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Desalegn M, Shitemaw T, Getahun GK, Lemma L. Parental knowledge and attitude of postoperative paediatric pain: stepwise linear regression analysis. FRONTIERS IN PAIN RESEARCH 2024; 5:1340375. [PMID: 38577246 PMCID: PMC10993867 DOI: 10.3389/fpain.2024.1340375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
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.
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Affiliation(s)
- Mitiku Desalegn
- Department of Anesthesia, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | | | - Genanew Kassie Getahun
- Department of Public Health, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia
| | - Lire Lemma
- Department of Health Informatics, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
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Ndengeyingoma A, Lebel V, Alvarez SB. Children and pain: Assessment and management according to parents' perspective. Res Nurs Health 2023; 46:93-100. [PMID: 36286326 DOI: 10.1002/nur.22271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/27/2022] [Accepted: 10/08/2022] [Indexed: 01/09/2023]
Abstract
Pain in children is frequent. Parents evaluate their children's pain to decide how to manage it or to share information with caregivers. This qualitative descriptive study aims to identify elements influencing the evaluation and management of pain in children from a parent's perspective. Participants were recruited through a pediatric center and university family medicine clinic. Participants had to have used medication for their child that was prescribed "as needed" to manage their child's pain in the month preceding the interview, whether it was a prescription-strength medication or an over-the-counter strength prescription. Semi-directed interviews 30-45 min in duration were conducted with 16 parents in the Outaouais region of Quebec (Canada), either at the participant's home or by phone (after the declaration of the COVID-19 pandemic). A thematic analysis was completed to identify themes in the data from these individual interviews. The evaluation of children's pain by their parents is influenced by the parents' experience with pain and the expression of the pain by the children, whereas the actions to relieve the pain are based on the beliefs surrounding pain management in children. Evaluation of pain is complex since many parents' beliefs influence this evaluation and the subsequent pain management. The study results raise healthcare professionals' awareness regarding several elements which influence the evaluation of children's pain and its management by their parents.
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Affiliation(s)
| | - Valérie Lebel
- Department of Nursing, Université du Québec en Outaouais, Gatineau, Québec, Canada
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Assessment of Saudi Mothers' Attitudes towards Their Children's Pain and Its Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010348. [PMID: 33466456 PMCID: PMC7796466 DOI: 10.3390/ijerph18010348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/31/2020] [Accepted: 01/01/2021] [Indexed: 12/03/2022]
Abstract
Background and objective: Pain is a bothersome issue that is common among newborns and children of all ages. Pain can be managed using various pharmacological and/or non-pharmacological strategies, which can be delivered by healthcare providers or parents. The aim of this study is to assess the attitude of mothers toward their children’s pain and its management. Methods and materials: A descriptive cross-sectional web-based study was conducted using a developed self-reported questionnaire, from March 2018 to April 2018. Participants involved were Arabic-speaking mothers of children aged between 0 and 12. The data collected included pharmacological and non-pharmacological treatment methodologies utilized to treat pain and the mothers’ attitude towards pain management. Statistical Package for Social Sciences, version 25 was applied to analyze the data, and descriptive statistics were performed. Results: As per the results of this study, the most common site of children’s pain as reported by the mothers was mouth/throat (211; 52.9%), abdomen (199; 49.9%), followed by head (58; 14.5%), and finally, ears (69; 17.3%). The frequency of children’s pain, as stated by the mothers, was less than once a month (196; 49.1%), once in a month (137; 34.3%), and once in a week (48; 12%). The non-pharmacological methods used by mothers at home for the management of their children’s pain were as follows: letting them take rest or sleep (250; 62.6%), feeding them with fluids (228; 57.1%), applying cold packs (161; 40.4%), providing massage therapy (147; 36.8%), using warm packs (141; 35.3%), and taking them to play (119; 29.8%). Conclusion: The misconceptions about pediatric pain management among Saudi mothers that can affect the children’s quality of life are quite noticeable. Implementing educational and awareness programs about the management of child pain could play a major role in making the parents understand the impacts of their misconceptions.
