Alm Fredrik, Lööf Gunilla, Blomberg Karin, Ericsson Elisabeth
Department of Anaesthesia and Intensive Care School of Health Sciences Faculty of Medicine and Health Örebro University Örebro Sweden.
Department of Paediatric Anaesthesia and Intensive Care Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden.
Paediatr Neonatal Pain. 2021 May 10;3(2):75-86. doi: 10.1002/pne2.12051. eCollection 2021 Jun.
The objective of this study was to explore children's and caregivers' experiences and management of postoperative recovery at home after tonsil surgery. The study had an explorative qualitative design with an inductive approach. Twenty children (5-12 years of age) undergoing tonsillectomy or tonsillotomy with or without adenoidectomy participated along with their caregivers in semi-structured interviews at a mean time of 28 days after surgery. The interviews were analyzed with content analysis. One main category emerged from the interviews: children and caregivers struggle to establish resilience in a challenging recovery. The families' resilience relied on their situational awareness and capacity to act, which in turn formed a basis for the ability to return to normal daily life. Children and caregivers described the recovery as an evident interruption of daily life which had an impact on the children's physical and psychological well-being. Both children and caregivers described the pain as a central concern. The families used different pharmacological and complementary strategies to manage the pain, which in some cases were complex. Some families said that the analgesics were insufficient in preventing breakthrough pain, and spoke about a lack of support as well as inadequate and contradictory information from healthcare staff. Caregivers also expressed uncertainty, ambivalence, or anxiety about the responsibility associated with their child's recovery. To optimize and support the recovery after tonsil surgery, it is crucial to obtain knowledge of children's and caregivers' perspectives of postoperative recovery at home. The results indicate that the postoperative period included several troublesome experiences for which neither the children nor the caregivers were informed or prepared. The experience of pain was significant, and often complex to manage. To increase families' resilience, the information provided by healthcare professionals needs to be broadened. Multidisciplinary teamwork is necessary to achieve this goal.
本研究的目的是探讨儿童及其照料者在扁桃体手术后在家中进行术后恢复的经历和管理情况。该研究采用探索性定性设计和归纳法。二十名接受扁桃体切除术或扁桃体切开术（伴或不伴腺样体切除术）的5至12岁儿童及其照料者参与了研究，在术后平均28天接受了半结构化访谈。访谈采用内容分析法进行分析。访谈中出现了一个主要类别：儿童和照料者在具有挑战性的恢复过程中努力建立恢复力。家庭的恢复力依赖于他们的情境意识和行动能力，这反过来又构成了恢复正常日常生活能力的基础。儿童和照料者将恢复描述为对日常生活的明显干扰，这对儿童的身心健康产生了影响。儿童和照料者都将疼痛视为核心问题。家庭采用了不同的药物和辅助策略来管理疼痛，在某些情况下这些策略很复杂。一些家庭表示，镇痛药在预防突破性疼痛方面不足，并提到缺乏支持以及医护人员提供的信息不足且相互矛盾。照料者也表达了对与孩子恢复相关责任的不确定性、矛盾心理或焦虑。为了优化和支持扁桃体手术后的恢复，了解儿童和照料者对术后在家恢复的看法至关重要。结果表明，术后期间包括一些儿童和照料者都未被告知或未做好准备的麻烦经历。疼痛体验很显著，而且往往难以管理。为了增强家庭的恢复力，医护专业人员提供的信息需要拓宽。实现这一目标需要多学科团队合作。
