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Kwa ZY, Li J, Loh DL, Lee YY, Liu G, Zhu L, Pikkarainen M, He H, Mali VP. An Intelligent Customer-Driven Digital Solution to Improve Perioperative Health Outcomes Among Children Undergoing Circumcision and Their Parents: Development and Evaluation. JMIR Form Res 2024; 8:e52337. [PMID: 38363589 PMCID: PMC10907943 DOI: 10.2196/52337] [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: 09/05/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Circumcision as a common elective pediatric surgery worldwide is a stressful and anxiety-inducing experience for parents and children. Although current perioperative interventions proved effective, such as reducing preoperative anxiety, there are limited holistic solutions using mobile apps. OBJECTIVE This paper aims to describe the development and primary evaluation of an intelligent customer-driven smartphone-based app program (ICory-Circumcision) to enhance health outcomes among children undergoing circumcision and their family caregivers. METHODS Based on the review of the literature and previous studies, Bandura's self-efficacy theory was adopted as the conceptual framework. A multidisciplinary team was built to identify the content and develop the apps. Semistructured interviews were conducted to evaluate the ICory-Circumcision. RESULTS The ICory-Circumcision study was carried out from March 2019 to January 2020 and comprised 2 mobile apps, BuddyCare app and Triumf Health mobile game app. The former provides a day-by-day perioperative guide for parents whose children are undergoing circumcision, while the latter provides emotional support and distraction to children. In total, 6 participants were recruited to use the apps and interviewed to evaluate the program. In total, 4 main categories and 10 subcategories were generated from content analysis. CONCLUSIONS ICory-Circumcision seemed to lean toward being useful. Revisions to ICory-Circumcision are necessary to enhance its contents and features before advancing to the randomized controlled trial. TRIAL REGISTRATION ClinicalTrials.gov NCT04174404; https://clinicaltrials.gov/ct2/show/NCT04174404.
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Affiliation(s)
- Zhi Yin Kwa
- Department of Nursing, National University Hospital, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Jinqiu Li
- Nursing Department, Zhuhai Campus, Zunyi Medical University, Zhuhai, China
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dale Lincoln Loh
- National University Health System, Singapore, Singapore
- Department of Paediatric Surgery, National University Hospital, Singapore, Singapore
| | - Yang Yang Lee
- National University Health System, Singapore, Singapore
- Department of Paediatric Surgery, National University Hospital, Singapore, Singapore
| | - Guangyu Liu
- Integrated Health Promotion, Ministry of Health Office for Healthcare Transformation, Singapore, Singapore
| | - Lixia Zhu
- Hôpital Chinois de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Minna Pikkarainen
- Department of Health Technology and Rehabilitation and Department of Product Design, Oslo Metropolitan University, Oslo, Norway
- Martti Ahtisaari Institute, Oulu Business School, University of Oulu, Oulu, Finland
| | - Honggu 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
| | - Vidyadhar Padmakar Mali
- National University Health System, Singapore, Singapore
- Department of Paediatric Surgery, National University Hospital, Singapore, Singapore
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Bakir E, Briggs M, Mackintosh-Franklin C, Marshall M, Achaliwie F. Communication, information, involvement and decision making: A systematic scoping review of child-parent-nurse relationships during postoperative pain management. J Clin Nurs 2023. [PMID: 36841960 DOI: 10.1111/jocn.16655] [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: 09/14/2022] [Revised: 11/11/2022] [Accepted: 02/06/2023] [Indexed: 02/27/2023]
Abstract
AIMS To examine the existing literature on child-parent-nurse relationships (in relation to communication, information, and involvement and decision-making) during postoperative pain management. BACKGROUND Pain in children is under-reported and under-treated in hospitals and research has continued to report high rates of pain among hospitalised children worldwide. The role of child-parent-nurse relationships may be a factor and to date, no review has been identified that focus on these relationships during postoperative pain management. DESIGN A systematic scoping review following Arksey and O'Malley with further adaptations based on JBI. METHODS A systematic search for published primary studies was conducted using the Medline, CINAHL, British Nursing Index, ASSIA, PsycINFO, Science Direct and Web of Science in English from 2000 to 2022. Two reviewers independently carried out data screening and extraction and any differences were resolved with the assistance of a third reviewer. The data were analysed using thematic analysis and presented descriptively. This study followed the PRISMA-ScR Checklist. RESULTS A total of 37 studies met the inclusion criteria. The findings mainly demonstrated a focus on the perspectives of parents and nurses with less on children's perspectives and none of the studies explored child-nurse relationships. The findings were categorised under three themes: communication, information, and involvement and decision making. CONCLUSION A prevailing deficiency in child-parent-nurse relationships significantly contributed to suboptimal postoperative pain care, causing prolonged and untreated postoperative pain in children. Children's hesitation in communicating with nurses, the limited communication skills of nurses, and the weak communication position of parents in a hospital setting all hindered the development of strong relationships between children, parents, and nurses. The unclear definition of the roles of children and parents in postoperative pain management resulted in confusion for both parents and nurses. This was exacerbated by parents' lack of knowledge and inadequate guidance from nurses, ultimately leading to a decreased level of parental involvement in their child's postoperative pain management while in the hospital. Unattended requests for pain management caused children to experience prolonged pain and led to a deterioration in the relationship between parents and nurses, as well as a reduction in the parents' ability to provide pain care to their child. RELEVANCE TO CLINICAL PRACTICE This study highlights the reasons behind the suboptimal management of postoperative pain in children. The importance of the relationship between children, parents, and nurses in pain management must be acknowledged, and the results of this study may be used to inform improvements in nursing pain management practices. NO PATIENT OR PUBLIC CONTRIBUTION Patient or public contribution is not a necessary stage in a systematic scoping review following Arksey and O'Malley's framework.
