POSTOPERATIVE PAIN IN CHILDREN - DEVELOPMENTAL AND FAMILY INFLUENCES ON SPONTANEOUS COPING STRATEGIES

Despite advances in pharmacological approaches to pain control, most c hildren who undergo surgery continue to experience moderate to severe postoperative pain. Children and their parents are forced to rely on p ersonal resources to cope with this severe stressor. This study examin ed children and parents' reactions to post-operative pain, including s tress appraisal and cognitive-behavioural coping processes from a deve lopmental perspective. Sixty children (7-16 years) and their parents p rovided interview and psychometric data about pain and coping on the d ay following surgery. Observational data also was provided by nurses. Findings indicated moderate to severe levels of postoperative pain wer e common. Older children (10-16 years) provided more complex and multi dimensional pain descriptions. All children described a variety of sel f-control strategies found to be helpful in managing postoperative pai n. Older children were more likely to report using cognitive coping st rategies, yet they reported lower overall self-efficacy. Multiple regr ession analyses revealed that coping strategy use, perceived self-effi cacy, and frequency of catastrophizing thoughts were significantly pre dictive of children's pain, affective distress, and physical recovery. Parents were accurate judges of their child's pain and affective dist ress. Parental anxiety was positively related to child anxiety, and in versely related to child self-efficacy and frequency of cognitive copi ng. Parents acknowledged historical transmission of coping ideas, larg ely through verbal suggestions and reassurances. Implications for clin ical practice are discussed.