Parental factors influencing postoperative pain in children : a systematic review

Context: Postoperative pain after surgery in children is an underestimated and complex problem. Several predictors which contribute to this poor outcome are linked to child, system, medication or parental factors. Parents are important partners in an efficient postoperative pain management. Objective: To examine which specific parental factors might be associated with postoperative pain of children. Data sources: Pubmed/MEDLINE, Web of Science, Cochrane database, Embase and PsycARTICLES Study selection: Inclusion of studies written in english which examine specific parental related predictors for increased postoperative pain in children aged up to 18 years. Randomized controlled trials, observational, cohort, case-control, case series, cross sectional were included from January 1995 up until April 2021. Data extraction and Data synthesis: A data extraction form was used and due to clinical and methodological heterogeneity the findings are presented in a narrative form. Results: Out of 647 search results, 22 studies were withheld in the final analysis. The parental related predictors can be grouped in five categories: culture; lack of knowledge; attitude; anxiety and parental pain catastrophizing. Limitations: The results indicate a high level of heterogeneity. Conclusions: Parental related risk factors found seem to be associated with worse child postoperative pain scores but additional studies are needed