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Affiliation(s)
- Ebru Bakir
- Department of Paediatric Nursing, Faculty of Health Science, Izmir Katip Celebi University, Izmir, Turkey
| | - Michelle Briggs
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Carolyn Mackintosh-Franklin
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Marie Marshall
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Francisca Achaliwie
- Department of Nursing, School of Nursing and Midwifery, CK Tedam University of Technology and Applied Sciences, Navrongo, Ghana
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Mathias EG, Pai MS. Anxiety and Pain in Children Undergoing Surgery: A Scoping Review. J Perianesth Nurs 2022; 37:545-550. [DOI: 10.1016/j.jopan.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/21/2021] [Accepted: 10/03/2021] [Indexed: 01/17/2023]
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Serafimova T, Ascough C, Parslow RM, Crawley E. Experiences of pain in paediatric chronic fatigue syndrome/myalgic encephalomyelitis: a single-centre qualitative study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001201. [PMID: 36053633 PMCID: PMC8852759 DOI: 10.1136/bmjpo-2021-001201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/08/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Moderate to severe pain affects up to two-thirds of children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and is associated with worse fatigue and physical functioning. This research aims to gain a greater insight into pain experienced by these children. METHODS Thematic analysis of qualitative data from semistructured interviews with 13 children with CFS/ME (mean age=15.3 years, 67% female) was completed. RESULTS Thematic analysis enabled construction of three themes: children's wide-ranging experiences of pain, negative impact of pain and lack of effective treatment for pain and nine subthemes. The first theme demonstrated highly varied pain experiences, ranging from 'like [being]… on fire', like 'being stabbed' to 'like…lead'. Children experienced pain in multiple sites and with wide-ranging frequency and severity. The second theme highlighted the profound negative impact of pain on multiple aspects of children's lives. Physical activity was severely impaired; some children 'couldn't leave bed' or 'couldn't…brush [their] own hair'. Abdominal pain meant some would 'go…days without eating'. Pain substantially impacted on mental health, leaving children feeling 'agitated', experiencing 'really bad panic attacks' or making them '[want to] breakdown'. Children felt they 'can't do the things that everyone else can do', had 'missed out' and are 'behind everyone'. Some avoided socialising as they 'don't want to stop everyone else'. The final theme demonstrates the absence of adequate treatment for pain, with participants reporting 'nothing has ever really got rid of it' and only 'slightly [takes] the edge off' and other experiencing side effects. CONCLUSIONS Pain in paediatric CFS/ME is highly variable, common and often results in severe physical limitation and poor mental health. Effective treatments for pain represent an unmet need.