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Yan C, Cheung RSY, Wong CL, Cheng HY, Liu F, Huang H, Ewig CLY, Li CK, Zhang H, Cheung YT. Stress and Perception of Procedural Pain Management in Chinese Parents of Children With Cancer. J Pain Symptom Manage 2021; 61:90-102.e5. [PMID: 32640278 DOI: 10.1016/j.jpainsymman.2020.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/04/2020] [Accepted: 06/22/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Children with cancer are exposed to repeated painful and invasive procedures. This study examines Chinese parents' stress and perception toward their children's procedural pain control. METHODS We recruited 265 parents of children (aged <18 years) diagnosed with hematological cancer (74.7%) and solid tumors (25.3%) from two major public hospitals. Parents used a scale (0-10) to rate perceived pain experienced by their child when undergoing lumbar puncture (LP), bone marrow aspirate, or/and biopsy. They reported their stress level and attitudes toward analgesics using the adapted Pain Flexibility Scale for Parents and Parental Medication Attitude Questionnaire. General linear modeling was used to identify factors associated with perception outcomes. RESULTS Parents (72.8% mothers, age 36.5 [6.8] years) expressed that they were worried (31.7%) and had difficulty with concentration (57.7%) when the child was in pain. Among parents whose children had undergone LP (n = 207), 39.1% perceived that their child still experienced severe pain (pain score >7) even with existing pain control measures. Parents reported concerns over side effects of analgesics (69.4%) and addiction (35.1%). Half of the parents (47.2%) perceived that analgesics should only be reserved for severe pain. Parents who were older (estimate = 2.07, SE = 0.87; P = 0.0054) and had lower education attainment (estimate = -3.38, SE = 1.09; P = 0.0021) had a more negative attitude toward analgesics use. Higher parental distress was associated with avoidance of analgesics use (rs = 0.17, P = 0.0052). CONCLUSION Our findings suggested that subgroups of Chinese parents demonstrated distress with their child's pain and harbored misconceptions over analgesics use. Future work includes devising targeted psychoeducation interventions for these parents.
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Affiliation(s)
- Cuixia Yan
- Department of Pediatric Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Rita Sum-Yi Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Fengying Liu
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haiying Huang
- Department of Pediatric Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Celeste Lom-Ying Ewig
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi-Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Hui Zhang
- Department of Pediatric Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Boztepe H, Ay A, Akyüz C. Maternal Pain Management at Home in Children with Cancer: A Turkish Sample. J Pediatr Nurs 2020; 50:e99-e106. [PMID: 31434636 DOI: 10.1016/j.pedn.2019.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/09/2019] [Accepted: 08/09/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of the present study was to examine maternal pain management in children with cancer and the associated factors. DESIGN AND METHODS The present work is a descriptive and cross-sectional study. Data for the study were obtained from mothers of children in the age group of 0 to 18 years undergoing treatment for solid tumors in Pediatric Oncology Service and Outpatient Clinics (n = 112). We used a questionnaire on parental pain management practices at home, the knowledge about pain and analgesic drugs, Spielberger State-Trait Anxiety Inventory (STAI), and Pain Catastrophizing Scale (PCS) to collect the data. RESULTS Several mothers taking part in the study reported various misconceptions about the assessment of children's pain, analgesic drugs, and usage of limited non-pharmacological methods for managing pain in children with cancer. No significant relationships were found between mothers' pain management practices, knowledge of pain assessment and analgesic drugs, and mothers' and children's sociodemographic characteristics or mothers' pain catastrophizing and anxiety about their own pain. CONCLUSIONS The findings of the study revealed that the majority of mothers of children with cancer had misconceptions regarding knowledge of pain assessment and analgesic drugs; these misconceptions potentially lead to manage children's pain associated with cancer ineffectively. Findings indicate mothers' information and support needs for children's cancer pain management in the home settings. PRACTICE IMPLICATIONS A further understanding of barriers to parental pain management in children with cancer in the home setting will contribute immensely in developing appropriate management practices.
