Crandall Margie, Lammers Cathy, Senders Craig, Braun Jerome V, Savedra Marilyn
Department of Patient Care Services, University of California Davis Health System, United States.
Int J Pediatr Otorhinolaryngol. 2008 Oct;72(10):1523-33. doi: 10.1016/j.ijporl.2008.07.004. Epub 2008 Aug 30.
To examine the effects of pre-operative tonsillectomy pain education on children's (7-13 years) self-reported pre-operative anxiety and post-operative clinical outcomes (i.e., anxiety, pain intensity, quality of pain and sleep, oral intake, perceptions of pre-operative education, and pain expectation).
A prospective, repeated measures, quasi-experimental design using an age appropriate pain education booklet (n = 30) and a standard care comparison group (n = 30) was employed to investigate children's pre- and post-education anxiety and post-operative tonsillectomy with or without adenoidectomy subjective experiences in the hospital and home settings. Group comparisons were performed using the Wilcoxon test, Fisher's exact test, repeated measures analysis of variance, and mixed model regression.
There were no significant differences between groups for measures of anxiety, pain intensity, quality of pain and sleep, oral intake, or expected pain. There was no change in anxiety before or after pre-operative education (P = 0.85). Ninety-six percent (n = 25) of the children in the intervention group reported that pre-operative pain education helped with their post-operative pain and 72% (n = 16) in the control group stated that it would be helpful to learn about pain before surgery. The majority of children in both the intervention and control groups (96%, 91%, respectively) stated learning about the 0-10 numeric pain intensity scale helped or would be helpful to learn pre-operatively.
Pre-operative pain education did not affect anxiety. Children valued pre-operative pain education. Pre-operative pain education may influence children's perceptions of medical care.
探讨术前扁桃体切除术疼痛教育对7至13岁儿童自我报告的术前焦虑及术后临床结局（即焦虑、疼痛强度、疼痛性质和睡眠、经口摄入量、对术前教育的认知以及疼痛预期）的影响。
采用前瞻性、重复测量、准实验设计，使用适合儿童年龄的疼痛教育手册（n = 30）和标准护理对照组（n = 30），调查儿童在教育前后的焦虑情况以及扁桃体切除术后（无论是否同时行腺样体切除术）在医院和家庭环境中的主观体验。采用Wilcoxon检验、Fisher精确检验、重复测量方差分析和混合模型回归进行组间比较。
两组在焦虑、疼痛强度、疼痛性质和睡眠、经口摄入量或预期疼痛的测量指标上无显著差异。术前教育前后焦虑无变化（P = 0.85）。干预组96%（n = 25）的儿童报告术前疼痛教育对其术后疼痛有帮助，对照组72%（n = 16）的儿童表示术前了解疼痛会有帮助。干预组和对照组的大多数儿童（分别为96%和91%）表示了解0至10数字疼痛强度量表对术前学习有帮助或会有帮助。
术前疼痛教育不影响焦虑。儿童重视术前疼痛教育。术前疼痛教育可能会影响儿童对医疗护理的认知。
