Primer on adult patient satisfaction in perioperative settings.

The topic of patient satisfaction has gained increasing importance over the past decade. Due to the impact of patient satisfaction on health care quality, understanding factors that predict satisfaction is vital. The purpose of this review is to examine the literature and identify factors related to patient perioperative satisfaction as well as predictive variables that, if modified, can enhance satisfaction scores of patients undergoing surgery. Our review reports that patient satisfaction scores are affected by modifiable factors such as clinician-patient communication, information provision to patients, and operational function of a hospital. Non-modifiable factors affecting patient satisfaction scores include patient demographics such as gender, age, and education. In order to enhance patient perioperative satisfaction, we suggest that anesthesiologists and surgeons focus their efforts on enhancing their communication skills and providing information that is appropriately tailored to the understanding of their patients

Developmental and Cultural Perspectives on Children’s Postoperative Pain Management at Home

Outpatient surgery is extremely common in children, and approximately 4 million children experience significant pain after surgery in the USA each year. Management of children\u27s postoperative pain in the home setting is suboptimal and is impacted by characteristics of children and parents, as well as the larger family and cultural context. In particular, developmental status of the child, parental beliefs regarding pain expression and analgesic use in children, cultural values and language barriers can affect management of children\u27s postoperative pain. Targeting the myriad barriers to children\u27s pain management by capitalizing upon the use of tailored interventions may help bridge the gap between the translation of pain management guidelines to the home setting

Adult coping with childhood sexual abuse: A theoretical and empirical review

Coping has been suggested as an important element in understanding the long-term functioning of individuals with a history of child sexual abuse (CSA). The present review synthesizes the literature on coping with CSA, first by examining theories of coping with trauma, and, second by examining how these theories have been applied to studies of coping in samples of CSA victims. Thirty-nine studies were reviewed, including eleven descriptive studies of the coping strategies employed by individuals with a history of CSA, eighteen correlational studies of the relationship between coping strategies and long-term functioning of CSA victims, and ten investigations in which coping was examined as a mediational factor in relation to long-term outcomes. These studies provide initial information regarding early sexual abuse and subsequent coping processes. However, this literature is limited by several theoretical and methodological issues, including a failure to specify the process of coping as it occurs, a disparity between theory and research, and limited applicability to clinical practice. Future directions of research are discussed and include the need to understand coping as a process, identification of coping in relation to adaptive outcomes, and considerations of more complex mediational and moderational processes in the study of coping with CSA

An experience sampling study of physical activity and positive affect: investigating the role of situational motivation and perceived intensity across time

The nature of the association between physical activity and positive affect is complex, prompting experts to recommend continued examination of moderating variables. The main purpose of this 2-week field study was to examine the influence of situational motivational regulations from self-determination theory (SDT) on changes in positive affect from pre- to post- to 3-hours post-physical activity. Another purpose was to clarify the relationship between physical activity intensity [i.e., Ratings of Perceived Exertion (RPE)] and positive affect at the stated time points. This study employed an experience sampling design using electronic questionnaires. Sixty-six healthy and active, multiple-role women provided recurrent assessments of their physical activity, situational motivation, and positive affect in their everyday lives over a 14-day period. Specifically, measures were obtained at the three time points of interest (i.e., pre-, post-, 3-hours post-physical activity). The data were analyzed using multilevel modeling. Results showed that intrinsic motivation was related to post-physical activity positive affect while the influence of identified regulation appeared 3-hours post-physical activity. In addition, RPE, which was significantly predicted by levels of introjection, was more strongly associated with an increase in positive affect post-physical activity than three hours later. The theoretical implications of these findings vis-à vis SDT, namely in regards to a viable motivational sequence predicting the influence of physical activity on affective states, are discussed. The findings regarding the differential influences of RPE and motivational regulations carries applications for facilitating women’s well-being

Child Physical Abuse and Neglect

Although poor and inhumane treatment of children is not a new phenomenon (Doerner & Lab, 1998; Wolfe, 1999), child physical abuse and neglect were not identified as serious social problems until the 1960s, with the publication of Kempe and colleagues’ description of battered-child syndrome (Kempe, Silverman, Steele, Droegemueller, & Silver, 1962). In this influential study, Kempe and colleagues described the clinical manifestation of this syndrome in terms of the deleterious physical consequences maltreated children experienced, ranging from undetected outcomes to those that cause significant physical impairments. Rather than exploring the potential psychological sequelae of maltreated children, Kempe focused on detailing the psychiatric profiles of abusive parents. They concluded that, although not all maltreating parents possess severe psychiatric disturbances, “in most cases some defect in character structure is probably present; often parents may be repeating the type of child care practiced on them in their childhood” (p. 112). Since Kempe and colleagues’ original characterization of physical abuse, professionals have grappled with exactly how to define child maltreatment. As many have pointed out, child maltreatment is a complex and heterogeneous problem (e.g., Cicchetti, 1990; Wolfe & Mc- Gee, 1991; Zuravin, 1991) that is difficult to define (Wolfe, 1987, 1999). In a summary of definitional consider ations, Zuravin (1991) suggested that operational definitions of abuse and neglect should differentiate among subcategories of maltreating behavior and should consider issues such as severity and chronicity. Before we discuss the respective definitions of child physical abuse and neglect, we will briefly review the legal aspects of these definitions

Complementary and Alternative Medicine Attitudes and Use in Caregivers of Patients with Lung Cancer

https://digitalcommons.psjhealth.org/summit_all/1071/thumbnail.jp

Child Postoperative Pain: Impact of Child Temperament and Parent Mood on Pain After Surgery