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Affiliation(s)
- Teona Serafimova
- Centre for Academic Child Health, University of Bristol, Bristol, UK
| | - Caitlin Ascough
- Centre for Academic Child Health, University of Bristol, Bristol, UK
| | | | - Esther Crawley
- Centre for Academic Child Health, University of Bristol, Bristol, UK
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Cui X, Zhang J, Gao Z, Sun L, Zhang F. A randomized, double-blinded, placebo-controlled, single dose analgesic study of preoperative intravenous ibuprofen for tonsillectomy in children. Front Pediatr 2022; 10:956660. [PMID: 36052360 PMCID: PMC9424767 DOI: 10.3389/fped.2022.956660] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Tonsillectomy is a recognized treatment for children with tonsil hypertrophy and results in significant postoperative oropharyngeal pain. Fentanyl and other morphine-like analgesics are widely used as perioperative analgesia but are associated with side effects such as vomiting, nausea, and respiratory depression. As the least toxic non-steroidal anti-inflammatory drug, ibuprofen may be effective and safe for pain control after tonsillectomy. We aimed to explore whether the addition of intravenous (IV) ibuprofen administered at induction can reduce the need for early postoperativeanalgesics. STUDY DESIGN AND METHODS This randomized, double-blind, controlled clinical trial enrolled 95 pediatric patients who underwent tonsillectomy. Participants aged 6 months to 12 years were randomly assigned to either the experimental and control groups (1:1). The children were premedicated 15 min before surgery with IV ibuprofen 10 mg kg-1 or placebo (normal saline). Pain was scored at 15, 30, and 120 min after extubation, and IV fentanyl (0.5 mcg kg-1) was administered when the Faces, Legs, Activity, Cry, and Consolability (FLACC) Scale was ≥7 and deemed appropriate by the nursing staff in the post-anesthesia care unit (PACU). The visual analog scale was used as a supplementary evaluation for older children (≥7 years old) who were awake and could self-report pain. The primary outcome variable was the number of patients who received postoperative analgesia. RESULTS The requirement for rescue fentanyl was reduced by 18% with the addition of IV ibuprofen (P = 0.043). There were no signficant differences in the amount of fentanyl administered postoperatively (P = 0.127). Compared with the placebo group, the number of children who needed more than one dose of rescue fentanyl decreased in the experimental group, but the differences were not significant (P = 0.056). There were no significant differences between the groups in terms of operative blood loss (P = 0.978), vomiting, or postoperative bleeding (P = 0.474). CONCLUSION It is safe to administer IV ibuprofen 15 min before tonsillectomy, and it can significantly reduce the need for rescue fentanyl. IV ibuprofen should be considered as an important part of the multimodal approach for postoperative analgesia in children. CLINICAL TRIAL REGISTRATION Chictr.org.cn, identifier: ChiCTR2100044508.
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Affiliation(s)
- Xiaohuan Cui
- Department of Anesthesiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Jianmin Zhang
- Department of Anesthesiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Zhengzheng Gao
- Department of Anesthesiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Lan Sun
- Department of Anesthesiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Fuzhou Zhang
- Department of Anesthesiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
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Carter B, Harris J, Jordan A. How nurses use reassurance to support the management of acute and chronic pain in children and young people: An exploratory, interpretative qualitative study. PAEDIATRIC AND NEONATAL PAIN 2021; 3:36-44. [PMID: 35548850 PMCID: PMC8975211 DOI: 10.1002/pne2.12045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/12/2020] [Accepted: 01/06/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Bernie Carter
- Faculty of Health, Social Care and Medicine Edge Hill University Ormskirk UK
| | - Jane Harris
- Faculty of Health, Social Care and Medicine Edge Hill University Ormskirk UK
| | - Abbie Jordan
- Department of Psychology Centre for Pain Research University of Bath Bath UK
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Dagg B, Forgeron P, Macartney G, Chartrand J. Adolescent Patients' Management of Postoperative Pain after Discharge: A Qualitative Study. Pain Manag Nurs 2020; 21:565-571. [PMID: 32553416 DOI: 10.1016/j.pmn.2020.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/30/2020] [Accepted: 04/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adolescents are typically admitted for a short period of time after inpatient surgery, leaving much of their recovery to occur at home. Pain, and thus pain management, is a major component of recovery at home. Research among pediatric outpatient surgical patients has found that pain experienced in the community setting after discharge is often severe and is related to knowledge deficits resulting in inadequate pain management. However, there is little research on community pain management after inpatient surgery. AIM This study aimed to explore the pain experiences of seven adolescents who underwent inpatient surgery. DESIGN This study used Interpretative Phenomenological Analysis as a methodology. SETTING This study took place at a pediatric tertiary care hospital in Canada. PARTICIPANTS 7 adolescents participated, all of whom underwent inpatient surgery with admission between 2-14 days in length. METHODS Semi-structured interviews were conducted 2 to 6 weeks post-discharge. RESULTS Three themes were identified that described their experiences, including managing severe pain at home with minimal preparation, changes in the parent-child relationship, and difficulties returning to school and regular activities. CONCLUSIONS Involving adolescents directly in discharge education, particularly with the use of novel interventions and coaching, may improve outcomes. KEY PRACTICE POINTS Adolescent patients experience significant pain after discharge from hospital after inpatient surgical procedures. Adolescents are in need of adolescent-specific pain management education to increase skill and knowledge and address pain management-related misconceptions. Greater emphasis on involving adolescents in their own pain care and novel intervention could prove useful in improving outcomes.
