Study Of Pain Intervention Models On Postoperative Pain In Children With Tethered Cord Syndrome

Operation is the only way for Children with Tethered Cord Syndrome. Because the operation is complicated and need long incisions,the patients have significant postoperative pain. It’s so important for patients to build postoperative pain intervention model。ObjectiveTo explore the effects of the integrative pain intervention models of family-centered care and multimodal nonpharmacological interventions on postoperative pain and anxiety in infants with tethered cord syndrome, and anxiety, satisfaction with nursing in parents of children with tethered cord syndrome. According to the actual perception of nursing personnel in the management of pediatric pain, to provide effective reference for further development of pain management services.Methods1ObjectsA quasi-experiment controlled design was employed.20cases of3-12years old children with tethered cord syndrome and their parents in The Third Affiliated Hospital of Zhengzhou University from October,2011to March,2012were selected as control group through convenience sampling.20cases of3-12years old children with tethered cord syndrome and their parents were selected as intervention group from March,2012to December,2012.2MethodsThe control group children used the common clinical care model, and their parents acquired convention health and postoperative nursing care education. The intervention group used integrative pain intervention models of family-centered care and multimodal nonpharmacological interventions.The Faces Pain Scale(FPS), The modified Yale Preoperative Anxiety Scale(YPAS), State Anxiety Inventory(SAI), Newcastle Satisfaction with Nursing Scale (NSNS) were used to assess the two groups after the intervention. In-depth interview was conducted on8pediatric nurses adopting qualitative research.3Statistics analysisSPSS17.0was used to analysis all data. Mean and Std deviation were used to describe the measurement data such as age. Frequency was used to describe the count data such as gender. Significant difference of the measurement data between two groups of children were compared by two independent-sample Mann-Whitney U test and T test. Difference between the count data of the two groups of children were compared by Fisher exact test. Two independent-sample T test were used to compare the difference of anxiety in two sets of parents before the intervention. After intervention, the two groups’ scores of FPS, YPAS, SAI and NSNS were analyzed by two independent-sample T test and Mann-Whitney U test. The significant level was a=0.05.Results1The comparison of indicators between intervention group and control groupThe data of age, age structure, gender, residence and operation time did not differ significantly between the two groups (P>0.05).2The comparison of postoperative pain and anxiety in children between intervention group and control group1hour and24hour after intervention, pain scores measured in this study were not significantly different (P>0.05).8-16hour after the surgery, the scores of FPS and YPAS were significantly decreased in the intervention group compared with the control group (P<0.05).3The comparison of the scores of anxiety and satisfaction with nursing of parents of children with tethered cord syndrome between before and after interventionThere is no significant difference of the scores of anxiety and of parents between intervention group and control group before intervention (P>0.05).After intervention, the scores of anxiety of parents were decreased in the intervention group compared with the control group (P<0.05). The scores of NSNS were significantly increased in the intervention group compared with the control group (P<0.05).4Through this qualitative research,4themes were extractedThrough this qualitative research,4themes were extracted:common experiences of pain in children, limited knowledge of pain assessment scale, lack of pain treatment knowledge and non-pharmaceutical intervention knowledge, multiple challenges on pain management.ConclusionsThe integrative pain intervention models of family-centered care and multimodal non-pharmacological interventions can relief children’s postoperative pain and anxiety, alleviate parents’ anxiety, improve satisfaction with nursing during their children with tethered cord syndrome were in the hospital.