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Hammack Johnson A, Conley B, Koruthu S, Smith A. Pediatric Preanesthesia Anxiety and Factors of Family Satisfaction. J Perianesth Nurs 2023; 38:312-317. [PMID: 36528451 DOI: 10.1016/j.jopan.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Pediatric patients scheduled for procedures with anesthesia experience stress and feelings of anxiety, but frequently lack the opportunity to report their feelings. Pediatric patient anxiety may be related to internal (patient perceptions/emotions) or external (demographic/family knowledge/satisfaction) factors. The purpose of the study was to explore patient reports of anxiety in young school-age through adolescent ages, and factors of family satisfaction before a scheduled procedure with anesthesia. DESIGN Cross-sectional, descriptive, and correlational. METHODS A voluntary survey including family-report of patient age and past anesthesia, type of procedure, family satisfaction factors (knowledge of anesthesia; perioperative concerns), and patient-report of anxiety with a visual analog scale (0-10) was offered to eligible families at their preanesthesia clinic appointment. FINDINGS Completed surveys from 80 families (mean age of patient = 12 years; range 7-17 years) showed legally authorized guardians (LAGs) felt the preanesthesia visit helped them understand anesthesia information, but they also had concerns, such as complications and pain. Patient anxiety ratings ranged from 0 to 10 (M = 3.3, SD = 3.1), and were slightly higher for patients 11 years and younger (M = 3.8; SD = 3.4). Anxiety ratings were not significantly correlated with other factors measured. CONCLUSIONS Pediatric patients, ages 7-17, report preanesthesia anxiety levels ranging from "not at all" to "worst imaginable," unrelated to demographic or family factors. Family members have perioperative concerns that need to be addressed before scheduled procedures. There is an impetus for improvement in psychosocial assessment and health care team collaboration to meet needs in a family-centered preanesthesia care model.
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Affiliation(s)
- Ann Hammack Johnson
- Department of Nursing, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX; Anesthesia for Childrens, Children's Health, Children's Medical Center Dallas, Dallas, TX.
| | - Bonita Conley
- Anesthesia for Childrens, Children's Health, Children's Medical Center Dallas, Dallas, TX
| | - Sharon Koruthu
- Anesthesia for Childrens, Children's Health, Children's Medical Center Dallas, Dallas, TX
| | - Ashley Smith
- Anesthesia for Childrens, Children's Health, Children's Medical Center Dallas, Dallas, TX
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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] [What about the content of this article? (0)] [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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Jaaniste T, Wood JG, Johnson A, Nguyen H, Chan DB, Powell A, Pfeiffer G, Wong B, Champion GD. Trajectory of Pain, Functional Limitation, and Parental Coping Resources Following Pediatric Short-stay Surgery: Factors Impacting Rate of Recovery. Clin J Pain 2021; 37:698-706. [PMID: 34369414 DOI: 10.1097/ajp.0000000000000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although there are many benefits of short-stay hospital admissions for high volume, pediatric surgical procedures, this model of care places greater responsibility on parents for the management of children's pain. This study aimed to document the trajectory of child pain outcomes and a range of parent-reported functional outcomes following discharge from a short-stay surgical admission. Moreover, we aimed to document the trajectory of parental perceived personal coping resources. Second, we assessed whether parental dispositional factors, assessed before hospital discharge, predicted the child's pain intensity and parent-reported functional recovery. METHODS Participants included children (aged 4 to 14 y) admitted for a short-stay tonsillectomy or appendectomy, and their parents. Parents completed a questionnaire before discharge from hospital. Demographic and surgical information was recorded from medical records. Following discharge, daily assessments of pain and functioning were carried out over a 10-day period using iPods or mobile phones. Predischarge and postdischarge data were obtained for 55 child and parent dyads. RESULTS Pain intensity scores returned to low levels (2/10 or less) by day 5 for appendectomy and day 10 for tonsillectomy. Parents' perceived personal coping resources increased more slowly following tonsillectomy than appendectomy. Controlling for time since surgery and parental coping resources, parental pain-related catastrophizing was a significant predictor of child pain and functional recovery. DISCUSSION Short-stay surgery results in parents facing considerable burden in managing their child's pain and functional impairment over a 10-day period. The potential value of screening for parental pain-related catastrophizing before discharge from hospital warrants further consideration and may enable identification of children likely to experience poorer recovery.
