Abstract
It has been well documented that postoperative pain can be emotionally devastating for children, and nurses should play a major role in providing appropriate and effective postoperative pain management for children. However, O’ConnerVon (2000) highlighted that, although surgical techniques and anaesthetic agents have greatly improved in recent years, nursing preparation for children undergoing surgery and their parents, including postoperative pain control, remains inadequate. There is also an increasing expectation for parents to take responsibility in caring for their child whilst in hospital, particularly in postoperative pain management. However, in a study of preparing children and family psychologically for surgery, Ellerton and Merriam (1994) revealed that most parents found it difficult to accept the role of helping their children manage the stressful experience of surgery and postoperative pain. Lack of understanding about the upcoming procedures, unfamiliarity with the hospital environment and insufficient knowledge of pain assessment and skills in alleviating postoperative pain of their child have been identified as the major factors contributing to parental stress. In this paper, He et al. (2005) emphasized that nurses are responsible in enhancing parents’ knowledge of pain assessment and management. He et al. (2005) also stressed the importance of parental involvement in the postoperative care of their child, particularly in the management of their child’s postoperative pain using non-pharmacological methods. Through participating in the nursing care, parents can not only give their child a sense of security and comfort but also take a more active role in helping their child to experience less stress and a more positive response to surgery. The benefits of using non-pharmacological methods were not mentioned in this paper but have been reported in one of the authors’ previous publication (Polkki 2002). Previous studies also failed to address what the essential components of these non-pharmacological methods are, the exact mechanism of how these methods work and why such methods results in positive outcomes. The effectiveness of using nonpharmacological methods in alleviating pain for adults has been well documented (Roykulcharoen & Good 2004); however, empirical evidence for using non-pharmacological methods in alleviating postoperative pain in children remains under-researched. Furthermore, although this paper reported nurses’ preference for providing parental guidance on different non-pharmacological methods, it is unclear which nonpharmacological methods are most effective in alleviating children’s postoperative pain. Additionally, it is unclear which of these methods are more acceptable to children and their parents. The questionnaire used in this study has been translated into Chinese and validated. However, it is not clear which questions were modified according to Chinese culture. It may not also address the different non-pharmacological methods used by parents that are not listed in the questionnaire. Some modifications were also made to the background questions, such as age, education, nursing position, professional work experience and the number of the nurses’ children. However, additional background information such as whether the nurses themselves have used non-pharmacological pain interventions and the type they have used for their own children. Such personal experiences could influence the guidance nurses provide to parents. In addition, this study did not address how cultural factors influenced the choice of guidance provided to parents by Chinese nurses, as well as the perception of pain by Chinese parents and their children as pain is susceptible to extensive cultural factors. Tsoi and Pryde (1999) highlighted that Chinese children are influenced by sociocultural values, such as obedience and social conformity and inhibition of self-expression. As a result, Correspondence: Ho Cheung William Li, The Nethersole School of Nursing, Esther Lee Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China. Telephone: (852) 26098103, E-mail: williamli@cuhk.edu.hk
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