An Integrative Review of Interventions to Support Parents When Managing Their Child's Pain at Home (original) (raw)
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Promoting children's pharmacological postoperative pain alleviation at home
Pediatric nursing
This study evaluated the influence of parental use of Parents' Post-Operative Pain Measure (PPPM) on 1 to 2-year-old children's pharmacological pain alleviation at home. Fifty parents whose child had undergone day surgery in three University Hospitals in Finland between January 2006 and June 2007 completed questionnaires. Parents of the intervention group (n=29) were provided with PPPM as an intervention to promote children's pain relief at home, while parents in the control group (n=1) did not receive the PPPM. The use of PPPM had a positive effect on pain management; total dosing of analgesics was higher in the intervention group on all three study days. However, the difference was not statistically significant. Optimal dosing was provided only for 12% of the children in the intervention group, whereas no children in the control group received optimal dosing. The parents of the intervention group did not consider analgesics to be helpful more often than the parents in ...
Can we improve parents' management of their children's postoperative pain at home?
Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
Thousands of children undergo surgery each year, and a shift toward same-day surgeries and decreased lengths of hospital stay results in parents being increasingly responsible for their child's postoperative care. Recent studies have tested interventions designed to improve parent management of their children's postoperative pain at home, but progress in this area has been limited by a lack of synthesis of these findings. To conduct a systematic review of interventions to improve parent management of children's postoperative pain at home. Articles evaluating interventions to improve management of their children's postoperative pain were identified using a library scientist-designed search strategy applied in EMBASE, PubMed, CINAHL and PsycINFO. Two independent raters assessed each study for eligibility and extracted data. Of the 147 articles identified for the review, eight met the inclusion criteria. Interventions included pain education, training in pain assessment...
Chinese parent's use of nonpharmacological methods in children's postoperative pain relief
Scandinavian Journal of Caring Sciences, 2006
Chinese parent's use of nonpharmacological methods in children's postoperative pain relief Parental participation in paediatric postoperative care is common in China. However, the knowledge is limited on what methods parents use to relieve their children's postoperative pain in hospital. The purpose of this study was to describe what nonpharmacological methods parents use to relieve their children's postoperative pain and factors related to this. A previously validated Scandinavian questionnaire survey was conducted in five provincial hospitals in Fujian, China, in 2004. Parents (n ¼ 206) whose children had undergone operation were asked to complete questionnaires concerning nonpharmacological methods for children's pain relief. The response rate was 88%. Results show that the most commonly used methods by parents were emotional support strategies, helping with daily activities, distraction and imagery. Breathing technique was the method used least frequently. Fathers and parents who were older, more educated, employed and with earlier hospitalization experience with their children used pain alleviation methods more frequently than mothers and parents without these characteristics. Moreover, parents used some methods more frequently with boys, younger children, as well as children admitted for selective operations, with longer duration of hospitalization and with moderate or severe pain. Parents utilized various nonpharmacological methods for children's pain relief, especially those easy to use. This study may serve to focus healthcare providers' efforts on educating parents with respect to various nonpharmacological pain alleviation methods available for postoperative pain. Furthermore, this study provides parents an opportunity to be aware of their role in their children's pain management.
Managing pain in children: where to from here?
Journal of Clinical Nursing, 2010
Aims and objectives. The aims of this study are to review research published in the past 15 years to provide insight into the factors impacting on the management of pain in children and identify strategies that can be used to improve pain management practices. Background. The evidence to guide nurses' pain management practices is readily available, in the form of clinical guidelines. However, children's nurses' pain management practices continue to fall short of the ideal with children experiencing moderate to severe unrelieved pain. Several factors have been suggested as providing an explanation for this. There is a need to explore the impact each of these factors have on pain management practices further. With this in mind, a literature review was undertaken. Design. Literature review. Methods. A computerised literature search was carried out using CINAHL, Medline and the British Nursing Index. The search terms used were as follows: pain, pain assessment, pain management, education, quality and nurses. Articles published in the last 15 years were included in the review. Results. Several themes emerged from this review of the literature as possible explanations for why children's pain is still not managed effectively. These include knowledge deficits; incorrect or outdated beliefs about pain and pain management; the decision-making strategies used and organisational culture. Conclusions. Improving pain management requires a multifactorial approach encompassing: education, institutional support, attitude shifts and change leaders. Issues that need addressing include education, decision-making strategies and organisational practices. Further research needs to be carried out to determine other factors that impact on pain management practices. Relevance to clinical practice. Despite the evidence to guide practice being readily available children continue to experience unrelieved pain. The strategies identified in this article may help to ensure that pain is relieved effectively.