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Affiliation(s)
- Tiina Jaaniste
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Jordan G Wood
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Anya Johnson
- Work and Organisational Studies, University of Sydney Business School, Darlington, NSW, Australia
| | - Helena Nguyen
- Work and Organisational Studies, University of Sydney Business School, Darlington, NSW, Australia
| | - David Bertrand Chan
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Alexandra Powell
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Genevieve Pfeiffer
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - Brandon Wong
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
| | - G David Champion
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Women's and Children's Health, University of New South Wales, Kensington
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Gholami S, Mojen LK, Rassouli M, Pahlavanzade B, Farahani AS. The Predictors of Postoperative Pain Among Children Based on the Theory of Unpleasant Symptoms: A Descriptive-Correlational Study. J Pediatr Nurs 2020; 55:141-146. [PMID: 32950821 DOI: 10.1016/j.pedn.2020.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Postoperative pain (POP) is a common outcome of surgical interventions among children. Identifying POP contributing factors can help identify children who are at risk for POP and facilitate POP management. The aim of the study was to determine the predictors of POP based on the Theory of Unpleasant Symptoms. DESIGN AND METHODS This descriptive-correlational study was conducted in 2018-2019 on 153 children purposively recruited. Data were collected using a personal characteristics questionnaire, the Coping Strategies Questionnaire, the Child Pain Anxiety Symptoms Scale, and a Visual Analogue Scale for Pain. The SPSS software (v. 21.0) was used for data analysis. RESULTS Twelve participants were excluded and final data analysis was done on the data obtained from 141 participants. Most of participants were male (65.2%), underwent abdominal surgery (53.2%), and experienced POP (86.5%). Their age mean was 8.58±2.23. Linear regression analysis revealed that the physiological factors of heart rate, preoperative pain, and surgery duration as well as the psychological factors of anxiety and coping strategies were significant predictors of POP among children. All these factors collectively explained 34% of the total variance of POP. Situational factors (such as age, gender, and ethnicity) had no significant effects on POP. CONCLUSIONS Heart rate, preoperative pain, surgery duration, anxiety and coping as predictive factors of POP can be considered when designing effective POP management strategies. PRACTICE IMPLICATIONS The findings provide a better understanding about the predictors of POP and can be used to develop pain management among children.
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Affiliation(s)
- Sara Gholami
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Iran
| | - Leila Khanali Mojen
- Department of Medical Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Iran.
