Stress and Perception of Procedural Pain Management in Chinese Parents of Children with Cancer.J Pain Symptom Manage. 2020 Jul 05 [Online ahead of print]JP
Children with cancer are exposed to repeated painful and invasive procedures. This study examines Chinese parents' stress and perception towards their children's procedural pain-control.
We recruited 265 parents of children (aged <18 years) diagnosed with hematological cancer (74.7%) and solid tumors (25.3%) from two major public hospitals. Parents used a scale (0-10) to rate perceived pain experienced by their child when undergoing lumbar puncture (LP), bone marrow aspirate or/and biopsy. They reported their stress level and attitudes towards analgesics using the adapted Pain Flexibility Scale for Parents and Parental Medication Attitude Questionnaire. General linear modelling was used to identify factors associated with perception outcomes.
Parents (72.8% mothers, age 36.5[6.8] years) expressed that they were worried (31.7%) and had difficulty with concentration (57.7%) when the child was in pain. Among parents whose children had undergone LP (n=207), 39.1% perceived that their child still experienced severe pain (pain score>7) even with existing pain control measures. Parents reported concerns over side effects of analgesics (69.4%) and addiction (35.1%). Half of the parents (47.2%) perceived that analgesics should only be reserved for severe pain. Parents who were older (Estimate=2.07, SE=0.87; P=0.0054) and had lower education attainment (Estimate=-3.38, SE=1.09; P=0.0021) had a more negative attitude towards analgesics use. Higher parental distress was associated with avoidance of analgesics use (rs=0.17, P=0.0052).
Our findings suggested that subgroups of Chinese parents demonstrated distress with their child's pain and harbored misconceptions over analgesics use. Future work includes devising targeted psychoeducation interventions for these parents.