Parents' perceptions and use of analgesics at home after children's day surgery
Pediatric Anesthesia, 2003
Background: Children are found to suffer from unnecessarily severe postoperative pain following day surgery. Reasons for parents' insufficient use of analgesics may be based on misleading perceptions of children's analgesics. The purpose of this study was to describe parents' perceptions and use of analgesics for children after discharge at home. Methods: In this survey, 840 questionnaires were given to parents, and answers from 201 mothers and 114 fathers whose children, aged 1-6 years, had undergone day surgery in 10 Finnish hospitals are presented. Results: One-third (36%) of the children were assessed as having moderate or severe postoperative pain after discharge. More than three-quarters of the parents had given analgesics to the child. Analgesics were given mostly to children who were assessed to have pain and found to have several types of pain behaviour. Most of the parents had accurate perceptions of children's analgesics, but some of them had misleading perceptions of the nature and adverse effects of children's analgesics, which were related to giving analgesics to the child. Fathers, more often than mothers, seem to have such misleading perceptions. Conclusions: Parents tended to give analgesics to children who actually needed pain alleviation. Parents' perceptions of children's analgesics were mostly accurate. However, misleading perceptions of children's analgesics also exist among the parents. These misleading perceptions appear to decrease parents' use of children's postoperative pain medication.
Pediatric Anesthesia
Background: Effective pain management involves a cycle of continual pain assessment, good pain control strategies, and assessment of a standard quality improvement measures. A validated questionnaire that focuses on the quality of postoperative pain management in pediatric surgical patients and parental satisfaction on pain treatment is lacking. We, therefore, modified the revised American Pain Society Patient Outcome Questionnaire to evaluate the quality of postoperative pain management in a pediatric surgical setting. The primary aim of this study was to validate the modified version of revised American Pain Society Patient Outcome Questionnaire. Methods: Parents whose children aged below 12 years and were scheduled for elective surgery in a teaching hospital, were approached to participate in this survey. The reliability of the modified version of revised American Pain Society Patient Outcome Questionnaire was evaluated using Cronbach's alpha test, while the construct validity was assessed with a principal component analysis using a varimax rotation. The parental satisfaction with pain treatment received was measured. Results: A total of 108 parents completed the questionnaire. The internal consistency of the questionnaire shows a Cronbach's alpha of 0.798. Principal component analysis revealed a four-factor structure of the 12 items which explained 69.7% of the total variance. The factors are "Interference of sleep and activity," "Pain severity and drowsiness," "Perception of care," and "Adverse effects," respectively. Our study showed that this questionnaire is a valid and reliable measure for "Interference of sleep and activity" and "Pain severity and drowsiness" factors, but not for "Perception of care" and "Adverse effects." The results for "Perception of care" and "Adverse effects," therefore, should be reported as individual items instead of total score. The parental satisfaction with pain treatment given was good (median 8.0; IQR 3.0). Conclusion: The modified version of revised American Pain Society Patient Outcome Questionnaire is a feasible and easy instrument to administer. The questionnaire can be used to obtain feedback from parents about the outcomes and
Signa Vitae, 2020
Objectives: To evaluate effects of parental pain management educational interventions on postoperative pain assessment, intensity and duration of small children after a one-day-pediatric surgery. Methods: We conducted a prospective randomized, observational study of parental and nurse’s pain assessments in children. The Parents’ Postoperative Pain Management rating scale (PPPM), Wong-Baker FACES Pain Rating Scale (W-B) or the Numerical Rating Scale (NRS) was used. The children’s pain was assessed by parents who were or were not (intervention vs. control groups) preoperatively educated about pain management postoperatively in the hospital and the first three days at home. Nurses who cared for the children postoperatively in the hospital, independently from the parents, assessed the children’s postoperative pain with W-B and NRS. Results: One hundred and fifty-two parents and their children were included in the study. Complete data were available for 142 parents and their children, wi...