Analysis of pain and satisfaction with pain care in postoperative pediatric orthopaedic patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/163703
Category:
Abstract
Type:
Presentation
Title:
Analysis of pain and satisfaction with pain care in postoperative pediatric orthopaedic patients
Author(s):
Polomano, Rosemary; Reighard, Cynthia J.; Segal, Lee S.
Author Details:
Rosemary Polomano, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA, email: rpolomano@psu.edu; Cynthia J. Reighard; Lee S. Segal
Abstract:
Purpose: The primary goals of this investigation were to 1) develop an age-appropriate instrument to measure pain outcomes and satisfaction with pain care, and 2) examine pain characteristics among children having orthopaedic surgery. Specific Aims: To evaluate reports of pain intensity and perceptions of the effectiveness of pain treatment and satisfaction with pain care, to test the reliability and validity of the Penn State Children's Hospital Pain Care Report Card (PCRC) and to identify predictors of satisfaction with pain care among children. Framework: The PCRC instrument was developed from the adult Brigham and Women's Hospital Satisfaction with Pain Care Questionnaire with permission. Methods: A consecutive series of 53 children (n=13, 6-9 years old; n=40, 10-18 years old) were recruited from an outpatient pediatric orthopaedic practice with parental consent. After surgery, subjects were asked to report their pain intensity every 4 hrs, when getting OOB, during physical therapy and following the transitions from epidural/IV opioids to oral analgesics using the Faces Pain Rating Scale (FRS) (0-no hurt to 5-hurts worst). Older children (10 to 18) recalled their average, worst and least pain once a day and assigned a grade- A, B, C, D or F to their pain medication. At discharge, all children completed the PCRC, which included 6 items on pain levels measured by the FRS and 6 items on satisfaction using the grading system. Results and Conclusions: Overall, younger children reported less pain (mean 1 +/- .83); p< 0.05) on the day of surgery than older children (2.1 +/- 1.35). There were no significant differences by age for pain intensity on postoperative days 1 and 2 and PCRC scores. Strong correlations were noted between the average of current pain scores and the recall of average pain for the day of surgery (r=0.71; p< 0.001) and postoperative day 1 (r=0.71; p < 0.001), indicating that older children can recall their pain. Children having spine surgery had more daily pain (one-way ANOVA; p< 0.05) compared to hip and lower extremity procedures and also poorer satisfaction with pain care (PCRC 70.8 +/- 14.8; p< 0.05) compared to children having hip surgery (PCRC 85.9 +/- 11.6). Increased pain levels after transitioning from epidural/IV opioid analgesia to oral analgesics were associated with poorer satisfaction, explaining 38% (p< 0.05) of the variance in the PCRC. The amount of time that children perceived that they had to wait for their pain medication had no measurable effect on satisfaction with pain care. Internal consistency reliability for the items 7 to 12 on the PCRC was 0.66 for younger children and 0.87 for older children. Implications: Pain outcomes and perceptions of patient satisfaction with pain care can be obtained from children if age-appropriate questions are asked and measurement scales are familiar and easy to use. These findings have significant implications for administering more effective oral analgesia and monitoring pain outcomes once epidural/IV PCA is discontinued and for identifying children at greater risk for pain following orthopaedic surgery.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleAnalysis of pain and satisfaction with pain care in postoperative pediatric orthopaedic patientsen_GB
dc.contributor.authorPolomano, Rosemaryen_US
dc.contributor.authorReighard, Cynthia J.en_US
dc.contributor.authorSegal, Lee S.en_US
dc.author.detailsRosemary Polomano, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA, email: rpolomano@psu.edu; Cynthia J. Reighard; Lee S. Segalen_US
dc.identifier.urihttp://hdl.handle.net/10755/163703-
dc.description.abstractPurpose: The primary goals of this investigation were to 1) develop an age-appropriate instrument to measure pain outcomes and satisfaction with pain care, and 2) examine pain characteristics among children having orthopaedic surgery. Specific Aims: To evaluate reports of pain intensity and perceptions of the effectiveness of pain treatment and satisfaction with pain care, to test the reliability and validity of the Penn State Children's Hospital Pain Care Report Card (PCRC) and to identify predictors of satisfaction with pain care among children. Framework: The PCRC instrument was developed from the adult Brigham and Women's Hospital Satisfaction with Pain Care Questionnaire with permission. Methods: A consecutive series of 53 children (n=13, 6-9 years old; n=40, 10-18 years old) were recruited from an outpatient pediatric orthopaedic practice with parental consent. After surgery, subjects were asked to report their pain intensity every 4 hrs, when getting OOB, during physical therapy and following the transitions from epidural/IV opioids to oral analgesics using the Faces Pain Rating Scale (FRS) (0-no hurt to 5-hurts worst). Older children (10 to 18) recalled their average, worst and least pain once a day and assigned a grade- A, B, C, D or F to their pain medication. At discharge, all children completed the PCRC, which included 6 items on pain levels measured by the FRS and 6 items on satisfaction using the grading system. Results and Conclusions: Overall, younger children reported less pain (mean 1 +/- .83); p< 0.05) on the day of surgery than older children (2.1 +/- 1.35). There were no significant differences by age for pain intensity on postoperative days 1 and 2 and PCRC scores. Strong correlations were noted between the average of current pain scores and the recall of average pain for the day of surgery (r=0.71; p< 0.001) and postoperative day 1 (r=0.71; p < 0.001), indicating that older children can recall their pain. Children having spine surgery had more daily pain (one-way ANOVA; p< 0.05) compared to hip and lower extremity procedures and also poorer satisfaction with pain care (PCRC 70.8 +/- 14.8; p< 0.05) compared to children having hip surgery (PCRC 85.9 +/- 11.6). Increased pain levels after transitioning from epidural/IV opioid analgesia to oral analgesics were associated with poorer satisfaction, explaining 38% (p< 0.05) of the variance in the PCRC. The amount of time that children perceived that they had to wait for their pain medication had no measurable effect on satisfaction with pain care. Internal consistency reliability for the items 7 to 12 on the PCRC was 0.66 for younger children and 0.87 for older children. Implications: Pain outcomes and perceptions of patient satisfaction with pain care can be obtained from children if age-appropriate questions are asked and measurement scales are familiar and easy to use. These findings have significant implications for administering more effective oral analgesia and monitoring pain outcomes once epidural/IV PCA is discontinued and for identifying children at greater risk for pain following orthopaedic surgery.en_GB
dc.date.available2011-10-27T11:12:20Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:12:20Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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