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Implications for practice and research
Parents use various strategies to manage their children's postoperative pain, but they also face challenges and want support from health professionals.
More effective and family-informed interventions are needed to improve children's pain management at home.
Interventions would require evaluating to establish their effectiveness.
Previous studies have described children's experiences of postoperative pain1 ,2 and parents' experiences of managing their child's postoperative pain at home.2 However, it is unclear what the facilitators and barriers are in relation to how parents manage their child's postoperative pain at home.
The purpose of the study by Longard et al was to explore parents' experiences of managing their child's postoperative pain at home in order to support the development of more effective family-informed interventions for improving children's pain management. The study used an exploratory qualitative study design with data collected using semistructured interviews with 10 biological parents of children 5–6 years of age. The children had undergone tonsillectomy surgery at a paediatric tertiary care centre in Eastern Canada, and were discharged within 23 hours of the surgery without complications. Data were analysed using content analysis, with NVivo software used to sort and manage the data.
Parents reported different levels of postoperative pain experienced by their children at home, varying from very little to considerable pain and used a range of analgesic medication to manage the pain based on guidelines or their child's choices. Their experiences were influenced by: (1) balancing the pros and cons of giving analgesia medications: some parents expressed concerns about the side effects of medications; (2) managing the emotional and psychological effects of children's pain during the recovery time; and (3) parents information needs: some parents sought further advice after discharge from a range of sources such as local pharmacist.
Longard et al's study focused on parents' experiences of managing their child's postoperative pain at home, in order to identify parents' information needs to help them better manage their child's postoperative pain. The study found that child's postoperative pain appeared to be better managed at home when compared with findings in previous studies,3 which might suggest that child's pain management at home has improved. The study also found that there was variability in parents' use of prescribed pain medications to relieve pain; however, as previously reported,4 some parents were concerned about the side effects of the medications and had misconceptions about the additive properties of analgesic medications. Moreover, parents faced numerous burdens like distress when managing their child's emotional responses and own emotions.4 Although parents reported that they received sufficient information, some still sought advice from healthcare professionals after discharge.
The importance of this study to future practice is recognition of the need to support parents in better coping with their children's postoperative pain at home. Parents need information, emotional and social support from a multidisciplinary team with assistance from local resources, including community clinicians. Information provided should include: explanations about the mild to severe pain their child may have after operation even with the use of analgesic medications; physical and psychological pain management strategies; and the possible short-term burdens parents may expect to face. The information can be tailored to meet the needs of each family, by considering the child's age, development level, parental beliefs about pain management and cultural background.5 The information can be provided online due to the fact that the current generation is used to obtain information using their smart phones. Although the study found that parents' information needs were met, they struggled to manage their child's pain at home. Longard et al proposed the need for future studies including: (1) qualitative studies to understand the specific barriers that make the process challenging for the families and what healthcare professionals can do to help support family; and (2) more effective patient and family-informed interventions to improve children's pain management at home. Technology-based interventions will be promising, as in the modern society, people are increasingly using smart phones to interact, obtain information and manage their health needs.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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