OBJECTIVE: Do children receiving either an information intervention or a coping intervention report less postoperative pain than children receiving a combination. DESIGN: Experimental design. POPULATION, SAMPLE, SETTING, YEARS: The population was children undergoing major orthopaedic surgery. The sample was 101 (mean age: 13.9)children undergoing surgery at a southeastern medical center from 1997-2001. Seventy-nine percent were female and 83% were Caucasian. CONCEPTS: The intervention and self-report of pain. METHODS: Children and their parents were approached during their preoperative clinic appointment and asked to participate. After informed consent was obtained, children were randomly assigned to a concrete-objective, a coping, a combination or a control group.On postoperative Days 2 and 4, children's pain was assessed using a visual analogue scale. FINDINGS: On postoperative Day 4, children receiving an intervention that included a combination of concrete-objective information plus coping reported the least pain (F(1,84)=4.69,p=.03. There was no effect on Day 2. CONCLUSIONS: Concrete-objective information appears to facilitate children's understanding of the challenges of the surgery, including pain, but learning specific techniques to cope with pain appears to be necessary to maximize the benefit. IMPLICATIONS: Non-pharmacologic pain relief measures that include information plus coping can be used to decrease children's pain and augment pharmacolgic pain management. Future studies should consider the parents as active participants who can coach their children to use specific behaviors to reduce pain.
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