Effects of Preoperative Parental Pain Management Educational Interventions on the Postoperative Pain Intensity and Duration of Small Children Who Underwent One-Day Surgery: A Prospective Randomized Controlled Trial
1Department of Pediatric Intensive Therapy, Division of Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
2Faculty of Health Science, University of Maribor, Maribor, Slovenia
3Rho Sigma Research & Statistics, Novo Polje cesta I 55 c, Ljubljana, Slovenia
4Faculty of Criminal Justice nad Security University of Maribor, Ljubljana, Slovenia
5Neonatology Section, Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slovenia
6Chair of Pediatrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Online publish date: 16 September 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, with one parent, usually the mother (108 (76.1 %)), being involved at all stages of the study. No differences in children’s postoperative pain scores and analgesic use at home were found between the two parental groups (intervention and control groups). Parental pain scores after surgery was strongly positively correlated with pain duration, and analgesic use by their children at home. Pain intensity scores assessed by nurses in the hospital were lower compared to parental pain intensity scores. There was high inter-rater reliability between the PPPM, Wong-Baker, and NRS scales. Conclusions: No differences in postoperative pain in children were found between the intervention and control groups of parents. Parents gave higher scores of pain intensity in children than nurses did.
Pain rating scales, Small child, Surgery, One-day hospital, Parents, Pain
Dejan Kobal,Barbara Kegl,Vanja Erculj,Stefan Grosek. Effects of Preoperative Parental Pain Management Educational Interventions on the Postoperative Pain Intensity and Duration of Small Children Who Underwent One-Day Surgery: A Prospective Randomized Controlled Trial. Signa Vitae. 2020.doi:10.22514/sv.2020.16.0057.
 McGrath PJ, Stevens BJ, Walker SM, and Zempsky WT. Oxford Textbook of Paediatric Pain. 1st ed. Oxford University Press. 2014. p. 687.
 Wong Baker FACESfoundation. (n.d.). 2015. Accessable on: http://wongbakerfaces.org/.
 Fogel KJ, Gerkensmeyer JE, Joyce BA, et al. Validity of the Faces and Word Descriptor scales to measure procedural pain. J Pediatr Nurs. 1996;11:368-374.
 Hunter M, McDowell L, Hennessey R, et al. An evaluation of the Faces Pain Scale with young children. J Pain Symptom Manage. 2000;20:122-129.
 Garra G, Singer AJ, Taira BR, et al. Validation of the Wong-Baker FACES Pain Rating Scale in Pediatric Emergency Department Patients. Acad Emerg Med. 2010;17:50-54.
 Bailey B, Daoust R,Doyon-Trottier E, et al. Validation and properties of the verbal numeric scale in children with acute pain. Pain. 2010;149:216-221.
 Miró J, Castarlenas E, Huguet A. Evidence for the use of a numerical rating scale to assess the intensity of pediatric pain. Eur J Pain. 2009;13:1089-1095.
 von Baeyer CL. Numerical rating scale for self-report of pain intensity in children and adolescents: recent progress and further questions. Eur J Pain. 2009;13:1005-1007.
 von Baeyer CL, Chambers CT, Eakins DM. Development of a 10-Item Short Form of the Parents Postoperative Pain Measure: The PPPM-SF. J of Pain. 2011;12:401-406.
 Chambers CT, Reid GJ, McGrath PJ, et al. Development and preliminary validation of a postoperative pain measure for parents. Pain. 1996;68:307-313.
 Chambers CT, Finley GA, McGrath PJ, et al. The parents postoperative pain measure: replication and extension to 2-6-year-old children. Pain. 2003;105:437-443.
 Finley GA, Chambers CT, McGrath PJ, et al. Construct validity of the Parents’ Postoperative Pain Measure. Clin J Pain. 2003;19:329-334.
 Chng HY, He HG, Chan SW, et al. Parents’ knowledge, attitudes, use of pain relief methods and satisfaction related to their children’s postoperative pain management: a descriptive correlational study. J Clin Nurs. 2015;24:1630-1642.
