Parents’ management of adolescent patients’ postoperative pain after discharge: A qualitative study

Abstract

Background: Short hospital admission periods following pediatric inpatient surgery leave parents responsible for managing their child's postoperative pain in the community following discharge. Little is known about the experiences of parents caring for their child's postoperative pain after discharge home following inpatient surgery. Research examining parental postoperative pain management following their child's day surgery has found that parents are challenged in their pain management knowledge and practices. Aims: This interpretative phenomenological analysis study sought to understand parents' experiences caring for their child's postoperative pain at home. Methods: Semistructured telephone interviews were conducted with seven parents between 2 weeks and 6 months after their child's discharge from hospital. Results: Identified themes were coming home without support, managing significant pain at home, and changes in the parent-child relationship. Conclusions: Parents could potentially benefit from nurses optimizing educational interventions, from receiving ongoing support of transitional pain teams, and from assistance with return to school planning. RÉSUMÉ Contexte: Les courtes périodes d'hospitalisation après une chirurgie pédiatrique en milieu hospitalier laissent les parents responsables de la prise en charge de la douleur postopératoire de leur enfant dans la communauté après son congé. On sait peu de choses sur les expériences des parents qui s'occupent de la douleur postopératoire de leur enfant après leur retour à la maison suite à une chirurgie en milieu hospitalier. La recherche portant sur la prise en charge de la douleur postopératoire par les parents suite à la chirurgie d'un jour de leur enfant a révélé que les parents font face à des difficultés en ce qui concerne leurs connaissances et leurs pratiques en matière de prise en charge de la douleur. Objectifs: Cette étude d'analyse phénoménologique interprétative visait à comprendre l'expérience des parents qui s'occupent de la douleur postopératoire de leur enfant à la maison. Méthode: Des entretiens téléphoniques semi-structurés ont été menés avec sept parents entre deux semaines et six mois après la sortie de l'hôpital de leur enfant. Résultats: Les thèmes recensés ont été le retour à la maison sans soutien, la prise en charge d'une douleur importante à la maison et les changements dans la relation parent-enfant. Conclusions: Les parents pourraient potentiellement bénéficier de l'optimisation des interventions éducatives par des infirmières, d'un soutien continu de la part des équipes de la douleur transitoire et d'une aide à la planification du retour à l'école.

Qualitative research and pain: Current controversies and future directions

“… 12 , 26 We argue that small sample sizes are not a weakness of qualitative research but rather a core characteristic of many qualitative methodologies, given that the data are intended to provide rich and deep exploration rather than broad surveys of phenomena. As illustrated in the Special Issue, Dagg et al 27 show how small samples can be a strength by facilitating an in-depth idiographic approach to understanding the experience of pain that may not be accessible by the adoption of a more nomothetic approach. Dagg et al 27 explored the experiences of ten parents managing their children’s postoperative pain after discharge home from the hospital.…”

“…As illustrated in the Special Issue, Dagg et al 27 show how small samples can be a strength by facilitating an in-depth idiographic approach to understanding the experience of pain that may not be accessible by the adoption of a more nomothetic approach. Dagg et al 27 explored the experiences of ten parents managing their children’s postoperative pain after discharge home from the hospital. Using an interpretive phenomenological analytic design, the authors provided rich, in-depth descriptions of the logistical, emotional, and relational challenges faced by parents providing postoperative pain care at home that provides important insights for both clinicians and researchers designing interventions.…”

“… 34 By example, Tabeefar et al 35 used thematic saturation as a construct to guide sampling adequacy in their study of community pharmacists’ experiences with chronic pain, which was guided by the principles of grounded theory. Conversely, and in line with phenomenological inquiry, the studies by Dagg et al, 27 Mustafa et al, 29 and Woodgate et al 16 focused on obtaining rich personal accounts and describing the similarities and differences in experiences across participants. A one-size-fits-all approach to evaluating qualitative studies, as is often done by non-qualitative experts, disregards the core epistemological and ontological underpinnings of the various qualitative designs.…”

“…This carefully curated collection includes high-quality, cutting-edge empirical qualitative studies in pain that highlight theoretical and methodological advancements in the field. The studies included in this Special Issue employ a range of qualitative methodologies, including grounded theory, 35 phenomenology, 16 , 27 , 29 qualitative description, 28 and arts-based approaches. 15 , 17 The collection of studies also demonstrates the array of methods of data collection possible in qualitative research, including both traditional (e.g., one-on-one interviews 27 , 29 , 35 ) and novel (e.g., photovoice, 16 object elicitation, 28 social media posts 15 ) methods.…”

“…The studies included in this Special Issue employ a range of qualitative methodologies, including grounded theory, 35 phenomenology, 16 , 27 , 29 qualitative description, 28 and arts-based approaches. 15 , 17 The collection of studies also demonstrates the array of methods of data collection possible in qualitative research, including both traditional (e.g., one-on-one interviews 27 , 29 , 35 ) and novel (e.g., photovoice, 16 object elicitation, 28 social media posts 15 ) methods. Finally, the Special Issue articles illustrate the capacity of qualitative research to capture the meaning and experience of pain in diverse populations, including children with anxiety, 16 critically ill patients, 28 pharmacists working with individuals with chronic pain, 35 immigrant women, 29 parents of children who have undergone surgery, 27 individuals with heart disease, 17 and those with various forms of chronic pain.…”