Nurses' and parents' attitudes toward pain management and parental participation in postoperative care of children

Over the last 25 years, inadequate pain management for postoperative children continues to be reported in the literature. Inadequate postoperative pain management leads to detrimental physiological and psychological effects, and lengthens children's hospitalisation. Parental participation can improve the quality of care in hospital and after discharge. Both pain management and parental participation are influenced by the attitudes of nurses and parents. However, only little attention has been paid to this field particularly in Taiwan.\ud \ud \ud \ud The purpose of the present study was: firstly, to understand nurses' and parents' attitudes toward pain management and parental participation in postoperative child care. Secondly, to explore the personal factors affecting their attitudes to pain management and parental participation. The third purpose was to compare nurses' and parents' attitudes toward pain management and parental participation in postoperative care of children in Taiwan. A descriptive, cross sectional design was used to survey paediatric nurses (n=63) and parents (n=133) of children from 0 to 17 years old who had undergone surgery in three Taiwan teaching hospitals.\ud \ud \ud \ud The findings indicate that misconceptions about pain medications were found in both parents and nurses. Both parents and nurses held neutral to positive attitudes towards parental participation and postoperative pain management. Both parents and nurses who had higher education levels had more positive attitudes toward the use of pain medication. Parents who were younger, had a higher education level, had previous experience of caring for their child during hospitalisation, had previous experience with their child having surgery and who had younger children, had more positive attitudes toward parental participation. Nurses who had more working experience with children had more positive attitudes toward parental participation. Nurses and parents all had higher agreement in using non-pharmacological methods for children's postoperative pain relief. Nurses had more agreement than the parents in the subscale of "parent-professional collaboration" and another five items in the PPAS questionnaire which included parents being allowed to change simple dressings, restrain their child, and feed their baby; parents being informed; and enhanced professional-patient relationship with parental involvement. Parents had more positive attitudes than nurses to the subscale of "parent presence" and the parents were more in favour than nurses of the provision of facilities such as free meals or parking fees.\ud \ud \ud \ud Improvement in the quality of children's pain management requires more education to enhance nurses' and parents' knowledge and attitudes toward children's pain management and parental participation. Additional programs are needed that target nurses with less paediatric experience as well as older parents to develop more positive attitudes to parental participation. Paediatric nurses need to be aware and satisfy parents' desire to be present during their child's hospitalisation, as well as help parents to clarify their misconceptions about side effects and tolerance of analgesics utilisation