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Surgeons' aims and pain assessment strategies when managing paediatric post-operative pain: A qualitative study
Alison M Twycross1, Anna M Williams2, G Allen Finley3
1London South Bank University, United Kingdom a.twycross@lsbu.ac.uk.
Insights
Paediatric surgeons aim to keep children comfortable after surgery, considering pain cues and daily activities. They balance realistic expectations with the child
Area of Science:
- Pediatric Surgery
- Pain Management
- Qualitative Research
Background:
- Post-operative pain in children is a significant clinical issue.
- Nurses' aims in pediatric pain management are documented.
- Surgeons' perspectives on managing pediatric post-operative pain remain unexplored.
Purpose of the Study:
- To explore the aims of paediatric surgeons in managing post-operative pain.
- To understand surgeons' decision-making processes regarding pediatric pain.
Main Methods:
- Qualitative study employing semi-structured interviews.
- Participants: 8 consultant surgeons from various specialties in a Canadian pediatric hospital.
- Data analysis focused on identifying surgeons' stated aims and considerations.
Main Results:
- The primary aim identified was to ensure the child's comfort, defined by pain levels and functional ability.
- Surgeons prioritize children's behavioral pain cues and parental input in treatment decisions.
- Pain management is viewed as a balancing act, incorporating tacit and explicit knowledge, with an acceptance of some expected post-operative pain.
Conclusions:
- Paediatric surgeons aim for child comfort, integrating diverse factors into pain management strategies.
- Surgeons' approach involves a realistic perspective, acknowledging the diagnostic role of pain.
- Further research into surgeons' specific pain management protocols and their impact on patient outcomes is warranted.
Abstract:
Children experience moderate to severe pain post-operatively. Nurses have been found to have a variety of aims in this context. Surgeons' aims when managing post-operative pain have not been explored. This qualitative study set out to explore paediatric surgeons' aims when managing post-operative pain in one paediatric hospital in Canada. Consultant surgeons (n = 8) across various specialities took part in semi-structured interviews. Surgeons' overarching aim was to keep the child comfortable. Various definitions of comfortable were given, relating to the child's experience of pain itself and their ability to undertake activities of daily living. Children's behavioural pain cues seem to be a primary consideration when making treatment decisions. Parents' views regarding their child's pain were also seen as important, suggesting children may not be seen as competent to make decisions on their own behalf. The need to maintain a realistic approach was emphasised and pain management described as a balancing act. Surgeons may draw on both tacit and explicit knowledge when assessing children's pain. There appears to be an expectation among surgeons that some pain is to be expected post-operatively and that the diagnostic value of pain may, in some cases, supersede concerns for the child's pain experience.
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