Parents' attitudes toward pain medication, parents' perception of children's pain and parents' management of children's pain at home following day surgery or short-stay surgery

Anderson, Colleen McDavid (2002) Parents' attitudes toward pain medication, parents' perception of children's pain and parents' management of children's pain at home following day surgery or short-stay surgery. Masters thesis, Memorial University of Newfoundland.

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Abstract

A descriptive correlational study was designed to investigate parents' attitudes toward medication, parents' perceptions of children's pain and parents' management of children's pain at home following day or short-stay surgery in a convenience sample of fifty-six parents and children 2 to 12 years (Mean age 5.98 years, 58.9% males). This study was a replication and extension of a study by Finley, McGrath, Forward, McNeill, and Fitzgerald (1996). Data were collected over a 5 month period using a demographic data form, Parents' Attitudes Toward Medication tool, and a postoperative diary containing a Numerical Rating Scale (NRS), Parents' Postoperative Pain Measure (PPPM), analgesic record and Parents' Comforting Activities Checklist (PCAC). -- Study findings focussed on what parents did at home on the day of surgery and on the two days following surgery to manage their children's pain. Most parents provided acetaminophen or acetaminophen with codeine but the number of doses and amount of medication given often were not adequate to manage their children's pain. The highest mean pain intensity ratings were reported by parents with children who had a tonsillectomy and adenoidectomy (T & A) or circumcision. More children were identified with clinically significant pain on the Day of Surgery with the PPPM than with the NRS. Most parents gave their children between 0 and 3 doses of medication over the three days of the study even when they perceived their children to have clinically significant pain. Parents' attitudes toward medication were neutral to slightly positive with both positive and negative responses to statements on addiction and drug abuse. In approximately six years since the study by Finley et al. (1996) was published, little appears to have changed in the pharmacological management of children's pain at home following day surgery or short-stay surgery. -- The unique part of this study included the development and use of the PCAC to document parents' nonpharmacological management and evaluation of the effectiveness of these comforting activities. Parents provided a large number (M = 20, SD 7.78) of comforting activities to manage their children's postoperative pain. Parents' intuitively selected comforting activities that were appropriate for their children's age and cognitive level of development. Presence of parents was most frequently reported activity and also rated as the most effective. Parents' mean ratings of the effectiveness of comforting activities were higher than their mean ratings of the effectiveness of medication provided to manage their children's pain. This tool is an important contribution to understanding parent's care of their children at home following surgery. -- The major implication resulting from this study is the need for nursing to recognize the responsibility placed on parents to manage their children's pain and make needed resources available to them.

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