A prospective comparative study was conducted in 487 pediatric patients (69% male, mean age = 6.4 ± 4.0) to evaluate (a) the incidence, intensity, and characteristics of pain in pediatric patients at home during the first 24 hours and 5 days after surgery and (b) the factors associated with higher pain intensity, including the impact of an application (App) compared to the paper-and-pencil approach. Postoperative pain was assessed by patients or their parents at home using the ‘Bambino Gesù’ Children’s Hospital (Ospedale Pediatrico Bambino Gesù, OPBG) tool for participants aged 4–17 years or the Faces, Legs, Arms, Cry, and Consolability scale for participants less than four years old. Participants were assigned to two groups: those who used the paper-and-pencil version of the pain scale and those who used the App. Overall, 209 of the 472 (44%) participants reported pain during the first 24 hours, and 92 of the 420 (22%) reported pain between one and five days after surgery. Higher pain intensity scores were associated with being in the App group, directly assessing own pain, and using the OPBG tool. The App was effective in facilitating pain assessment. Health professionals could empower pediatric patients and their parents in assessing pain at home through a dedicated App.
AngSHKohSSLLeeXHHT, et al. (2018) Experiences of adolescents living with cancer: a descriptive qualitative study. Journal of Child Health Care22(4): 532–544.
2.
BarrCMaroisMSimI, et al. (2015) The PREEMPT study—evaluating smartphone-assisted n-of-1 trials in patients with chronic pain: study protocol for a randomized controlled trial. Trials16(1): 67.
3.
BrudvikCMoutteS-DBasteV, et al. (2017) A comparison of pain assessment by physicians, parents and children in an outpatient setting. Emergency Medicine Journal34(3): 138–144.
4.
CaiYLopataLRohA, et al. (2017) Factors influencing postoperative pain following discharge in pediatric ambulatory surgery patients. Journal of Clinical Anesthesia39: 100–104.
5.
ChiengYJSChanWCSKlainin-YobasP, et al. (2014) Perioperative anxiety and postoperative pain in children and adolescents undergoing elective surgical procedures: a quantitative systematic review. Journal of Advanced Nursing70(2): 243–255.
6.
ChouRGordonDBde Leon-CasasolaOA, et al. (2016) Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. The Journal of Pain17(2): 131–157.
7.
EckardCAsburyCBolducB, et al. (2016) The integration of technology into treatment programs to aid in the reduction of chronic pain. Journal of Pain Management & Medicine2(3): 118.
8.
FedeleDACushingCCFritzA, et al. (2017) Mobile health interventions for improving health outcomes in youth: a meta-analysis. JAMA Pediatrics171(5): 461–469.
9.
FordKCourtney-PrattHFitzgeraldM (2012) Post-discharge experiences of children and their families following children’s surgery. Journal of Child Health Care16(4): 320–330.
10.
ForsbergAVikmanIWälivaaraB-M, et al. (2015) Patients’ perceptions of their postoperative recovery for one month. Journal of Clinical Nursing24(13–14): 1825–1836.
11.
FortierMAMacLarenJEMartinSR, et al. (2009) Pediatric pain after ambulatory surgery: Where’s the medication?Pediatrics124(4): e588–e595.
12.
GallOChampigneulleBSchweitzerB, et al. (2015) Postoperative pain assessment in children: a pilot study of the usefulness of the analgesia nociception index. British Journal of Anaesthesia115(6): 890–895.
13.
GarlandLKennyG (2006) Family nursing and the management of pain in children. Paediatric Nursing18(6): 18–20.
14.
GarrettBTavernerTMcDadeP (2017) Virtual reality as an adjunct home therapy in chronic pain management: an exploratory study. JMIR Medical Informatics5(2): e11.
15.
HicksCLvon BaeyerCLSpaffordPA, et al. (2001) The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain93(2): 173–183.
16.
JaanisteTNoelMvon BaeyerCL (2016) Young children’s ability to report on past, future, and hypothetical pain states: a cognitive-developmental perspective. Pain157(11): 2399–2409.
17.
JacobEDuranJStinsonJ, et al. (2013) Remote monitoring of pain and symptoms using wireless technology in children and adolescents with sickle cell disease. Journal of the American Association of Nurse Practitioners25(1): 42–54.
18.
JenkinsBNFortierMA (2014) Developmental and cultural perspectives on children’s postoperative pain management at home. Pain Management4(6): 407–412.
19.
JibbLAStevensBJNathanPC, et al. (2017) Implementation and preliminary effectiveness of a real-time pain management smartphone App for adolescents with cancer: a multicenter pilot clinical study. Pediatric Blood & Cancer64(10): e26554.
20.
JonesKNordstokkeDWilcoxG, et al. (2018) The ‘work of childhood’: understanding school functioning in youth with chronic pain. Pain Management8(2): 139–153.
21.
KamperSJDissingKBHestbaekL (2016) Whose pain is it anyway? Comparability of pain reports from children and their parents. Chiropractic & Manual Therapies24: 24.
22.
KellyA-MPowellCVWilliamsA (2002) Parent visual analogue scale ratings of children’s pain do not reliably reflect pain reported by child. Pediatric Emergency Care18(3): 159–162.
