Reducing pediatric burn pain with parent participation.

We describe and evaluate the development and implementation of a parent participation program in the burn unit at The Hospital for Sick Children, Toronto, Ontario. The effect of parent participation on the multidisciplinary team member's role had to be taken into consideration, and effective, consistent education of the support for the multidisciplinary team had to be provided to ensure the success of the program. Unit-specific minimum standards of burn care were established as guides to support team members when they established the ground rules for the parents' participation. Education sessions were also held for staff to role-play problem-solving techniques. Including parents in the difficult daily treatments required changes in our admission procedures to maintain the family unit and to assess the parents' ability to provide emotional support for their child during the procedure. Early results of the program suggested that parental participation plays a major role in reducing a child's experience of pain during invasive procedures while allowing the family relationship to continue throughout all aspects of the hospitalization. The program also improved parents' coping strategies. The parents had a better understanding of the healing process and the need for specific measures, such as the use of compression garments, during the rehabilitation phase. This understanding may improve long-term compliance with treatment. Perceived difficulties with increased parental involvement were minimized through adequate education and preparation of the staff. Continued work is required, however, to objectively evaluate parent participation and its role in effectively reducing pain in the pediatric burn population.