Genevieve Pfeiffer1, Brandon Wong1, Jordan Wood1, Tiina Jaaniste1, David Champion1
Short-stay surgeries typically involve one to three days of hospitalization, yet post-surgical pain can often persist for up to two weeks in the case of post-tonsillectomy pain. Pain is known to negatively impact on a child’s physical functioning, mood, as well as the child’s and parents’ quality of life. The aim of this study was to investigate the relationship between parental and child psychological traits assessed prior to discharge from hospital and the child’s subsequent pain and functional outcomes following short-stay surgery (tonsillectomy or appendicectomy).
Children aged 3-18 years, and their parents (n=57 dyads), were recruited during their admission for short-stay tonsillectomy or appendectomy surgeries. Child-parent dyads completed pre-discharge questionnaires to examine their psychological factors (anxious depressive traits, pain catastrophising, and attitudes towards medication). Pain outcomes were assessed using time-stamped electronic questionnaires for up to 10 days following discharge from hospital, including daily measures of the child’s pain intensity, behavioural response to pain, degree of interference to daily functional activity, and disruption to sleep.
Multiple regression analyses revealed parent and child pre-discharge psychological variables collectively accounted for 55% of variance in a child’s average post-discharge pain intensity (R2=.55, p<0.01). Parental pain catastrophising, and anxious depressive profiles of the child, were significant individual predictors of average post-discharge pain intensity ratings. Post-discharge pain intensity statistically predicted the child’s average report of functional limitations and interference with sleep, with psychological variables of the child explaining an additional 19% of variance in functional outcomes (R2 =.43, p<0.01). Parental ‘negative affect’ measured pre-discharge also influenced the child’s sleep (β =.41, p<0.05).
Parental pain catastrophising, child anxious depressive traits and parental affect statistically predict post-discharge pain outcomes following pediatric surgery. These risk factors can be identified pre-discharge and have potential amenability to interventions.