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Affiliation(s)
- Bill Dagg
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
| | - Paula Forgeron
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Gail Macartney
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edwar Island, Canada
| | - Julie Chartrand
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Smeland AH, Rustøen T, Naess T, Nybro L, Lundeberg S, Reinertsen H, Diseth TH, Twycross A. Children's views on postsurgical pain in recovery units in Norway: A qualitative study. J Clin Nurs 2019; 28:2157-2170. [PMID: 30667569 DOI: 10.1111/jocn.14788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/27/2018] [Accepted: 01/14/2019] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore children's postsurgical experiences with pain and pain management in the recovery unit. BACKGROUND Children's pain is underestimated and undertreated. Untreated pain can cause unnecessary suffering, increased complication risks and may lead to chronic pain. Research exploring children's experiences with postoperative pain and pain management is limited. DESIGN A qualitative, exploratory study. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). METHODS Children (N = 20), 8-16 years old, took part in semi-structured interviews about their experiences with pain and postoperative pain management while they were in a recovery unit. Data were collected at two university hospitals in Norway. Content analysis was used to analyse the data. RESULTS Three themes emerged from the interviews: "children's experiences of what felt unpleasant and painful," "children's experiences with pain management" and "children's recommendations for future pain management". About half of the children reported moderate to severe pain while in the recovery unit and they did not always tell their nurses when they had pain. They also reported experiencing pain in places other than their surgical wounds and stated that nausea and vomiting felt unpleasant and painful. The children indicated that pain medications and the use of nonpharmacological methods helped them cope with their pain and provided several recommendations about how to improve pain management. CONCLUSION Paediatric postoperative pain management remains suboptimal. The children in our study provided useful information about their pain experiences, how to improve pain management and explained why they did not tell their nurses when they were in pain. RELEVANCE TO CLINICAL PRACTICE These findings should direct further improvements in paediatric postoperative pain management, such as increased use of pain assessment tools and preparatory information, as well as more appropriate administration of pain medications.
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Affiliation(s)
- Anja Hetland Smeland
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Tone Rustøen
- Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Torgun Naess
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Lill Nybro
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Stefan Lundeberg
- Pain Treatment Service, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Hanne Reinertsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Trond H Diseth
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alison Twycross
- School of Health and Social Care, London South Bank University, London, UK
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Nurses’ Knowledge, Attitudes and Clinical Practice in Pediatric Postoperative Pain Management. Pain Manag Nurs 2018; 19:585-598. [DOI: 10.1016/j.pmn.2018.04.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/11/2018] [Accepted: 04/01/2018] [Indexed: 11/18/2022]
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Pope N, Tallon M, Leslie G, Wilson S. Ask me: Children's experiences of pain explored using the draw, write, and tell method. J SPEC PEDIATR NURS 2018; 23:e12218. [PMID: 29790268 DOI: 10.1111/jspn.12218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/03/2018] [Accepted: 04/25/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Pain management within emergency departments (ED) remains challenging. Given that unrelieved pain in children is linked to a number of negative physiological and psychological consequences, optimal management of children's pain is paramount. Many studies exploring children's pain have adopted quantitative methods or sought the perspectives of adults. Compared to adults, studies examining children's views on pain and pain management are limited. This study aimed to explore children's pain experiences, their perception of pain management and expectations of the role of the nurse. DESIGN This was a qualitative descriptive study using an inductive approach. METHODS Fifteen children, aged 4-8 years who presented to the ED of an Australian tertiary pediatric hospital in acute pain participated. Data were collected using draw, write, and tell (DWT) technique and analyzed using thematic analysis. RESULTS Three themes emerged (1) "Security," (2) "My pain" with subthemes: "The pain feelings" and "My sad/happy feelings," (3) "Comfort and relief" with subthemes: "Taking my mind off it," "Resting" and "Hospital things." When in pain children needed to feel secure. Parents and nurses were important in fostering a secure environment for children. Children were capable of describing their pain and identified nonpharmacological strategies to help their pain. PRACTICE IMPLICATIONS Children as young as 4 years old can provide detailed accounts of their pain, which extends beyond physical dimensions to include visual, auditory, and sensory features. Nurses need to listen, be honest, and develop trust with children to be helpful. Nonpharmacological pain-relieving strategies can be implemented by parents and nurses in collaboration with the child. Fostering a secure environment is essential.
