Psychosocial Predictors of Children's Postoperative Pain

Palermo, Tonya M.; Drotar, Dennis; Lambert, Sally

doi:10.1177/105477389800700305

Cited by 23 publications

(19 citation statements)

References 18 publications

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“…Patient-controlled intravenous opioid analgesia (PCA) was not commonly used for children; this treatment was frequently used by 3% (5) and sometimes by 6% (10) of all departments. Parenteral opioids were frequently used by 59% (109) of departments, and potent opioids such as morphine, ketobemidone and pethidine were never or rarely used by 15% (27). There was no signi cant correlation between the use of opioids and frequency of pain.…”

Section: Pain Treatment Methodsmentioning

confidence: 99%

Acute and postoperative pain in children: a Swedish nationwide survey

2002

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Many studies demonstrate inadequate pain treatment in children. The aim of this nationwide survey was to evaluate the prevalence of acute and postoperative pain in children; extent of, and reasons for, inadequate pain therapy; therapy methods; pain‐management structure; and the need for education of healthcare professionals. Questionnaires concerning these points were sent to all departments in Sweden involved in the treatment of children. The response rate was 75% (299/395). Answers from physicians and nurses showed that, despite treatment, moderate to severe pain occurred in 23% of patients with postoperative pain and 31% of patients with pain of other origin. Postoperative pain seemed to be a greater problem in units where children were treated along with adults and in departments where fewer children were treated. According to 45% of physicians and nurses, treatment of pain could often or always be managed more efficiently. Pain assessments were performed regularly in 43% of all departments, but pain measurement was less frequent; 3% of the departments had no formal organization for pain management; and 15% never or infrequently used potent opioids. Educational needs were high. Insufficient pain treatment seemed to be mostly related to organizational aspects, such as inadequate prescriptions. Anxiety in children or parents also contributed to ineffective pain treatment. Swedish treatment practices for the management of pain in children roughly follow the published guidelines, but many improvements are still necessary. Conclusion: Acute pain in children is still undertreated in Swedish hospitals. This seems to be related mainly to organizational aspects.

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Section: Pain Treatment Methodsmentioning

confidence: 99%

Acute and postoperative pain in children: a Swedish nationwide survey

2002

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“…1 Research has shown that between 15%2 and 60%3–7 of children report moderate to severe acute postoperative pain (APSP). Prospective studies of pediatric APSP have shown that preoperative anticipatory anxiety, younger age, and lower anticipatory distress before surgery predict higher APSP intensity on the day of surgery,8,9 and negative affect and pessimistic expectations about surgery predict functional disability one week after oral surgery 10. In addition, studies conducted postoperatively have found that coping strategies, depression, and self-efficacy correlate with acute pain intensity scores following surgery among adolescents 11–14…”

Section: Introductionmentioning

confidence: 99%

Pain-related psychological correlates of pediatric acute post-surgical pain

Pagé¹,

Stinson²,

Campbell³

et al. 2012

JPR

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BackgroundPost-surgical pain is prevalent in children, yet is significantly understudied. The goals of this study were to examine gender differences in pain outcomes and pain-related psychological constructs postoperatively and to identify pain-related psychological correlates of acute post-surgical pain (APSP) and predictors of functional disability 2 weeks after hospital discharge.MethodsEighty-three children aged 8–18 (mean 13.8 ± 2.4) years who underwent major orthopedic or general surgery completed pain and pain-related psychological measures 48–72 hours and 2 weeks after surgery.ResultsGirls reported higher levels of acute postoperative anxiety and pain unpleasantness compared with boys. In addition, pain anxiety was significantly associated with APSP intensity and functional disability 2 weeks after discharge, whereas pain catastrophizing was associated with APSP unpleasantness.ConclusionThese results highlight the important role played by pain-related psychological factors in the experience of pediatric APSP by children and adolescents.

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“…Historically, there have been significant gaps in pain management in children, with less effective pain control in children as compared to adults (3). Among trainees, there is significant variation in knowledge and prescribing practices for analgesics (4).…”

Section: Introductionmentioning

confidence: 99%

Analgesic Prescribing Practices Can Be Improved by Low-Cost Point-of-Care Decision Support

Rosenbluth

Wilson

Maselli

et al. 2011

Journal of Pain and Symptom Management

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Context Codeine has become a controversial choice for analgesia in children compared to other commonly available drugs. Objectives To evaluate whether an educational campaign shifted resident prescribing patterns away from codeine toward more appropriate analgesics. Methods Our intervention consisted of a pocket-sized reference card given to all trainees and key staff on an inpatient pediatric acute care unit; pediatrics residents also had the option to attend a one-hour lecture. The pocket-card recommended against codeine (including rationale), and gave prescription guidance for our institution’s preferred formulary alternative analgesics, which included tramadol and hydrocodone. We used inpatient prescribing data to track the prescribing of codeine and alternative medications over time. Results Following the interventions, there was a significant decrease in the percentage of patients receiving codeine (13.5% of patients received the drug in the year before, 5.4% in the year after, P<0.0001). Use of hydrocodone-containing analgesics increased overall during the same period (7.4% to 16%, P<0.0001) as did tramadol use (0.2% to 2.6%, P<0.0001). There were no changes in pain management satisfaction scores. Conclusions A simple, low-cost educational campaign consisting primarily of a pocket guide to analgesics markedly improved analgesic prescribing patterns, and that improvement extended to services not targeted by the didactic component of our educational campaign. Point-of-care decision support via a pocket-card may be sufficient for effecting change in medication prescribing patterns of trainees.

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Psychosocial Predictors of Children's Postoperative Pain

Cited by 23 publications

References 18 publications

Acute and postoperative pain in children: a Swedish nationwide survey

Acute and postoperative pain in children: a Swedish nationwide survey

Pain-related psychological correlates of pediatric acute post-surgical pain

Analgesic Prescribing Practices Can Be Improved by Low-Cost Point-of-Care Decision Support

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