pain alleviation by themselves, their parents and nurses. Face-to-face structured interviews were conducted with 59 subjects who had undergone surgical procedures in three provincial hospitals in Fujian Province, China in 2004. Content analysis and descriptive statistics were used to analyse the data. According to the children's perceptions, they commonly used rest/sleeping, a physical method (positioning) and a strategy of emotional support (requiring presence of their parents); their parents frequently used helping with daily activities and all strategies of emotional support; the nurses mostly used a strategy of emotional support (comforting) and a physical method (positioning). Children's suggestions mainly concerned the application of non-pharmacological methods, especially presence of caregivers. In conclusion, pain-relieving methods we...
Assessment of post-operative pain in children: who knows best?
Pediatric Reports, 2012
Pain assessment in children can be extremely challenging. Most professional bodies recommend that parents or carers should be involved with their child’s pain assessment; but the evidence that parents can accurately report pain on behalf of their children is mixed. Our objective was to examine whether there were differences in post-operative pain score ratings between the child, nurse and parent or carer after surgery. Cognitively intact children aged four upwards, undergoing all surgical procedures, whose parents were present in the post-anaesthetic recovery unit (PACU), were studied. Thirty-three children were included in the study. The numerical rating scale was used to rate the child’s pain by the child, nurse and parent on arrival to the PACU and prior to discharge. We found strong correlations between children’s, nurses’ and parent’s pain scores on admission and discharge from PACU. The intraclass correlation of pain scores reported by children, nurses and parents was 0.94 (95...
Frontiers in pain research, 2024
Background: Despite the fact that mothers care for their children's pain in most cases, it has been noted that mothers have limited knowledge and attitude about paediatric pain. This study aims to assess parental knowledge and attitude of postoperative paediatric pain (POPP). Method: This is institutional based cross sectional study conducted with 102 parents at Nigist Eleni Mohamed Memorial Comprehensive Specialized Hospital (NEMMCSH). A convenience sampling technique was used to select parents. This study has used a questionnaire (Parental Pain Expression Perception (PPEM), examine parents' attitudes and knowledge about how their children exhibit their pain and Medication Attitude Questioner (MAQs), focuses on how parents feel about giving their child analgesic medication to alleviate post-operative pain). Descriptive statistics were utilized to analyse the parent's response and presented with frequency and percentage. Factor analysis to analyze factor structure and stepwise linear regression analysis to examine the impact of socio-demographic factors in predicting parental knowledge and attitude about POPP were done. The statistical tests were performed at 95% confidence interval and 5% significance level. Result: A total of 102 parents fulfilling the inclusion criteria were included. About 78% of parents agreed that children always express pain by crying or whining. The majority of parents (75.6%) believe children who are playing are not in pain. Regarding parental attitudes about pain medications, majority of parents (61%) believe that children should be given pain medication as little as possible because of its side effects. According to about 26.8% of parents, giving children pain medication for pain might teach them to use drugs for other issues. On the other hand, 63.4% of parents say that giving children pain medication as little as possible is the most effective way to manage their pain. Parents of younger children and parents from rural area are more likely to score higher in attention seeking sub-score of PPEP while parents from urban residence and those parents who are employed are more likely to perceive about the side effects of pain medications (Side effects factors). Conclusion: The overall knowledge and attitude of parents about postoperative pain and pain medications were poor.
Severe acute postoperative pain self-reported by children after ambulatory surgeries: a cohort study
Revista Brasileira de Enfermagem, 2021
Objectives: to estimate the incidence and the risk factors for severe acute postoperative pain self-reported on the first day after hospital discharge. Methods: cohort study with 279 children from both sexes (5-12 years old), indicated for ambulatory surgery in two Brazilian hospitals. Children were assessed at the pre-surgery, immediate postoperative and first postoperative day. Faces Pain Scale-Revised and Yale Preoperative Anxiety Scale Modified were used. Severe postoperative pain was defined as score ≥6. Cox regression analyses were used. Results: the incidence of severe postoperative pain was 15.8% (95%CI:10.7%-20.4%) on the first postoperative day. Preoperative anxiety (HR=2.23; p=0.049), severe preoperative pain (HR=2.78; p=0.031) and having undergone two surgical procedures (HR=2.91; p=0.002) were associated with severe postoperative pain. Conclusions the incidence of severe postoperative pain self-reported after hospital discharge was high. Anxiety and severe preoperative ...
Development and preliminary validation of a postoperative pain measure for parents
Pain, 1996
Parents are now primarily responsible for the at home assessment and treatment of their children's pain following minor surgery. Although some research has suggested that parents underestimate their children's pain following surgery, no behavioral measure exists to assist parents in pain assessment. The Postoperative Pain Measure for Parents was developed based"on cues parents reported using to assess their children's pain (e.g. changes in appetite, activity level). The purpose of the present study was to develop and validate this measure by examining the relation between parent-report of child behaviors and child-rated pain. Subjects were 110 children (56.49Z0 male) aged 7-12 years undergoing day surgery at a tertiary-care children's hospital and their parents. Parents and children completed a pain diary for the 2 days following surgery. Children rated their pain and emotional distress and parents rated the presence or absence of specific behaviors from a checklist. Correlations were conducted between each of the 29 behavioral items and child-rated pain on Day 1; 14 items with correlations less than 0.30 were dropped. The remaining 15 items were subjected to a principal axis factor analysis. A one-factor solution was the best fit for the data. The items were then summed to yield a total score out of 15. Internal consistency reliabilities for the measure and correlations with child-rated pain were high on both days following surgery. Child-rated pain and emotional distress were moderately correlated. The Postoperative Pain Measure for Parents was also positively correlated with child-rated emotional distress on both days following surgery.As child-ratedpain decreasedfromDay 1 to Day2, so did scoreson the behavioralmeasure.The Postoperative Pain Measurefor Parents was successfulin discriminatingbetweenchildrenwho had undergoneno/lowpain surgeriesand children who had undergonemoderateto high pain surgeries. There were no significant differences in scores on the behavioral measure for child age or sex. Using a cutoff score of six out of 15, the measure showed excellent sensitivity (> 80Yo)and specificity (> 80%) in selecting children who reported clinically significant levels of pain. This study provides preliminary evidence for the use of the Postoperative Pain Measure for Parents as a valid assessment tool with children between the ages of 7-12 years following day surgery. It is internally consistent and strongly related to child-rated pain. Future research should explore the use of this measure with a younger sample and children with developmental delays.
Coping with pain and surgery: Children’s and parents’ perspectives
International Journal of Behavioral Medicine, 1997
This article examines relations between coping with general and postoperative pain. children's and parents" coping ratings, and the contribution of temperament and coping to postoperative adjustment. Before and after day surgery, 7-to 12-year-aids (n = 124) rated their coping with pain. Parents rated their child's coping and temperament. Pain and distress were rated on the day of and 2 days fol]owing surgery. Coping with general and postoperative pain were moderately correlated (median r = .48). Except for distraction, all types of eopir~g strmegies were used more frequently for general than postoperative pain, Correlations between child and parent coping ratings were moderate (median r = ~36). After controlling for emotionality and medications, lower [evels of emotion-focused avoidance and higher levels of distraction were related to lower pain and distress. After controlling for a priori surgical group (no-low pain: moderate-high pain), emotionality, and medications, lower