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Updated: Dec 7, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
The relationship between parental factors, child symptom profile, and persistent postoperative pain interference and
Lauren C Siemer1, Emily Foxen-Craft2, Shobha Malviya1
1Department of Anesthesiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
Insights
Parental factors
Area of Science:
- Pediatric surgery
- Pain management
- Psychosomatic medicine
Background:
- Persistent or recurrent postoperative pain in children is influenced by both parental and child factors.
- The interplay between parental influences and a child's symptom profile on long-term pain outcomes remains unclear.
Purpose of the Study:
- To investigate the associations between parental factors, child symptomology, and long-term pain outcomes in children undergoing spinal fusion.
- To determine if child symptom profiles mediate the relationship between parental factors and postoperative pain.
Main Methods:
- Prospective, longitudinal study of 76 parent/child dyads undergoing spinal fusion.
- Parental surveys assessed pain history, pain relief preferences, and pain catastrophizing.
- Child symptom profiles (pain, catastrophizing, fatigue, depression, anxiety) and 1-year postoperative pain interference and analgesic use were evaluated.
Main Results:
- Parental factors were associated with the child's baseline symptom profile.
- Both parent and child factors correlated with long-term pain outcomes.
- Child symptom profiles fully attenuated the association between parental factors and long-term pain when all factors were considered.
Conclusions:
- The impact of parental factors on long-term postoperative pain is contingent upon the child's baseline symptom profile.
- Interventions for pediatric postoperative pain should integrate management of child symptoms alongside parental factors due to potential bidirectional relationships.
Objectives:
Both parental and child factors have been previously associated with persistent or recurrent postoperative pain in children. Yet, little is known about the relative contribution of parent factors or whether child symptom factors might impact the association between parent factors and long-term pain. The aim of this study was to explore the associations between parent factors, child symptomology, and the child's long-term pain outcomes after surgery.
Methods:
This prospective, longitudinal study included parents and their children who were scheduled to undergo spinal fusion for underlying scoliosis. Parents completed baseline surveys about their pain history, pain relief preferences (ie, preference to relieve their child's pain vs avoid analgesic risks), and pain catastrophizing (ie, beliefs about their child's pain). Children were classified previously into high vs low symptom profiles at baseline based on their self-reported pain, catastrophizing, fatigue, depression, and anxiety. Children were assessed 1-year after surgery for their long-term pain interference scores and analgesic use. Serial regression modeling was used to explore whether associations between parent factors and the outcomes were changed when accounting for child factors.
Results:
Seventy-six parent/child dyads completed all surveys. Parental preferences and catastrophizing were atemporally associated with the child's baseline psychological-somatic symptom profile. Though parent and child factors were both associated with the long-term pain outcomes, when all three factors were accounted for, the associations between parent factors and long-term pain was fully attenuated by the child's profile.
Discussion:
These findings suggest that the relationship between parent factors and long-term postoperative pain outcomes may be dependent on the child's symptom profile at baseline. Since there may be bidirectional relationships between parent and child factors, interventions to mitigate long-term pain should address child symptoms as well as parental factors.
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