 Chartrand J, Tourigny J, MacCormick J. The effect of an educational pre-operative DVD on parents’ and children’s outcomes after a same-day surgery: a randomized controlled trial. J Adv Nurs. 2017;73:599-611.
 Twycross AM, Williams AM, Bolland RE, et al. Parental attitudes to children’s pain and analgesic drugs in the United Kingdom. J Child Health Care. 2015;19:402-411.
 Helgadóttir HL, Wilson ME. A randomized controlled trial of the effectiveness of educating parents about distraction to decrease postop-erative pain in children at home after tonsillectomy. Pain Manag Nurs. 2014;15:632-640.
 Maclaren CJ, Twycross A, Mifflin K, et al. Can we improve parent’s management of their children’s postoperative pain at home? Pain Res Manag. 2014;19:e115-123.
 Fortier MA, Rosario AM, Rosenbaum A, et al. Beyond pain: predictors of postoperative maladaptive behavior change in children. Paediatr Anaest. 2010;20:445-453.
 Rajasagaram U, McD Taylor D, Braitberg G, et al. Paediatric pain assessment: differences between triage nurse, child and parent. J Paediatr Child Health . 2009;45:199-203.
 Maciocia PM, Strachana EM. Pain assessment in the paediatric Emer-gency Department: whose view counts? Eu J Emerg Med. 2003;10:264-267.
 Puntillo K, Neighbor M, O’Neil N, et al. Accuracy of Emergency Nurses in Assessment of Patient’s Pain. Pain Manag Nurs. 2003;4:171-175.
 Knutsson J, Tibbelin A, von Unge M. Postoperative pain after paediatric adenoidectomy and differences between the pain score made by the recovery room staff, the parent and the child. Acta Otolaryngol. 2006;126:1079-1083.
 Khin Hla TK, Hegarty M, Russell P,et al. Perception of pediatric pain: a comparison of postoperative pain assessments between child, parent, nurse, and independent observer. Paediatr Anaesth. 2014;24:1127-1131.
 Burcharth J, Pedersen M, Bisgaard T, et al. Nationwide prevalence of groin hernia repair. PLoS One. 2013;8:e54367.
 Jekel JF, Elmore JG, Katz DL, et al. Epidemiology, Biostatistics, and Preventive Medicine. Saunders Elsevier. 1996.
 Unsworth V, Franck LS, Choonara I. Parental assessment and manage-ment of children’s postoperative pain: a randomize clinical trial, J Child Health Care. 2007;11:186-194.
 Hegarty M, Calder A, Davies K, et al. Does take-home analgesia improve postoperative pain after elective day case surgery? A comparison of hospital vs parent-supplied analgesia. Paediatr Anesth. 2013;23:385-389.
 Kankkunen P, Vehviläinen-Julkunen K, Pietilä AM, et al. Promoting Children’s Pharmacological Post-Operative Pain Alleviation at Home. Pediatr Nurs. 2009;35:298-303.
 von Baeyer CL Self-report: the primary source in assessment after infancy. In: McGrath, P.J., Stevens, B.J., Walker, S.M., & Zempsky, W.T, editors. Oxford Textbook of Paediatric Pain. Oxford University Press. 2014. p. 370-378.
 Wong M, Copp PE, Haas DA. Postoperative Pain in Children After Dentistry Under General Anesthesia. Anesth Prog. 2015;62:140-152.
 Pagé MG, Campbell F, Isaac L, et al. Parental risk factors for the development of pediatric acute and chronic postsurgical pain: a longitudinal study. J Pain Research. 2013;30:727-741.
Science Citation Index Expanded (SciSearch) The Science Citation Index (SCI) is a citation index originally produced by the Institute for Scientific Information (ISI) and created by Eugene Garfield. It (Science Citation Index Expanded) covers more than 8,500 notable and significant journals, across 150 disciplines in science and technology, from 1900 to the present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.