Around 80% of children who undergo surgery experience moderate to severe postoperative pain. Various psychosocial factors contribute to exacerbations of this pain. A child’s inborn personality traits and style of interaction with the environment are known as temperament. Children who are less sociable and more distress-prone (e.g., those who cry, throw tantrums) are more likely to have an anxious temperament. This anxiety before and after surgery may lead to an increase in postoperative pain levels as well. Parent pain ratings do not always reflect true child pain. Overtime, a parent’s emotional state and mood may change how they perceive child pain. Parents who have more negative moods or are more distressed tend to report their child’s pain as worse and have a negative impact on a child’s pain. Therefore, parents play a crucial role in treatment after surgery. Given this, the purpose of this study was to see how child temperament factors are associated with postoperative pain and how parent mood moderates this relationship. These specific factors are analyzed in a sample of children ages 2-13 who underwent elective surgery at the Children’s Hospital of Orange County (N = 112). Prior to the surgery, parents completed online surveys assessing child temperament and parent mood. Postoperative pain measures were reported by both children and parents after surgery on days 1, 3, and 7. Child temperament factors did not interact with parent mood to predict postoperative pain. Emotionality and sociability were not significantly associated with parent pain measures or child pain after surgery (ps \u3e 0.05). However, other studies have shown that child temperament does affect pain in a hospital setting more than they do at home. Interestingly, pain in children was low at home after surgery (less than 3 on a scale of 0 to 10). It is possible that the impact of temperament and mood on pain were less potent once the child is at home following the surgery and pain is lower. Further investigation on the influence of temperament and mood on child pain is important to obtain more clarity and discover optimal methods of treating pain in children. Future work may benefit from investigating different surgical procedures that might lead to a greater diversity of pain once children are home

Sex as a Moderator in the Relationship between Post-operative Pain and Analgesics Administered in Children Undergoing Elective Surgery

About 85% of children who undergo elective surgery experience pain post-operatively and many do not receive proper pain management care after discharge. Most parents lack an understanding of proper pain care management using analgesics upon discharge. Research reveals that adults rate girls as more sensitive to pain and that they display a greater amount of pain in a pediatric post-operative environment. In adulthood, women report more sensations of pain and have a higher pain tolerance, which can be attributed to physiological characteristics. Nonetheless, the social differences by which boys and girls experience pain and express their pain cannot be denied. The purpose of this study is to understand the relationship between a child’s post-operative pain and the amount of analgesics given to the child, and how sex moderates this association. Parents of children ages 2-13 (59% male, 41% female) (N=112) were asked to evaluate the pain of their child and report the amount and type of analgesic use days 1, 3, and 7 post-operatively. The Parents Perceived Pain Management (PPPM) Scale was used to evaluate the child’s pain and analgesic use was self-reported. Using this scale in regression-based analysis, there was a significant association between pain and the amount of analgesic use given to the children on post-operative days 1 (ibuprofen: b = 0.24, t = 3.55, p \u3c 0.05, acetaminophen: b = 0.22, t = 5.38, p \u3c 0.05) and 3 (ibuprofen: b = 0.72, t = 4.81, p \u3c 0.05, acetaminophen: b = 0.34, t = 4.44, p \u3c 0.05); however; sex did not significantly moderate this association (ps \u3e .05). Evidence in this study does not suggest that boys receive different post-operative analgesic care from girls as a function of pain. Future analysis should analyze factors that interact with this association like the sex of the parent that is administering analgesics and the parent’s education of analgesic usage

Response to: Mindset Over Matter: Is Parental Health Mindset an Appropriate Target for Intervention?

Although we appreciate the thoughtful letter by Humphry and colleagues and are grateful for the opportunity to respond, we somewhat disagree with the interpretation of our findings by the authors

Pediatric Postoperative Pain Medication: Child Sex and Ethnicity Interact to Predict Parent Medication Attitudes

Over 85% of children experience significant pain after surgery. Despite this presence of pain, research suggests that a quarter of these children receive very little or even no pain medication at home. Such poor pain management in children can have harmful long-term consequences, both physically and psychologically. Previous research indicates that the amount of pain medication administered to children in the home may be significantly impacted by beliefs and attitudes parents have regarding analgesics. Given this, the purpose of the present study is to identify which demographic factors are associated with certain parent analgesic attitudes or misconceptions among pediatric patients ages 2-13 who have undergone elective surgery at the Children’s Hospital of Orange County (N = 112). Prior to surgery, parents completed surveys to report demographics and medication attitudes—fear of side effects, avoidance, and appropriate use attitude. Ethnicity was found to interact with child sex to predict parents’ fear of side effects, b = -4.750, p = 0.043. Specifically, among Hispanic households, parents of daughters expressed a greater fear of side effects from analgesics compared to parents of sons. The opposite trend was seen in White households, such that parents of sons expressed a greater fear of side effects compared to parents of daughters. This sex difference in Hispanic families may be due to the phenomenon machismo, a term characterized by the hypermasculine idealization of men. Specifically, Hispanic parents may express a significantly lower fear of side effects for their male children because they are encouraging their sons to be more stoic and “tough.” The hypermasculinity principles behind machismo, however, may not significantly transcend across other ethnic groups, as showcased by the opposite trend observed in White parents. These findings can be utilized to develop interventions that specifically target and educate parents who are likely to have misconceptions concerning analgesic use while still respecting the family’s culture, values, and practices