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Pain and behaviour changes in children following surgery
Nina Mary Power1, Richard F Howard, Angie M Wade
1UCL Institute of Child Health, London, UK.
Insights
Postoperative pain and problematic behaviors (PB) are common in children after surgery, persisting for weeks. Previous painful experiences and anxiety are key factors influencing PB, highlighting areas for improved care.
Area of Science:
- Pediatric Surgery Outcomes
- Child Psychology
- Pain Management
Background:
- Postoperative pain and problematic behaviors (PB) can significantly impact children's recovery after surgery.
- Understanding the long-term effects of day-case versus inpatient surgery on children's well-being at home is crucial.
Purpose of the Study:
- To quantify postoperative pain and PB in children after day-case or inpatient surgery.
- To identify factors associated with PB at 2 and 4 weeks post-discharge.
- To determine the relationship between pain and PB after adjusting for other variables.
Main Methods:
- A descriptive study involving 131 children (aged 2-12 years) and their parents.
- Data collected through direct observation and self-report questionnaires.
- Assessed pain and PB on day 2 and at weeks 1, 2, and 4 post-discharge.
Main Results:
- High incidence of pain (93%) and PB (73%) observed on day 2 post-discharge.
- Pain and PB decreased over time, but remained significant at week 4 (25% pain, 32% PB).
- Factors associated with PB included previous pain experience, parent/child anxiety, and parent education level.
Conclusions:
- A substantial proportion of children experience persistent pain and PB for weeks after surgery.
- Previous painful medical experiences and anxiety are significant, modifiable factors affecting children's outcomes.
- Healthcare providers and researchers should focus on these modifiable factors to improve pediatric surgical recovery.
Objectives:
To quantify postoperative pain and problematic behaviour (PB) in children at home following day-case (same day admission and discharge) or inpatient (≥1 night in hospital) surgery, to identify factors associated with PB at 2 and 4 weeks after discharge and to determine whether pain is associated with PB after adjustment for other factors.
Patients And Methods:
Children scheduled for elective surgery were recruited to a descriptive study involving direct observation and self-report questionnaires. The principal outcomes were pain and PB on the 2nd post-discharge day and after the 1st, 2nd and 4th weeks.
Results:
131 parents and their children (aged 2-12years) participated in the study. 93% of children had pain and 73% exhibited PB on day 2 after discharge. The incidence of pain and PB decreased over time, but 25% of children still had pain and 32% PB at week 4. Factors associated with PB were child's previous pain experience, parent and child anxiety and parent's level of education.
Conclusions:
There was a high incidence of pain and PB persisting for several weeks after surgery in this cohort of children. Previous painful medical experiences and anxiety were important modifiable factors that require further attention from healthcare providers and researchers to potentially improve health and social outcomes for children after surgery.
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