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Affiliation(s)
- Nicole Pope
- Child and Adolescent Health Service, Princess Margaret Hospital for Children, Perth, Australia.,West Australian Centre of Evidence Informed Healthcare Practice: a Joanna Briggs Institute Centre of Excellence, Curtin University, Perth, Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
| | - Mary Tallon
- West Australian Centre of Evidence Informed Healthcare Practice: a Joanna Briggs Institute Centre of Excellence, Curtin University, Perth, Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
| | - Gavin Leslie
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
| | - Sally Wilson
- Child and Adolescent Health Service, Princess Margaret Hospital for Children, Perth, Australia.,West Australian Centre of Evidence Informed Healthcare Practice: a Joanna Briggs Institute Centre of Excellence, Curtin University, Perth, Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
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Pope N, Tallon M, McConigley R, Wilson S. The experiences of acute non-surgical pain of children who present to a healthcare facility for treatment: a systematic review protocol. ACTA ACUST UNITED AC 2018; 13:12-20. [PMID: 26571278 DOI: 10.11124/jbisrir-2015-2466] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The qualitative objective of this systematic review is to identify and synthesize the best available evidence on experiences of acute non-surgical pain, including pain management, of children (between four to 18 years) when they present to a healthcare facility for treatment.The specific objectives are to identify: BACKGROUND The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage". The pain experience is multifaceted and complex, extending beyond the physiological interpretation of a noxious stimulus, encompassing other dimensions, including; psychological, cognitive, sociocultural, affective and emotional factors. Pain can be described as chronic (persisting for three months or more) or acute (a time limited response to a noxious stimuli). Over the past 50 years clinical research has made revolutionary contributions to better understanding pediatric pain. The once pervasive erroneous notion that infants do not experience pain the same way as adults has been firmly dispelled. We now know that nervous system structures associated with the physiological interpretation of pain are functional as early as fetal development. Despite this critical knowledge and the growing global commitment to improving pediatric pain management in clinical practice, evidence repeatedly suggests that pain management remains suboptimal and inconsistent, a phenomenon commonly referred to as oligoanalgesia. Research evidence has linked poorly managed pain in the pediatric population to negative behavioral and physiological consequences later in life. Effective pain management is therefore a priority area for health care professionals. Improved understanding of children's experiences of acute non-surgical pain may lead to improved pain management and a reduction in oligoanalgesia.In the 1970s and 1980s, studies began exploring the subjective experiences of pediatric pain and discovered children's abilities to articulate their pain experiences, and to link causes and consequences of their pain. Developmental trends or age related patterns with regards to children's expressions and experiences of pain were identified. Recent studies have also recognized apparent trends in children's understanding and expressions of pain; these follow an age and cognitive development trajectory in line with Piaget's theories of development.For many children psychosocial aspects of pain, including emotions like fear, stress and anxiety, are often more unpleasant than the painful experience itself. Emotional responses such as distress and anxiety are commonly associated with the anticipation of pain, can exacerbate and intensify the pain experience, and can significantly lower a child's pain threshold. One study utilized an observational pain assessment tool to explore children's pain experiences. The findings indicated that children who underwent "non-painful" procedures (such as restraint) had equal, and in some cases higher, pain scores than those who underwent painful procedures (such as intravenous cannulation).Several studies exploring pediatric pain within health care settings (including, but not limited to, general practitioners, hospitals, emergency departments and outpatient clinics) have adopted quantitative methods, some examined parents' perspectives, and others explored nurses' perceptions. While results of such studies have added to the existing body of knowledge that supports the need to focus on improving pediatric pain management, it has been suggested that failing to ask children directly risks not capturing subjective experiences of pain from the children's perspectives in their entirety. Seeking the children's perspectives could provide a more reliable and adequate means of gaining insight into their needs and expectations when they are in pain.A single centered study in Singapore used semi-structured face-to-face interviews (n=15) to explore children's experiences of pain management postoperatively. While the children, aged between six and 12 years, identified the role of analgesia in managing their pain, they also placed significant emphasis on the role of parents and health care professionals in implementing non-pharmacological interventions in pain management. These results are relevant as they provide insights into how children experience and express pain, and their expectations of health care professionals in managing their pain. These findings draw attention to effective pain management approaches when caring for children. Similarly, a UK study adopted a cross sectional descriptive design using the draw and write technique aimed at investigating children's views on what helped when they were in pain. The children (n=71) were aged between four and 16 years. Findings revealed that children viewed themselves as active agents in pain management, while also placing significant emphasis on the importance of parents and nurses in managing their pain. In both studies, children valued nurses for social interactions, such as kindness and humor, rather than the provision of clinical care, including analgesia administration. Adjunct therapies such as distraction, visualization and music have also been shown to be effective in managing the pain experience in children.Not only do these findings demonstrate the complexity of the pain experience for the child, they also support the notion that improved pain management may come from research that is designed to better understand the entire pain experience from the child's perspective. While there are systematic reviews on interventions for managing children's pain, and one explored children's experiences in the postoperative context, none have considered children's experiences of acute non-surgical pain when they present for treatment. This qualitative systematic review aims to identify and synthesize results of studies exploring children's experiences of pain and pain management.
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Affiliation(s)
- Nicole Pope
- 1Princess Margaret Hospital for Children, Child and Adolescent Health Service, Perth, Australia2West Australian Centre of Evidence Informed Healthcare Practice: a Collaborating Center of Joanna Briggs Institute, Curtin University, Perth, Australia3School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia
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Santos PMD, Silva LFD, Depianti JRB, Cursino EG, Ribeiro CA. Nursing care through the perception of hospitalized children. Rev Bras Enferm 2017; 69:646-53. [PMID: 27508468 DOI: 10.1590/0034-7167.2016690405i] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 02/23/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to describe the perception of hospitalized children of school age, on nursing care and understand what are, from their perspective, the best ways to address it to when performing such care. METHOD qualitative, descriptive, exploratory research, with concepts of Vygotsky used as theoretical framework. The data collection occurred through interviews mediated by drawings and was performed with ten school children, with the interview later transcribed and submitted to a thematic analysis. RESULTS showed the importance of playing during hospitalization, of a friendly and caring approach and providing explanations regarding the performed procedures. CONCLUSION nursing professionals need to consider how the children would like to receive the care being provided, so that their singularities are respected, characterizing nursing actions according to a perspective of the whole human being.