| | - Maryam Rassouli
- Department of Pediatric Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Iran
| | - Bagher Pahlavanzade
- Departments of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Iran
| | - Azam Shirinabadi Farahani
- Department of Pediatric Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Iran
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Gude P, Gustedt F, Bellgardt M, Vogelsang H, Herzog-Niescery J, Dazert S, Weber TP, Volkenstein S. High dose ibuprofen as a monotherapy on an around-the-clock basis fails to control pain in children undergoing tonsil surgery: a prospective observational cohort study. Eur Arch Otorhinolaryngol 2020; 277:2115-2124. [DOI: 10.1007/s00405-020-05929-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/16/2020] [Indexed: 12/14/2022]
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Postier AC, Chambers C, Watson D, Schulz C, Friedrichsdorf SJ. A descriptive analysis of pediatric post-tonsillectomy pain and recovery outcomes over a 10-day recovery period from 2 randomized, controlled trials. Pain Rep 2020; 5:e819. [PMID: 32440612 DOI: 10.1097/PR9.0000000000000819] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/18/2019] [Accepted: 02/04/2020] [Indexed: 12/21/2022] Open
Abstract
Pediatric tonsillectomy involves an often painful and lengthy recovery period, yet the extended recovery process is largely unknown. This article describes postoperative recovery outcomes for 121 children aged 4 to 15 (mean 6.6 years, SD = 2.3) years enrolled in 1 of 2 clinical trials of analgesia safety and efficacy after tonsillectomy. Postoperative analgesia included scheduled opioid analgesic plus acetaminophen/ibuprofen medication use (first 5 days) and “as-needed” use (last 5 days). Clinical recovery as measured daily by the Parents' Postoperative Pain Measure (PPPM; an observational/behavioral pain measure), children's self-reported pain scores, side-effect assessments, need for unanticipated medical care, and satisfaction with recovery over 10 days was assessed. Higher Parents' Postoperative Pain Measure scores were correlated with poorer sleep, receipt of breakthrough analgesics, distressing side effects, higher self-reported pain scores, and need for unanticipated medical care. Higher self-reported pain scores were associated with more distressing adverse events, including nausea, vomiting, insomnia, lower parent satisfaction, and unplanned medical visits and hospitalizations. Pain and symptoms improved over time, although 24% of the children were still experiencing clinically significant pain on day 10. Scheduled, multimodal analgesia and discharge education that sets realistic expectations is important. This study adds to the emerging body of literature that some children experience significant postoperative pain for an extended period after tonsillectomy.
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Aghaki-Allen MR, Patil VK. Association between children's emotional/behavioral problems before adenotonsillectomy and postoperative pain scores at home: A comment. Paediatr Anaesth 2019; 29:1072. [PMID: 31602738 DOI: 10.1111/pan.13737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Vinod K Patil
- Anaesthetics Department, Queens Hospital, London, UK
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Sekhavatpour Z, Khanjani N, Reyhani T, Ghaffari S, Dastoorpoor M. The effect of storytelling on anxiety and behavioral disorders in children undergoing surgery: a randomized controlled trial. Pediatric Health Med Ther 2019; 10:61-68. [PMID: 31372090 PMCID: PMC6628943 DOI: 10.2147/phmt.s201653] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/11/2019] [Indexed: 11/23/2022]
Abstract
Background One of the most frightening procedures for children is surgery. This study aimed to assess the effect of animated illustrated stories on anxiety and behavioral disorders in children after surgery. Methods In this randomized controlled clinical trial (RCT), 60 children between 4 and 8 years who went through adenotonsillectomy were divided into two groups based on random numbers. In the intervention group, animated illustrated books were read for the children by the researcher, for 30 mins, on the night before surgery. Child’s anxiety was measured using the Revised Children’s Manifest Anxiety Scale (RCMAS) and Behavioral Disorder questionnaire (a researcher-made tool) before and 10 days after the book reading. Data were analyzed using descriptive statistics and the non-parametric Mann–Whitney U test and Wilcoxon signed-rank test. Results The results showed that mean scores of physiological anxiety (P-value<0.001), social concerns/concentration (P-value=0.012), and total anxiety (P-value<0.001), except worry/oversensitivity (P-value=0.140), statistically significantly decreased in the intervention group after book reading, but mean total anxiety and its three dimensions did not show statistically significant differences before and after treatment in the control group (P-value>0.05). Mean scores of the Behavioral Disorder questionnaire significantly decreased in the intervention group after book reading (P-value=0.001), but significantly increased in the control group (P-value<0.001). Conclusion The results showed that reading animated illustrated books could be effective in reducing anxiety and behavioral disorders in children after surgery. It seems that these books could be a new and creative way to distract children and can be used as supportive care.
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Affiliation(s)
- Zohreh Sekhavatpour
- Department of Pediatric Nursing, Anesthesiology, School of Paramedicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Narges Khanjani
- Department of Epidemiology, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Tayebeh Reyhani
- Department of Nursing, Faculty of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sogol Ghaffari
- Department of Psychologist, Dezful University of Medical Sciences, Dezful, Iran
| | - Maryam Dastoorpoor
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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