title: Long-Term Pain and Recovery After Major Pediatric Surgery: A Qualitative Study With Teens, Parents, and Perioperative Care Providers.
abstract: Research developing targeted treatment focused on coping with children's long-term pain after surgery is needed because of the high prevalence of chronic pain after surgery. This qualitative study aimed to: 1) understand the child's and family's experiences of pain over the course of their surgical experience, and 2) gather stakeholder input regarding potential barriers and facilitators of perioperative intervention delivery. Fifteen children ages 10 to 18 years who underwent recent major surgery, their primary caregivers, and 17 perioperative health care providers were interviewed. Interviews were coded using semantic thematic analysis. The perioperative period presented emotional challenges for families. Families felt unprepared for surgery and pain. Recovery and regaining physical functioning at home was challenging. Families struggled to return to valued activities. Families reported interest in a perioperative psychosocial intervention. Providers endorsed that families would benefit from enhanced coping skills. They emphasized that families would benefit from more detailed preparatory information. Providers suggested that flexible intervention delivery at home would be ideal. Research developing interventions addressing pain and anxiety in children undergoing major surgery is critically needed. The findings of the present study can inform intervention development with the aim of improving short- as well as long-term recovery in children undergoing major surgery.
  
  
  
  This qualitative study examined children and their parents' experience of long-term pain and recovery after major surgery, identifying barriers and facilitators of perioperative intervention delivery. Families experienced surgery as stressful, and felt underprepared for pain and recovery. Families and health care providers expressed interest in a preoperative intervention teaching coping skills.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; Center for Clinical and Translational Research, Seattle Children's Hospital, Seattle, Washington. Electronic address: jennifer.rabbitts@seattlechildrens.org.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Rabbitts
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Rachel V
authors.initials: RV
authors.lastname: Aaron
authors.affiliation: Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Emma
authors.initials: E
authors.lastname: Fisher
authors.affiliation: Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington; Department of Biological Sciences, Columbia University, New York, New York.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Lang
authors.affiliation: Department of Microbiology, University of Washington, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Caroline
authors.initials: C
authors.lastname: Bridgwater
authors.affiliation: Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Gabrielle Ghafari
authors.initials: GG
authors.lastname: Tai
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Tonya M
authors.initials: TM
authors.lastname: Palermo
mesh_terms: D000293:Adolescent; D002648:Child; D059350:Chronic Pain / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000523:psychology*; D010290:Parents; D019990:Perioperative Care / Q000523:psychology*; D036301:Qualitative Research; D020127:Recovery of Function
keywords: Chronic postsurgical pain; anxiety; behavioral; pediatric pain; perioperative; psychosocial; risk factors; sleep