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Affiliation(s)
- Priscila Mattos Dos Santos
- Faculdade Pequeno Príncipe, Programa de Residência de Enfermagem em Saúde da Criança e do Adolescente. Curitiba-PR, Brasil
| | - Liliane Faria da Silva
- Universidade Federal Fluminense, Escola de Enfermagem Aurora de Afonso Costa. Niterói-RJ, Brasil
| | | | - Emília Gallindo Cursino
- Universidade Federal Fluminense, Escola de Enfermagem Aurora de Afonso Costa. Niterói-RJ, Brasil
| | - Circéa Amália Ribeiro
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem. São Paulo-SP, Brasil
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Pope N, Tallon M, McConigley R, Leslie G, Wilson S. Experiences of acute pain in children who present to a healthcare facility for treatment: a systematic review of qualitative evidence. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:1612-1644. [PMID: 28628521 DOI: 10.11124/jbisrir-2016-003029] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Pain is a universal and complex phenomenon that is personal, subjective and specific. Despite growing knowledge in pediatric pain, management of children's pain remains sub-optimal and is linked to negative behavioral and physiological consequences later in life. As there is no synthesis of these studies, it was timely to undertake a systematic review. OBJECTIVES To identify, evaluate and synthesize the existing qualitative evidence on children's experiences of acute pain, including pain management, within a healthcare facility. INCLUSION CRITERIA TYPES OF PARTICIPANTS Children aged four to 18 years (inclusive) attending a healthcare facility who experienced acute pain associated with any injury, medical condition or treatment. PHENOMENA OF INTEREST Children's experiences and perceptions of their acute pain, pain management and expectations of others in managing their pain. Studies on children's experiences of pain in the postoperative context were excluded as a systematic review exploring this phenomenon had previously been published. Studies reporting on children's experiences of chronic pain were also excluded. CONTEXT Any healthcare facility including general practitioners' surgeries, hospitals, emergency departments and outpatient clinics. TYPES OF STUDIES Qualitative studies including phenomenology, grounded theory, ethnography, action research and feminist research designs. SEARCH STRATEGY Using a three-step search strategy, databases were searched in December 2015 to identify both published and unpublished articles from 2000 to 2015. Studies published in languages other than English were excluded. METHODOLOGICAL QUALITY All studies that met the inclusion criteria were assessed by at least two independent reviewers for methodological quality using a standardized critical appraisal tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). DATA EXTRACTION Data were extracted from the papers included in the review using standardized data extraction tool from JBI-QARI. DATA SYNTHESIS Findings were pooled using JBI-QARI. Findings were rated according to their level of credibility and categorized based on similarity in meaning and then were subjected to a meta-synthesis. RESULTS Four studies were included in this review. Two meta-syntheses were generated from five categories based on 21 findings: first, children can express their pain experiences in terms of cause, location, meaning and quality. Children's pain experiences include both physical and psychological dimensions. Children's pain experiences are influenced by their previous pain experiences, pain expectations and sociocultural factors. Second, children use a range of cognitive/behavioral and sensory/physical self-soothing strategies not only to help manage their pain, but also rely on the actions and presence of others as helpers when they are in pain. CONCLUSION Children's pain is a multi-dimensional complex phenomenon relying upon a multi-modal approach to management. Children as young as four years are capable of articulating their pain in terms of location, intensity and depth. The way children perceive, express and respond to pain is shaped by sociocultural factors, previous pain experiences and their expectations of pain. Children, parents and healthcare professionals play an important role in managing children's pain experiences.