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Affiliation(s)
- Handan Boztepe
- Department of Nursing, Faculty of Health Sciences, Atılım University, İncek, Ankara, Turkey
| | - Ayşe Ay
- Pediatric Nursing Department, Faculty of Nursing, Hacettepe University, Sıhhiye, Ankara, Turkey.
| | - Canan Akyüz
- Professor Pediatric Oncology Department, Hacettepe University Institute of Oncology, Hacettepe University, Sıhhiye, Ankara, Turkey
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Nascimento LC, Warnock F, Pan R, Silva-Rodrigues FM, Castral TC, De Bortoli PS, de Moraes DC, Scochi CGS. Parents' Participation in Managing Their Children's Postoperative Pain at Home: An Integrative Literature Review. Pain Manag Nurs 2019; 20:444-454. [DOI: 10.1016/j.pmn.2018.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 12/02/2018] [Accepted: 12/04/2018] [Indexed: 10/26/2022]
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Miao NF, Wang TC, Chang FC, Lee CH, Chi HY, Huang LJ, Pan YC. Prevalence and Association of Pain Experiences, Medication Literacy, and Use of Medication among Children and Adolescents in Taiwan. J Pediatr Nurs 2019; 46:e64-e71. [PMID: 30898459 DOI: 10.1016/j.pedn.2019.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study assessed the prevalence of children's and adolescents' pain experiences and use of medicine and examined the relationships between pain experiences, medication knowledge, literacy, and use of medicine. METHOD A probability-proportionate-to-size sampling method was used to systematically draw a random sample of schools. In 2014, a national representative sample of 2309 students from 35 primary schools (5th-6th grade), 2700 students from 30 middle schools, and 2013 students from 20 high schools completed the online survey. RESULTS Overall, 85.6% of children and adolescents reported experiencing pain during the past year that included headache (63.0%), throat ache (59.3%), muscle ache (58.3%), stomach pain (42.9%), menstrual pain (girls: 42.1%), and dental pain (38.5%). Children and adolescents had taken cold/cough medicine (48.1%), acetaminophen (15.0%), antacids (14.8%), and nonsteroidal anti-inflammatory drugs (NSAIDs) (10.5%) in the past year. Multivariate analysis results indicated that after controlling for pain experiences children and adolescents who had lower levels of medication knowledge and literacy were more likely to use pain medication and antacids more frequently. In addition, children and adolescents who had lower medication knowledge, lower literacy, asked doctors to prescribe antacids, and co-administered with antacids were more likely to report long-term use of antacids. CONCLUSIONS Lower levels of medication knowledge and literacy among children and adolescents were associated with more frequent use of pain medication and antacids.
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Affiliation(s)
- Nae-Fang Miao
- Department of Nursing, Taipei Medical University, Taiwan.
| | - Tzu-Chueh Wang
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan.
