Abstract
Adenotonsillectomy is performed in children on an outpatient basis, and pain is managed by parents. A pain diary would facilitate pain management in the ambulatory setting. Our objective was to evaluate the parental response rate and the compliance of a prototype electronic pain diary (e-diary) with cloud storage in children aged 2–12 years recovering from adenotonsillectomy and to compare the e-diary with a paper diary (p-diary). Parents recorded pain scores twice daily in a pain diary for 2 weeks post-operation. Parents were given the choice of an e-diary or p-diary with picture message. A total of 208 patients were recruited, of which 35 parents (16.8%) chose the e-diary. Most parents (98%) chose to be contacted by text message. Eighty-one families (47%) returned p-diaries to us by mail. However, the response rate increased to 77% and was similar to that of the e-diary (80%) when we included data texted to the research phone from 53 families. The proportion of diaries with Complete (e-diary:0.37 vs. p-diary:0.4) and Incomplete (e-diary:0.43 vs. p-diary:0.38) data entries were similar. E-diaries provide a means to follow patients in real time after discharge. Our findings suggest that a smartphone-based medical health application coupled with a cloud would meet the needs of families and health care providers alike.
Highlights
Published: 29 June 2021Adenotonsillectomy is one of the most common surgeries performed in the pediatric population, and the vast majority of children are discharged from hospital the same day.The burden of managing postoperative pain at home is delegated to the primary caregiver.despite perioperative education emphasizing expectations and discharge instructions, there is evidence that for many of these children pain persists for 2 weeks followingtonsillectomy ± adenotonsillectomy (TA) and that the pain is not adequately controlled [1,2,3,4].Pain assessment in children requires that parents repeatedly evaluate pain throughout the day and night
When we looked at the Incomplete diaries (n = 80), participants with the e-diary tended to drop out 3 days earlier (POD5 [interquartile range (IQR) 3, 10]) than participants with the p-diary
This study sought feedback from parents to inform the development of a prototype e-diary with cloud storage suitable for use in the home environment
Summary
Published: 29 June 2021Adenotonsillectomy is one of the most common surgeries performed in the pediatric population, and the vast majority of children are discharged from hospital the same day.The burden of managing postoperative pain at home is delegated to the primary caregiver.despite perioperative education emphasizing expectations and discharge instructions, there is evidence that for many of these children pain persists for 2 weeks followingTA and that the pain is not adequately controlled [1,2,3,4].Pain assessment in children requires that parents repeatedly evaluate pain throughout the day and night. Adenotonsillectomy is one of the most common surgeries performed in the pediatric population, and the vast majority of children are discharged from hospital the same day. Despite perioperative education emphasizing expectations and discharge instructions, there is evidence that for many of these children pain persists for 2 weeks following. Pain assessment in children requires that parents repeatedly evaluate pain throughout the day and night. Common tools to facilitate pain assessment in the outpatient setting are a pain scale and a pain diary. Paper diaries were employed and data were entered manually by the parents. One cannot assume that a parent did not enter all data in a single day [6]
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