Catherine Vincent, PhD, RN, Funded Projects
Parents' Management of Children's Pain at Home after Surgery: Phase II
Funding Source: Shaw Faculty Collaborative Research Grant, Children's Memorial Hospital
Dates: 10/01/08 - 09/30/10
Co-Principal Investigators: Children's Memorial Hospital
Abstract: Thousands of children each year experience pain from surgical procedures. Due to shortened hospital stays, children's pain is often managed at home by parents, yet few controlled studies have been conducted to examine the effectiveness of parents' ability to relieve their children's pain. Untreated pain can have deleterious effects on cardiovascular, pulmonary, gastrointestinal, and immunological functioning which can result in delayed recovery, prolonged hospitalization, and worsening illness. Researchers have shown that children are experiencing moderate to severe pain at home and that parents are administering insufficient pain medication to relieve their children's pain. The aim of this study is to compare usual discharge teaching for children's home pain management and the Home Pain Management for Children (HPMC) intervention for effects on child outcomes (pain intensity and satisfaction with pain level), parent outcomes (amounts of pain medication administered and satisfaction with children's pain level) and a system outcome (use of unplanned health-care services for pain-related symptoms) daily, over the first three post-discharge days. In addition, we will examine parents' and children's expectations and concerns about pain management at home after surgery. The Faces Pain Scale will be used to measure children's pain intensity. The amount of pain medication will be determined by calculating the percent of pain medication ordered by the physician that is administered by parents. Parents and children will be asked direct questions to measure their satisfaction with pain levels and use of health-care services. Open-ended questions will be asked to identify parents' and children's expectations and concerns. Descriptive analysis will be used to summarize sample characteristics and outcome variables. Between-group differences will be tested with t-tests, Mann-Whitney U , Chi-square, and repeated-measures ANOVA. This study addresses Children's Memorial Hospital's strategic goal to improve children's pain management and initiative to improve discharge teaching, as well as the American Pain Society's 2005 recommendation to involve patients and families in the pain management plan. This research has the potential to improve children's pain relief, increase both parents' and children's satisfaction with pain levels, and to be more cost-effective than usual care by decreasing the use of unplanned health-care services after discharge. Furthermore, findings from this study will increase our understanding of parents' and children's expectations and concerns about pain management at home and provide direction for future education and research to improve children's pain relief.