| | - Chun-Hsien Lee
- Division of Pharmacy, Tri-Service General Hospital, Taiwan
| | - Hsueh-Yun Chi
- Department of Health Developing and Marketing, Kainan University, Taoyuan, Taiwan
| | - Li-Jung Huang
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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Zhu L, Chan WCS, Liam JLW, Xiao C, Lim ECC, Luo N, Cheng KFK, He HG. Effects of postoperative pain management educational interventions on the outcomes of parents and their children who underwent an inpatient elective surgery: A randomized controlled trial. J Adv Nurs 2018; 74:1517-1530. [DOI: 10.1111/jan.13573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2018] [Indexed: 01/24/2023]
Affiliation(s)
- Lixia Zhu
- Department of Pharmacology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
- National University Health System; Singapore Singapore
| | - Wai-Chi Sally Chan
- School of Nursing and Midwifery; Faculty of Health and Medicine; The University of Newcastle; Callaghan NSW Australia
| | - Joanne Li Wee Liam
- Division of Nursing; KK Women's and Children's Hospital; Singapore Singapore
| | | | | | - Nan Luo
- Saw Swee Hock School of Public Health; National University of Singapore; National University Health System; Singapore Singapore
| | - Kin Fong Karis Cheng
- National University Health System; Singapore Singapore
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Hong-Gu He
- National University Health System; Singapore Singapore
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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Abstract
BACKGROUND Neonates cared for in neonatal intensive care units are exposed to many painful and stressful procedures that, cumulatively, could impact later neurodevelopmental outcomes. However, a systematic analysis of these effects is yet to be reported. OBJECTIVES The aim of this research was to review empirical studies examining the association between early neonatal pain experiences of preterm infants and the subsequent developmental outcomes of these children across different ages. METHODS The literature search was performed using the PubMed, PsycINFO, Lilacs, and SciELO databases and included the following key words: "pain," "preterm," and "development." In addition, a complementary search was performed in online journals that published pain and developmental studies to ensure all of the target studies had been found. The data were extracted according to predefined inclusion and exclusion criteria. RESULTS Thirteen studies were analyzed. In infants born extremely preterm (gestational age ≤29 wk) greater numbers of painful procedures were associated with delayed postnatal growth, with poor early neurodevelopment, high cortical activation, and with altered brain development. In toddlers born very preterm (gestational age ≤32 wk) biobehavioral pain reactivity-recovery scores were associated with negative affectivity temperament. Furthermore, greater numbers of neonatal painful experiences were associated with a poor quality of cognitive and motor development at 1 year of age and changes in cortical rhythmicity and cortical thickness in children at 7 years of age. CONCLUSIONS For infants born preterm, neonatal pain-related stress was associated with alterations in both early and in later developmental outcomes. Few longitudinal studies examined the impact of neonatal pain in the long-term development of children born preterm.
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He HG, Klainin-Yobas P, Ang ENK, Sinnappan R, Pölkki T, Wang W. Nurses' provision of parental guidance regarding school-aged children's postoperative pain management: a descriptive correlational study. Pain Manag Nurs 2014; 16:40-50. [PMID: 24957816 DOI: 10.1016/j.pmn.2014.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 02/28/2014] [Accepted: 03/17/2014] [Indexed: 11/27/2022]
Abstract
Involving parents in children's pain management is essential to achieve optimal outcomes. Parents need to be equipped with sufficient knowledge and information. Only a limited number of studies have explored nurses' provision of parental guidance regarding the use of nonpharmacologic methods in children's pain management. This study aimed to examine nurses' perceptions of providing preparatory information and nonpharmacologic methods to parents, and how their demographics and perceived knowledge adequacy of these methods influence this guidance. A descriptive correlational study using questionnaire surveys was conducted to collect data from a convenience sample of 134 registered nurses working in seven pediatric wards of two public hospitals in Singapore. Descriptive statistics, independent-samples t test, and multiple linear regression were used to analyze the data. Most nurses provided various types of cognitive information to parents related to their children's surgery, whereas information about children's feelings was less often provided. Most nurses provided guidance to parents on positioning, breathing technique, comforting/reassurance, helping with activities of daily living, relaxation, and creating a comfortable environment. Nurses' provision of parental guidance on preparatory information and nonpharmacologic methods was significantly different between subgroups of age, education, parent or not, and perceived knowledge adequacy of nonpharmacologic methods. Nurses' perceived knowledge adequacy was the main factor influencing their provision of parental guidance. More attention should be paid to nurses who are younger, have less working experience, and are not parents. There is a need to educate nurses about nonpharmacologic pain relief methods to optimize their provision of parental guidance.
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Affiliation(s)
- Hong-Gu He
- Alice Lee Centre for Nursing Studies Department, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies Department, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emily Neo Kim Ang
- Clinical and Oncology Nursing, National University Hospital, Singapore
| | | | - Tarja Pölkki
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies Department, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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