Mothers’ experience of involvement in their child's postoperative pain relief

Background: Children often experience moderate to severe pain at hospital postoperatively. Unrelieved pain has undesirable psychological and physical consequences. Parental involvement can assist health professionals in reaching a desirable level of postoperative pain management for children. Indeed, adequate interactions between parents and paediatric health professionals can reduce the child’s experience of pain. Aims: The research aimed to explore mothers’ involvement in their child’s postoperative pain management, in hospital and following discharge, and to identify ways in which their participation in pain management activities can be strengthened. Methods: This was a qualitative single case study. Data were collected through participant observations with 20 mother/child dyads and semi-structured interviews with those mothers, as well as semi-structured interviews with 21 nurses, and a review of documents in the paediatric surgical department (hospital policies and forms). Thematic analysis was carried out with NVivo software. Findings: The following themes and sub-themes were generated from the study data: 1) acquisition and provision of information (expected type, frequency, and duration of pain after surgery, pain intensity score and pain relief medication, and non-pharmacological pain management methods), 2) communication deficiency (communication between mothers and health professionals, language barrier, and nurses’ attitudes), 3) emotional and physical support (family company, mothers’ concerns, comfortable environment and food and sleep requirements), 4) social and cultural influences (patriarchal society, cultural beliefs, and work status), 5) hospital facilities (entertainments, follow-up programs, pain management courses for nurses, and materials). Overall, mothers needed more information about their child’s pain after surgery. More communication was required between mothers, nurses, and surgeon and other health professionals. Mothers needed more emotional support and physical support from family and health professionals. Mothers required that their social and cultural background be understood and acted upon by health professionals. Mothers wanted increased hospital facilities and services to improve their participation. Conclusion: This study has helped to raise awareness about the extent of mothers’ involvement in their child’s postoperative pain management in Saudi Arabia hospitals, and has identified ways to improve the current situation. Health professionals and hospital systems must improve information provided to mothers, increase interaction between mothers and health professionals, strengthen mother support, pay greater attention to the cultural background of mothers, and improve hospital facilities to adequately involve mothers