Pediatric Postoperative Pain Management in Korea: Parental Attitudes Toward Pain and Analgesics, Self-Efficacy, and Pain Management.

PURPOSES: This study aimed to explore parental attitudes toward children's pain and analgesic drugs and parental self-efficacy and use of pain relief strategies in children's postoperative pain management in Korea, and to identify the relationships among these variables. DESIGN AND METHODS: A cross sectional descriptive study was conducted. Participants were 124 parents of hospitalized children (aged 4-9 years) undergoing tonsillectomy in Korea. RESULTS: A considerable proportion of parents held misconceptions about how children express pain. For example, 87.9% of parents perceived that children always tell their parents when they are in pain. Moreover, parents reported significant attitudinal barriers to analgesic use with 60.5% of parents believed that side effects are something to worry about when giving children pain medication. Parental attitudes to use analgesics were significantly different by children's gender, family income, and length of hospital stay. Emotional support methods such as touch, parental presence, and comfort/reassurance were the frequently used, whereas cognitive-behavioral approaches such as distraction were less frequently used nonpharmacological pain relief strategies. A parent's self-efficacy in managing children's pain significantly correlated with the appropriate use of analgesics and parental use of pain relief strategies. CONCLUSIONS: Promoting parental self-efficacy in postoperative pain management is important. Educational interventions focused on behavioral changes of parents, including practical guidance for pharmacological and nonpharmacological pain relief strategies, are needed. PRACTICE IMPLICATIONS: Providing parents with proper, effective education about children's postoperative pain management should not only provide accurate information but should also enhance parents' self-efficacy in assessing and managing children's pain.

Effects of a posttonsillectomy management program using a mobile instant messenger on parents' knowledge and anxiety, and their children's compliance, bleeding, and pain.

PURPOSE: Pediatric tonsillectomy is a highly common surgery for children. The inclusion of tonsillectomy in the diagnosis-related group payment system in Korea has resulted in a shorter hospital stay for patients who undergo tonsillectomy. This, in turn, provides parents with additional caregiver roles in the home. OBJECTIVES: This study aimed to investigate the effects of a postdischarge management program (PDMP) using Mobile Instant Messenger (MIM) on parents' knowledge and state anxiety about postoperative care, and their children's compliance with care instructions at home, frequency of bleeding, and pain intensity after tonsillectomy. DESIGN AND METHODS: A nonequivalent control group nonsynchronized design. SETTINGS AND PARTICIPANTS: Participants were 52 tonsillectomy children aged 3-7 years and their 52 parents (27 for the experimental group and 25 for the control group) from a hospital, in Korea. The control group received a routine written and oral predischarge education, while the experimental group received a predischarge education and a daily MIM for 7 days. For the experimental group, bidirectional communication between the nurse and parent when necessary using MIM are available during the intervention period. RESULTS: Parents in the experimental group reported a significantly higher knowledge about postdischarge management and lower state anxiety than the control group. Children in the experimental group showed a significantly greater improvement in compliance with the care instructions at home than the control group. However, bleeding frequency and pain intensity were not significantly lower in the experimental group than that in the control group. PRACTICAL IMPLICATIONS: Nurses play a critical role in preventing and managing the complications of tonsillectomy. Providing proper parental education about pediatric posttonsillectomy care at home is critical for a successful recovery. With the explosion of smartphone technology, the MIM-based PDMP is a useful and effective strategy in helping parents and children in posttonsillectomy care at home.