23.
LallooCJibbLARiveraJ, et al. (2015) ‘There’s a pain app for that’: review of patient-targeted smartphone applications for pain management. The Clinical Journal of Pain31(6): 557–563.
24.
LallooCShahUBirnieKA, et al. (2017) Commercially available smartphone apps to support postoperative pain self-management: scoping review. JMIR mHealth and uHealth5(10): e162.
25.
LallooCStinsonJNBrownSC, et al. (2014) Pain-QuILT: assessing clinical feasibility of a Web-based tool for the visual self-report of pain in an interdisciplinary pediatric chronic pain clinic. The Clinical Journal of Pain30(11): 934–943.
26.
LeeJ-AChoiMLeeSA, et al. (2018) Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review. BMC Medical Informatics & Decision Making18: 1–1.
27.
LongardJTwycrossAWilliamsAM, et al. (2016) Parents’ experiences of managing their child’s postoperative pain at home: an exploratory qualitative study. Journal of Clinical Nursing25(17–18): 2619–2628.
28.
MacLaren ChorneyJTwycrossAMifflinK, et al. (2014) Can we improve parents’ management of their children’s postoperative pain at home?Pain Research & Management19(4): e115–e123.
29.
MarshallLC (2015) Mastering Patient and Family Education: A Healthcare Handbook for Success. Indianapolis: Sigma Theta Tau.
30.
McGearyDDMcGearyCAGatchelRJ (2012) A comprehensive review of telehealth for pain management: where we are and the way ahead. Pain Practice12(7): 570–577.
31.
McGrathPASeifertCESpeechleyKN, et al. (1996) A new analogue scale for assessing children’s pain: an initial validation study. Pain64(3): 435–443.
32.
MerkelSIVoepel-LewisTShayevitzJR, et al. (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatric Nursing23(3): 293–297.
33.
MoonRYHauckFRColsonER, et al. (2017) The effect of nursing quality improvement and mobile health interventions on infant sleep practices: a randomized clinical trial. JAMA318(4): 351–359.
34.
MwakaGThikraSMung’ayiV (2013) The prevalence of postoperative pain in the first 48 hours following day surgery at a tertiary hospital in Nairobi. African Health Sciences13(3): 768–776.
35.
NiZChaoYXueX (2016) An empowerment health education program for children undergoing surgery for congenital heart diseases. Journal of Child Health Care20(3): 354–364.
36.
NilssonSHanbergerLOlinderAL, et al. (2017) The Faces Emotional Coping Scale as a self-reporting instrument for coping with needle-related procedures: an initial validation study with children treated for type 1 diabetes. Journal of Child Health Care21(4): 392–403.
37.
PowerNMHowardRFWadeAM, et al. (2012) Pain and behaviour changes in children following surgery. Archives of Disease in Childhood97(10): 879–884.
38.
Rao-GuptaSKrugerDLeakLD, et al. (2018) Leveraging interactive patient care technology to improve pain management engagement. Pain Management Nursing19(3): 212–221.
39.
RosserBAEcclestonC (2011) Smartphone applications for pain management. Journal of Telemedicine and Telecare17(6): 308–312.
40.
ShararehBSchwarzkopfR (2014) Effectiveness of telemedical applications in postoperative follow-up after total joint arthroplasty. The Journal of Arthroplasty29(5): 918–922.e1.
41.
ShumSLimJPageT, et al. (2012) An audit of pain management following pediatric day surgery at British Columbia Children’s Hospital. Pain Research & Management17(5): 328–334.
42.
SmelandAHTwycrossALundebergS, et al. (2018) Nurses’ knowledge, attitudes and clinical practice in pediatric postoperative pain management. Pain Management Nursing19(6): 585–598.
43.
StinsonJNJibbLANguyenC, et al. (2015) Construct validity and reliability of a real-time multidimensional smartphone app to assess pain in children and adolescents with cancer. Pain156(12): 2607–2615.
44.
StinsonJNKavanaghTYamadaJ, et al. (2006) Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain125(1–2): 143–157.
45.
TwycrossAForgeronPWilliamsA (2015) Paediatric nurses’ postoperative pain management practices in hospital based non-critical care settings: a narrative review. International Journal of Nursing Studies52(4): 836–863.
46.
TwycrossAMWilliamsAMBollandRE, et al. (2015) Parental attitudes to children’s pain and analgesic drugs in the United Kingdom. Journal of Child Health Care19(3): 402–411.
47.
von BaeyerCLSpagrudLJMcCormickJC, et al. (2009) Three new datasets supporting use of the Numerical Rating Scale (NRS-11) for children’s self-reports of pain intensity. Pain143(3): 223–227.
48.
Walther-LarsenSAagaardGBFriisSM, et al. (2016) Structured intervention for management of pain following day surgery in children. Paediatric Anaesthesia26(2): 151–157.
49.
ZhouHRobertsPHorganL (2008) Association between self-report pain ratings of child and parent, child and nurse and parent and nurse dyads: meta-analysis. Journal of Advanced Nursing63(4): 334–342.
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