Child Pain Intensity and Parental Attitudes toward Complementary and Alternative Medicine Predict Post-Tonsillectomy Analgesic Use.
Child Pain Intensity and Parental Attitudes toward Complementary and Alternative Medicine Predict Post-Tonsillectomy Analgesic Use.
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DOI：
10.3390/children7110236
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发表时间：
2020-11-19
期刊：
影响因子：
--
通讯作者：
Stone AL
中科院分区：
文献类型：
--
作者：
Lee J;Delaney K;Napier M;Card E;Lipscomb B;Werkhaven J;Whigham AS;Franklin AD;Bruehl S;Stone AL
父母对疼痛干预的态度和对孩子疼痛强度的看法可能会影响术后镇痛药的使用。我们的研究探讨了儿童疼痛强度的日常波动和家长对补充和替代医学（CAM）的态度对小儿扁桃体切除术后镇痛药的影响。接受扁桃体切除术的儿童的父母（n = 33）完成了一项评估CAM态度的调查，并在术后7天电子日记中记录了他们孩子的每日疼痛强度和镇痛药物（对乙酰氨基酚、布洛芬或羟考酮）。采用Poisson分布的广义线性混合模型评估了人内（儿童每日疼痛强度）和人间（平均术后疼痛，父母CAM态度）组分对给药次数的影响。较高的每日疼痛强度与在给定的一天给予更多的羟考酮剂量相关，但对乙酰氨基酚或布洛芬无关。积极的父母CAM态度与羟考酮使用较少相关，超出了儿童日常疼痛强度和平均术后疼痛的变化。父母CAM的态度和他们的孩子的日常疼痛强度与父母决定扁桃体切除术后给予阿片类药物独立相关。了解影响镇痛药使用个体差异的因素有助于优化儿童术后疼痛管理。
Parental attitudes regarding pain interventions and perceptions of their child’s pain intensity likely influence the decision to administer postoperative analgesics. Our study examined the impact of daily fluctuations in child pain intensity and parental attitudes regarding complementary and alternative medicine (CAM) on analgesic administration following pediatric tonsillectomy. Parents of children undergoing tonsillectomy (n = 33) completed a survey assessing CAM attitudes and a 7-day postoperative electronic daily diary to record their child’s daily pain intensity and analgesic medications (acetaminophen, ibuprofen, or oxycodone). Generalized linear mixed models with Poisson distributions evaluated the effects of within-person (child’s daily pain intensity) and between-person (average postoperative pain, parental CAM attitudes) components on the number of medication doses administered. Higher daily pain intensity was associated with more oxycodone doses administered on a given day, but not acetaminophen or ibuprofen. Positive parental CAM attitudes were associated with less oxycodone use, beyond the variations accounted for by the child’s daily pain intensity and average postoperative pain. Both parental CAM attitudes and their child’s daily pain intensity were independently associated with parental decisions to administer opioids following tonsillectomy. Understanding factors influencing individual variability in analgesic use could help optimize children’s postoperative pain management.
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