Review of a Parent’s Influence on Pediatric Procedural Distress and Recovery

Brown, E. K.; Young, Alexandra De; Kimble, Roy; Kenardy, Justin

doi:10.1007/s10567-017-0252-3

Cited by 57 publications

(72 citation statements)

References 190 publications

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“…A limitation of the present study was that only the patient's psychological factors were evaluated in isolation to the parental ones. Studies have shown that parental psychological factors also play an important role in their children's response to pain [36,37]. Rabbitts et al (2014; observed that parental pain catastrophizing had a significant impact on pain trajectory membership, such that higher parental pain catastrophizing led to greater pain intensity in the acute postoperative period and late recovery after surgery [38,39].…”

Section: Discussionmentioning

confidence: 99%

Predicting Acute Postoperative Pain Trajectories and Long-Term Outcomes of Adolescents after Spinal Fusion Surgery

Ocay

Ingelmo

et al. 2020

Pain Research and Management

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Objectives. Acute pain trajectories are associated with long-term outcomes such as persistent pain and functional disability in adults. However, there are limited data on acute postoperative pain trajectories in the pediatric population. The aims of this study were to investigate acute postoperative pain trajectories, their predictors, and their impact on long- term outcomes in adolescents with idiopathic scoliosis. Methods. We evaluated the preoperative pain intensity, use of analgesics, psychosocial measures and physical functioning of adolescents scheduled to undergo spinal fusion, and their average 6-hour self-reported pain intensity scores for their entire hospital stay. Six months after surgery, baseline variables were reassessed. We used growth mixture modeling to conduct acute postoperative pain trajectory analysis and to identify predictors of pain trajectories. Generalized linear models were conducted to determine whether acute pain trajectories predict long-term outcomes. Results. One hundred and six patients were included in the best-fitted acute pain trajectory model that included four classes that differed in initial pain intensity and rates of change over time. Preoperative pain catastrophizer status and use of analgesics significantly predicted pain trajectory membership. Furthermore, at the 6-month follow-up, patients experiencing moderate-to-severe pain in the acute postoperative period were more likely to report higher levels of pain severity, use pain medication, and miss a greater number of school/work days due to back pain in the last three months. Discussion. Preoperative assessment and analyzing the progression of pain in the acute postoperative period can help identify those at risk of negative long-term outcomes after surgery.

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Section: Discussionmentioning

confidence: 99%

Predicting Acute Postoperative Pain Trajectories and Long-Term Outcomes of Adolescents after Spinal Fusion Surgery

Ocay

Ingelmo

et al. 2020

Pain Research and Management

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“…Given the association between pain and post-traumatic stress in children, 36 these sex differences in opioid administration may reflect underlying processes that affect the psychological response to traumatic injury. There is a need for increased awareness of communication and behaviors expressed by parents and providers toward each other and the child during the evaluation and management of pain in the pediatric trauma population, as these communications may be influenced by level of distress 37 and preconception about pain. [38][39][40] Providers should also look for opportunities to have discussions with patients and their families about communicating levels of pain and appropriate expectations of pain management during hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Who Hurts More? A Multicenter Prospective Study of In-Hospital Opioid Use in Pediatric Trauma Patients in the Midwest