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Affiliation(s)
- Nicole Pope
- 1Princess Margaret Hospital for Children, Child and Adolescent Health Service, Perth, Australia 2The Western Australian Group for Evidence Informed Healthcare Practice: a Joanna Briggs Institute Centre of Excellence, Curtin University, Perth, Australia 3School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia 4School of Public Health, Curtin University, Perth, Australia
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He HG. Parents require more information on how to manage their child's postoperative pain at home. Evid Based Nurs 2017; 20:49. [PMID: 28174203 DOI: 10.1136/eb-2016-102536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Simons J. A Proposed Model of the Effective Management of Children's Pain. Pain Manag Nurs 2016; 16:570-8. [PMID: 26256220 DOI: 10.1016/j.pmn.2014.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 11/30/2022]
Abstract
The aim of this study was to understand the various factors that contribute to the delivery of effective pain management. The current picture of pain management is complex and contradictory, with children in the hospital still experiencing unnecessary pain, nurses reporting better pain care than is evidenced, and parents who are reluctant to report their child's pain. There is a real need to focus on areas of excellence where pain management innovations have been successfully implemented. Five hospitals were visited in three countries: the United Kingdom, Sweden, and Australia, spending a week in each country. In all, 28 health care professionals were interviewed exploring innovations in pain management; the effect of improvements on children, parents, and nurses; and what helped and hindered the delivery of effective pain management. Better pain management provides nurses with confidence, which in turn gives children and parents confidence in their care and reduces anxiety for nurses. Resources, on the other hand, were a common issue in relation to obstacles to innovation. A recurring theme in all areas visited was the issue of culture and how it affected both negatively and positively on the management of children's pain. Strong leadership was integral to moving practice forward and to introducing the innovations that led to effective pain management. The key findings identified that underpin the effective management of children's pain are effective leadership, resources, and confidence; the consequences are less stress for children and nurses, more trusting relationships, and greater job satisfaction. A model of effective pain management is proposed.
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Affiliation(s)
- Joan Simons
- Health and Social Care, The Open University, Milton Keynes, United Kingdom.
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Sng QW, He HG, Wang W, Taylor B, Chow A, Klainin-Yobas P, Zhu L. A Meta-Synthesis of Children's Experiences of Postoperative Pain Management. Worldviews Evid Based Nurs 2016; 14:46-54. [DOI: 10.1111/wvn.12185] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Qian Wen Sng
- Staff Nurse, Division of Nursing; KK Women's and Children's Hospital; Singapore
| | - Hong-Gu He
- Associate Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Wenru Wang
- Assistant Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Beverley Taylor
- Professor, School of Nursing and Midwifery, Gippsland Campus; Monash University; Australia
| | - Aloysius Chow
- Research Assistant, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Piyanee Klainin-Yobas
- Associate Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Lixia Zhu
- Research Fellow, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
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Longard J, Twycross A, Williams AM, Hong P, Chorney J. Parents' experiences of managing their child's postoperative pain at home: an exploratory qualitative study. J Clin Nurs 2016; 25:2619-28. [PMID: 27349504 DOI: 10.1111/jocn.13307] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To understand parents' experiences of managing their child's postoperative pain at home. BACKGROUND Recent changes in children's health care services often shift the responsibility of managing children's postoperative pain to parents. Although pain management is important for good postoperative outcomes, it can be a challenging task for families, and children's pain is often under-managed. DESIGN This qualitative study used semi-structured interviews to explore parents' experiences of managing their child's postoperative pain at home. METHODS Participants were parents of 10 typically developing 5- and 6-year olds, who underwent (adeno)tonsillectomy, and experienced no complications leading to hospitalisation in the postoperative period. One-on-one interviews were conducted with parents within three months of their child's surgery. Interviews were transcribed verbatim and content analysis was used to identify themes in parents' experiences. RESULTS All children experienced some postoperative pain. Parents' experiences of managing their child's pain were impacted by balancing the pros and cons of administering analgesic medications, managing the emotional and psychological effects of their child's pain, as well as parents' information needs. CONCLUSIONS Most parents' information needs were met yet they still struggled to manage their child's pain. These findings provide insight into some of the barriers that make this process challenging for many families, and what health care centres can do to help support parents manage their child's postoperative pain at home. RELEVANCE TO CLINICAL PRACTICE The results of this study may aid in the design of interventions that will support parents when managing their child's postoperative pain at home and thus improve children's experiences.
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Affiliation(s)
- Julie Longard
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
| | | | - Anna M Williams
- Centre for Outcomes and Experience Research in Children's Health, Illness, and Disability (ORCHID), Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Paul Hong
- Pediatric Otolaryngology Clinic, IWK Health Centre, Halifax, NS, Canada
| | - Jill Chorney
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
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Experiences of Iranian Nurses on the Facilitators of Pain Management in Children: A Qualitative Study. PAIN RESEARCH AND TREATMENT 2016; 2016:3594240. [PMID: 27123342 PMCID: PMC4829710 DOI: 10.1155/2016/3594240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 02/20/2016] [Accepted: 03/06/2016] [Indexed: 11/18/2022]
Abstract
Background. Despite decades of research and the availability of effective analgesic approaches, many children continue to experience moderate-to-severe pain after hospitalization. Greater research efforts are needed to identify the factors that facilitate effective pain management. The aim of this study was to explore the perceptions of Iranian nurses on facilitators of pain management in children. Materials and Methods. This qualitative study collected the data profoundly through unstructured interviews with 19 nurses in Amirkola Children's Hospital in Babol and Children's Medical Center in Tehran, during 2013-2014. Purposeful sampling and analysis of the data were conducted using conventional qualitative content analysis. Results. Four themes were extracted through data analysis: mother and child participation in diagnosis and pain relief, the timely presence of medical staff and parents, proper communication, and training and supportive role of nurses. Conclusion. Mother and child participation in the report and diagnosis of pain and nonpharmacological interventions for pain by the mother, the timely presence of medical team at the patient's bedside, and proper interaction along with the training and supportive role of a nurse enhanced the optimal pain management in hospitalized children.
