Division of Pediatric Surgery, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA, 90027, USA; Department of Surgery, Keck School of Medicine of the University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, Los Angeles, CA 90032, USA.
J Pediatr Surg. 2024 Apr;59(4):718-724. doi: 10.1016/j.jpedsurg.2023.12.015. Epub 2023 Dec 19.
Little is known about how families make decisions regarding postoperative prescription opioid consumption. This qualitative study examines adolescent and parent perspectives on postoperative prescription opioid use.
We recruited adolescents aged 13-20 years old who received a postoperative opioid prescription and their parents from a previous longitudinal cohort study. We employed purposive sampling for recruitment to reflect local community sociodemographics including race/ethnicity, health literacy, and Spanish-language preference then conducted thematic analysis of focus group feedback.
Participants met in four virtual focus groups: adolescents from English-speaking households(n = 2), adolescents from Spanish-speaking households(n = 5), English-speaking parents(n = 4), and Spanish-speaking parents (n = 4). Five themes emerged: Parents (1) feared opioid use would result in overdose or addiction and (2) desired information about alternative medical and behavioral strategies to minimize use. (3) Parents felt empowered to manage their adolescent's opioid use and trusted their adolescent to prompt them for opioids. Adolescents trusted their parents to manage their opioid use but maintained their autonomy to limit opioid consumption when experiencing undesirable side effects. (4) Some adolescents and parents endorsed a preference for "not taking medication" in their households. (5) Both parents and adolescents reported previous knowledge of opioids prior to surgery, with adolescents learning more nuanced information about opioid safety after their surgeries.
Families feel empowered to manage their postoperative prescription opioid use but fear the negative effects of opioids and desire information on alternatives. Evidence-based, family-centric education from providers in a language preferred by the family could mitigate families' concerns and contribute to improved pain control and safety.
IV.
对于家庭如何决定术后处方类阿片类药物的使用，我们知之甚少。本项定性研究考察了青少年和家长对术后使用处方类阿片类药物的看法。
我们从先前的纵向队列研究中招募了接受术后阿片类药物处方的 13-20 岁青少年及其父母。我们采用目的抽样招募参与者，以反映当地社区的社会人口统计学特征，包括种族/民族、健康素养和西班牙语偏好，然后对焦点小组的反馈进行主题分析。
参与者在四个虚拟焦点小组中进行了讨论：来自英语家庭的青少年（n=2）、来自西班牙语家庭的青少年（n=5）、英语为母语的父母（n=4）和西班牙语为母语的父母（n=4）。出现了五个主题：（1）父母担心阿片类药物的使用会导致过量或成瘾，并希望获得有关替代医疗和行为策略的信息，以尽量减少使用。（2）父母感到有能力管理青少年的阿片类药物使用，并相信青少年会提醒他们使用阿片类药物。青少年信任父母管理他们的阿片类药物使用，但在经历不良副作用时，他们保持自主权，限制阿片类药物的消耗。（3）一些青少年和父母表示他们的家庭倾向于“不服用药物”。（4）（4）父母和青少年都报告在手术前对阿片类药物有一定的了解，而青少年在手术后对阿片类药物的安全性有了更细致的了解。
家庭有能力管理他们的术后处方类阿片类药物使用，但担心阿片类药物的负面影响，并希望获得替代方案的信息。来自以家庭偏好的语言提供的以家庭为中心的循证教育可以减轻家庭的担忧，并有助于改善疼痛控制和安全性。
IV。