Peláez

Davis

Spilman

et al. 2019

Journal of the American College of Surgeons

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BACKGROUND: Despite increased national attention on misuse of prescription and nonprescription opioids for adolescents and children, little is known about opioid use in a pediatric population during hospitalization for injury. The purpose of this investigation is to describe opioid administration and magnitude of opioid exposure in the first 48 hours of hospitalization in a pediatric trauma population. STUDY DESIGN: This is a secondary analysis of data collected for a randomized, prospective intervention study at 4 Midwestern children's trauma centers. Participants included children ages 10 to 17 years old, admitted to the hospital for unintentional injury. Descriptive statistics and multivariable modeling were used to characterize demographic factors and measure prevalence and magnitude of opioid use within the first 48 hours of hospitalization. RESULTS: Among 299 participants, 82% received at least 1 opioid administration. Children had increased odds of receiving an opioid (odds ratio [OR] 4.25; 95% CI 2.16 to 8.35) for every log increase of Injury Severity Scores (ISS), yet the majority of children with minor injury (61%) also received an opioid. Children with fractures and older children had higher odds of receiving an opioid. Amount of opioid, expressed as morphine milligrams equivalent (MME), significantly increased with child age, ISS, and fracture. CONCLUSIONS: Most pediatric trauma patients received an opioid in the first 48 hours of hospitalization, although prevalence and exposure varied by age, injury, and acuity. Aggressive pain management can be appropriate for injured pediatric patients; however, study results indicate areas for improvement, specifically for children with minor injuries and those receiving excessive opioid amounts.

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“…Parental anxiety and PTSS have been found to influence child procedural coping and distress behaviours through reduced parental coping-promoting and increased distress-promoting behaviours (Brown, De Young, Kimble, & Kenardy, 2019). Largely, parental behaviour during paediatric medical procedures has been related to child procedural coping and distress, and child procedural pain/fear (for a review, see Brown et al, 2018b). Given the role pain plays in wound healing, there is a potential cascade of parental acute psychological distress influencing child re-epithelialization through parenting behaviour influencing child pain severity.…”

Section: Statement Of Contributionmentioning

confidence: 99%

“…It is common for parents to experience psychological distress, including anxiety, guilt, and PTSS following a paediatric burn (Bakker, Van Loey, Van der Heijden, & Van Son, 2012;Stoddard et al, 2006). Largely, parental behaviour during paediatric medical procedures has been related to child procedural coping and distress, and child procedural pain/fear (for a review, see Brown et al, 2018b). Largely, parental behaviour during paediatric medical procedures has been related to child procedural coping and distress, and child procedural pain/fear (for a review, see Brown et al, 2018b).…”

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confidence: 99%

The role of parental acute psychological distress in paediatric burn re‐epithelialization

Brown

Young

Kimble

et al. 2019

British J Health Psychol

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Objectives. Following a paediatric burn, parents commonly experience high levels of acute psychological distress, which has been shown to increase child psychological distress as well as child procedural distress. The influence of psychological stress and perceived pain on wound healing has been demonstrated in several laboratory and medical populations. This paper investigates the influence of parental acute psychological distress and procedural behaviour on the child's rate of re-epithelialization, after controlling for child procedural distress. Design. A prospective observational study with longitudinal outcome.Methods. Eighty-three parents of children 1-6 years old reported acute psychological distress (post-traumatic stress symptoms [PTSS], guilt, pre-procedural fear, general anxiety/depression symptoms) in relation to their child's burn. A researcher observed parent-child behaviour at the first dressing change, and parents and nurses reported child procedural distress (pre-, peak-, and post-procedural pain and fear). These variables, along with demographic and injury information, were tested for predicting time to re-epithelialization. Date of re-epithelialization was determined by the treating consultant.Results. Days to re-epithelialization ranged from 3 to 35 days post-injury. A hierarchical multiple regression analysis found wound depth and size significantly accounted for 28% of the variance in time to re-epithelialization. In Block 2, child peak-procedural pain significantly accounted for 6% additional variance. In Block 3, parental PTSS significantly accounted for 5% additional variance.Conclusions. Parental PTSS appears to be an important but under-recognized factor that may influence their child's burn re-epithelialization. Further investigation is required to understand the mechanisms contributing to this association.

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Review of a Parent’s Influence on Pediatric Procedural Distress and Recovery

Cited by 57 publications

References 190 publications

Predicting Acute Postoperative Pain Trajectories and Long-Term Outcomes of Adolescents after Spinal Fusion Surgery

Predicting Acute Postoperative Pain Trajectories and Long-Term Outcomes of Adolescents after Spinal Fusion Surgery

Who Hurts More? A Multicenter Prospective Study of In-Hospital Opioid Use in Pediatric Trauma Patients in the Midwest

The role of parental acute psychological distress in paediatric burn re‐epithelialization

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