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He HG, Zhu L, Chan SWC, Liam JLW, Li HCW, Ko S, Klainin-Yobas P, Wang W. Therapeutic play intervention on children's perioperative anxiety, negative emotional manifestation and postoperative pain: a randomized controlled trial. J Adv Nurs 2015; 71:1032-43. [DOI: 10.1111/jan.12608] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2014] [Indexed: 12/21/2022]
Affiliation(s)
- Hong-Gu He
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | - Lixia Zhu
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | - Sally Wai-Chi Chan
- School of Nursing and Midwifery; The University of Newcastle; Callaghan New South Wales Australia
| | | | | | - Saw Sandar Ko
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | | | - Wenru Wang
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
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He HG, Zhu L, Chan WCS, Xiao C, Klainin-Yobas P, Wang W, Cheng KFK, Luo N. A randomized controlled trial of the effectiveness of an educational intervention on outcomes of parents and their children undergoing inpatient elective surgery: study protocol. J Adv Nurs 2014; 71:665-75. [DOI: 10.1111/jan.12521] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2014] [Indexed: 01/22/2023]
Affiliation(s)
- Hong-Gu He
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | - Lixia Zhu
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | | | - Chunxiang Xiao
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | | | - Wenru Wang
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | - Kin Fong Karis Cheng
- Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health; National University of Singapore; Singapore
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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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Chieng YJS, Chan WCS, Klainin-Yobas P, He HG. Perioperative anxiety and postoperative pain in children and adolescents undergoing elective surgical procedures: a quantitative systematic review. J Adv Nurs 2013; 70:243-55. [PMID: 23865442 DOI: 10.1111/jan.12205] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2013] [Indexed: 11/30/2022]
Abstract
AIMS To examine the relationship between perioperative anxiety and postoperative pain in children and adolescents undergoing elective surgical procedures and the differences in children's perioperative anxiety and postoperative pain among subgroups of demographics. BACKGROUND While anxiety and pain are regarded as two common problems experienced by children and adolescents perioperatively and the relationship between them has been reported in previous studies, there has been no review paper examining this phenomenon. DESIGN A quantitative systematic review. DATA SOURCES Nine electronic databases were searched for studies published in English from the inception date of the databases to December 2010, using various combinations of search terms of 'adolescents', 'anxiety', 'child', 'pain', 'surgery' and 'correlation/relationship'. REVIEW METHODS Using the Joanna Briggs Institute's comprehensive systematic review strategies, relevant studies were independently appraised and extracted by two reviewers using the standardized critical appraisal instruments and data extraction tool from Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. RESULTS Ten studies were included in this review from 943 studies initially retrieved. Children and adolescents who had higher level of perioperative anxiety experienced a higher level of postoperative pain. Inconclusive evidence was found regarding differences of perioperative anxiety and postoperative pain between demographic subgroups of gender, age and past surgical experience. CONCLUSION Results of this review inform healthcare providers of the role perioperative anxiety plays on children's and adolescents' postoperative pain and indicate the need to use interventions to reduce perioperative anxiety and, therefore, optimize their postoperative pain management during the perioperative period.
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Chieng YJS, Chan WCS, Liam JLW, Klainin-Yobas P, Wang W, He HG. Exploring influencing factors of postoperative pain in school-age children undergoing elective surgery. J SPEC PEDIATR NURS 2013; 18:243-52. [PMID: 23822848 DOI: 10.1111/jspn.12030] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 02/27/2013] [Accepted: 02/28/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to examine the influencing factors of postoperative pain among children undergoing elective surgery. DESIGN AND METHODS A survey was conducted in 2011 with a convenience sample of 66 children, 6 to 14 years old, in a tertiary hospital in Singapore. RESULTS Children experienced moderate preoperative anxiety and postoperative pain. Gender, preoperative anxiety, and negative emotional behaviors were significant influencing factors for postoperative pain. Boys reported less postoperative pain than girls. PRACTICE IMPLICATIONS Effective strategies for assessing and managing children's preoperative anxiety are needed to achieve an optimal postoperative pain management outcome.
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Foster RL. Our incredible failure to incorporate evidence about pediatric pain management into clinical practice. J SPEC PEDIATR NURS 2013; 18:171-2. [PMID: 23822841 DOI: 10.1111/jspn.12039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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