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A randomized controlled trial of the effectiveness of educating parents about distraction to decrease postoperative
Helga Lára Helgadóttir1, Margaret E Wilson2
1Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Insights
Educating parents on distraction techniques alongside pain medication management significantly reduces children
Area of Science:
- Pediatric Surgery
- Pain Management
- Child Psychology
Background:
- Increasing parental involvement in pediatric postoperative pain management is crucial due to early hospital discharge.
- Effective home-based pain management strategies are needed for children undergoing procedures like tonsillectomy.
Purpose of the Study:
- To evaluate the effectiveness of parent education on distraction techniques combined with pharmacologic pain management.
- To assess the impact on reducing postoperative pain in children aged 3-7 years at home.
Main Methods:
- Randomized controlled trial involving 93 children (ages 3-7) undergoing tonsillectomy.
- Two groups: pharmacologic pain management education (control) and education plus distraction techniques (experimental).
- Pain assessed via parent-reported pain behaviors and child-reported pain intensity on postoperative days 1 and 2.
Main Results:
- Parent education incorporating distraction significantly decreased mean pain behavior scores (p < .001), adjusting for initial pain.
- No significant difference in pain intensity was observed between the groups.
- Initial pain intensity on postoperative day 1 was strongly associated with follow-up pain intensity (p < .001).
Conclusions:
- Parental education on distraction techniques, in addition to pain medication management, is important for reducing children's postoperative pain behaviors.
- Distraction is a valuable component of home-based pain management strategies for pediatric tonsillectomy patients.
Abstract:
Today, parents are more involved with postoperative pain management, because children are discharged as early as possible after surgery. The purpose of this randomized controlled trial was to determine the effectiveness of educating parents to provide distraction in addition to pharmacologic pain management in decreasing postoperative pain at home for children ages 3 to 7 years. Ninety-three children aged 3-7 years having tonsillectomy at Landspitali, The National University Hospital of Iceland, and their parents were randomized to one of two intervention groups. The interventions were pharmacologic pain management education (control group) and pharmacologic pain management education with distraction (experimental group). Pain was measured by parent's report of pain behavior during the evening on postoperative days 1 and 2 and child's report of pain intensity on eight time points on postoperative days 1 and 2. Sixty-nine children had complete data. The results from RM-ANCOVA showed that when adjusting for pain intensity in the morning on postoperative day 1 that educating parents about distraction in addition to educating them about pain medication management decreases mean pain behavior scores (p < .001). There was no difference in pain intensity between the groups using RM-ANCOVA. However, there was association between pain intensity in the morning on postoperative day 1 and follow-up pain intensity (p < .001). The results from this study support the importance of educating parents of children having tonsillectomy about distraction in addition to educating them about pain medication management.
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