Is the sufficiency of discharge instructions related to children's postoperative pain at home after day surgery?

Päivi Kankkunen, Katri Vehviläinen-Julkunen, Anna-Maija Pietilä, Pirjo Halonen
Scandinavian Journal of Caring Sciences 2003, 17 (4): 365-72

BACKGROUND: Parents are expected to alleviate their children's pain at home after day surgery, and the methods of pain alleviation should be taught to the parents by the hospital staff. However, the lack of information related to children's pain alleviation has been pointed out in several studies.

AIM: To describe the relationship between the parent-rated sufficiency of discharge instructions and the postoperative pain behaviours of 1- to 6-year-old children at home after day surgery.

METHOD: Questionnaires were handed out to mothers (n = 201) and fathers (n = 114) whose child had undergone minor day surgery in 10 Finnish central hospitals. Percentages and cross-tabulation with chi-square test were used in data analysis.

ETHICAL ISSUES: The ethical board in each hospital accepted the study. Parental participation was voluntary.

RESULTS: The parents considered the discharge instructions to be fairly sufficient, but criticized their content, method of providing and timing. Insufficiency of the instructions was related to children's postoperative pain behaviours at home.

STUDY LIMITATIONS: The fairly low response rate of this study prevents generalization of the findings to all Finnish parents.

CONCLUSIONS: Both the content, the methods of providing and the timing of discharge instruction need to be developed in children's day surgery. Special attention should be paid to written instructions, which should be given to the parents prior to the day of the child's surgery. Further research is needed to explore the skills of hospital staff in advising the parents and other factors explaining children's postoperative pain at home.

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