Rabbitts Jennifer A, Aaron Rachel V, Fisher Emma, Lang Emily A, Bridgwater Caroline, Tai Gabrielle Ghafari, Palermo Tonya M
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; Center for Clinical and Translational Research, Seattle Children's Hospital, Seattle, Washington.
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington.
J Pain. 2017 Jul;18(7):778-786. doi: 10.1016/j.jpain.2017.02.423. Epub 2017 Feb 21.
Research developing targeted treatment focused on coping with children's long-term pain after surgery is needed because of the high prevalence of chronic pain after surgery. This qualitative study aimed to: 1) understand the child's and family's experiences of pain over the course of their surgical experience, and 2) gather stakeholder input regarding potential barriers and facilitators of perioperative intervention delivery. Fifteen children ages 10 to 18 years who underwent recent major surgery, their primary caregivers, and 17 perioperative health care providers were interviewed. Interviews were coded using semantic thematic analysis. The perioperative period presented emotional challenges for families. Families felt unprepared for surgery and pain. Recovery and regaining physical functioning at home was challenging. Families struggled to return to valued activities. Families reported interest in a perioperative psychosocial intervention. Providers endorsed that families would benefit from enhanced coping skills. They emphasized that families would benefit from more detailed preparatory information. Providers suggested that flexible intervention delivery at home would be ideal. Research developing interventions addressing pain and anxiety in children undergoing major surgery is critically needed. The findings of the present study can inform intervention development with the aim of improving short- as well as long-term recovery in children undergoing major surgery.
This qualitative study examined children and their parents' experience of long-term pain and recovery after major surgery, identifying barriers and facilitators of perioperative intervention delivery. Families experienced surgery as stressful, and felt underprepared for pain and recovery. Families and health care providers expressed interest in a preoperative intervention teaching coping skills.
由于手术后慢性疼痛的高患病率，需要开展旨在应对儿童手术后长期疼痛的靶向治疗研究。这项定性研究旨在：1）了解儿童及其家庭在手术过程中的疼痛经历，以及2）收集利益相关者关于围手术期干预实施的潜在障碍和促进因素的意见。对15名年龄在10至18岁之间近期接受大手术的儿童、他们的主要照顾者以及17名围手术期医疗服务提供者进行了访谈。访谈采用语义主题分析进行编码。围手术期给家庭带来了情感挑战。家庭对手术和疼痛感到毫无准备。在家中恢复和重新获得身体功能具有挑战性。家庭努力恢复到有价值的活动中。家庭表示对围手术期心理社会干预感兴趣。提供者认可家庭将从增强的应对技能中受益。他们强调家庭将从更详细的准备信息中受益。提供者建议在家中灵活实施干预将是理想的。迫切需要开展针对接受大手术儿童的疼痛和焦虑的干预研究。本研究的结果可为干预措施的制定提供参考，旨在改善接受大手术儿童的短期和长期恢复情况。
这项定性研究调查了儿童及其父母在大手术后长期疼痛和恢复的经历，确定了围手术期干预实施的障碍和促进因素。家庭将手术视为有压力的事情，并且对疼痛和恢复感到准备不足。家庭和医疗服务提供者对术前教授应对技能的干预措施表示感兴趣。
