Parental attitudes regarding analgesic use for children: differences in ethnicity and language.

The aim of this study was to identify the impact of ethnicity and language on parental attitudes regarding analgesic use to treat children's pain. A total of 206 parents of children undergoing outpatient surgery were recruited to complete the Medication Attitudes Questionnaire, a measure of parental beliefs about using analgesic medications to treat children's pain. Parents were grouped into one of 3 categories according to ethnicity and primary language spoken: English-speaking white, English-speaking Hispanic, and Spanish-speaking Hispanic. Group differences in pain medication attitudes were examined. After controlling for socioeconomic status, English-speaking Hispanic parents endorsed higher levels of misconceptions about pain medication use, including a tendency to avoid analgesic use for children, compared with English-speaking white and Spanish-speaking Hispanic parents. This study highlights parental characteristics, including ethnicity and language, which may place children at higher risk for undertreatment of acute pain based on misconceptions about analgesic use for children. Specifically, English-speaking Hispanic parents may be most likely to undertreat children's pain at home. Future studies are needed to identify the most appropriate means of providing education to counter parental misconceptions and support optimal pain management of children's pain in the home setting.

Fortier MA ，Martin SR ，Kain DI ，Tan ET ... -  《-》

Ethnicity and parental report of postoperative behavioral changes in children.

To examine the role of ethnicity and language in parent report of children's postoperative behavioral recovery. To compare incidence of new onset negative behavior change in English- and Spanish-speaking White and Hispanic children following outpatient surgery. Postoperative behavioral change in children is common; however, it is unknown whether cultural variables including ethnicity and language may influence parent report of children's behavioral recovery. Participants included 288 parents (English-speaking White, English-speaking Hispanic, Spanish-speaking Hispanic parents) of children undergoing outpatient elective surgery. Parents completed the post-hospitalization behavior questionnaire (PHBQ) and parents' postoperative pain measure (PPPM) on postoperative days one, three, and seven at home. Most parents (83%) reported onset of new negative behavioral change in children postoperatively. Generalized estimating equations revealed significant group differences in overall behavior change [Wald χ(2)(12) = 375.69, P < 0.0001] after controlling for demographic and socioeconomic differences. At all three postoperative days, Spanish-speaking Hispanic (SSH) parents reported lower negative behavioral changes in their children compared to English-speaking White (ESW) parents (day 1: P < 0.01; day 3: P < 0.001; day 7: P < 0.10). On postoperative days one and three, SSH parents also reported lower total PHBQ scores than English-speaking Hispanic (ESH) parents [day 1: χ(2)(1) = 6.72, P = 0.01; day 3: χ(2)(1) = 7.98, P = 0.005]. The present study provides evidence that parent report of children's postoperative behavioral recovery may be influenced by cultural variables, such as ethnicity and language. The present results contribute to a growing body of evidence that highlights the need for culturally sensitive assessment and care of families in the medical setting. The findings may reflect differences in cultural values such as stoicism; however, future studies would benefit from examination of the factors that may account for the differences in reported behavior change after surgery (i.e., report bias, cultural values).

Fortier MA ，Tan ET ，Mayes LC ，Wahi A ，Rosenbaum A ，Strom S ，Santistevan R ，Kain ZN ... -  《-》

Motivation and parental presence during induction of anesthesia: an examination of the role of ethnicity and language.

To examine the role of ethnicity and language in parental desire and motivation to be present for children's anesthesia induction. To compare motivation for parental presence at induction of anesthesia (PPIA) between English- and Spanish-speaking White and Hispanic parents of children undergoing outpatient surgery. The effectiveness of PPIA may depend, in part, on parental motivation and desire to be present at children's anesthesia induction; however, cultural variables such as ethnicity and language have not previously been explored in this relationship. Participants included 258 parents of children undergoing outpatient surgery and general anesthesia. Parents were grouped by self-reported ethnicity and primary language spoken into English-speaking White (ESW, n = 55), English-speaking Hispanic (ESH, n = 108), and Spanish-speaking Hispanic (SPH, n = 95) groups. Measures included the Motivation for Parental Presence during Induction of Anesthesia (MPPIA) and a 4-item measure of preference for PPIA. The majority of parents (73%) expressed a preference for PPIA. Analyses controlling for group differences in socioeconomic status and demographic variables revealed that English-(P = 0.03) and Spanish-speaking (P = 0.06) Hispanic parents reported significantly greater levels of desire to be present for their child's anesthesia induction compared to English-speaking White parents. English-speaking Hispanic parents also reported greater levels of beliefs about the impact of anxiety on children's anesthesia induction compared to English-speaking White parents (P = 0.07). Parental ethnicity and language may impact desire and motivation for PPIA, which may subsequently impact the effectiveness of PPIA and child anxiety at anesthesia induction. Future research should examine the impact of parental characteristics, including cultural variables, on children's preoperative anxiety.

Fortier MA ，Gomez SH ，Kain A 《-》

Postoperative pain management in Latino families: parent beliefs about analgesics predict analgesic doses provided to children.

The present study examined whether parental perceptions of children's pain impacted home-based pain management following outpatient surgery in a sample of Latino families from low socioeconomic backgrounds. Latino parents of children (n = 161) who underwent outpatient surgery were recruited for this study and completed measures assessing attitudes on pain and analgesic use (Parental Pain Expression Perceptions and Medication Attitudes Questionnaire) before their child's surgery. Parents also rated their child's pain after their child's surgery using the Parent Postoperative Pain Measure and collected data on the amount of analgesics they gave to their child on the first postoperative day. Hierarchical regression analyses examined whether parental attitudes predicted pain assessment and management at home. A majority of parents reported multiple misconceptions regarding children's pain and fears of side effects as well as avoidance of analgesic use. For example, over 80% reported believing that a child always tells their parents when they are in pain. Hierarchical regression analyses found that more fear and avoidance regarding analgesic use for children's pain predicted parents providing fewer doses of analgesic to their children on the first postoperative day (β = -0.21, P = 0.028). Preoperative parents' beliefs regarding analgesics for treatment of children's pain may adversely impact parent postoperative analgesic administration at home in Latino families.

Rosales A ，Fortier MA ，Campos B ，Kain ZN ... -  《-》

Desire for perioperative information and parental ethnicity.

To examine the role of ethnicity, language, and socioeconomic variables in parental desire for information regarding children's surgery.   To compare anesthetic and surgical information desired between English- and Spanish-speaking White and Hispanic mothers of children undergoing outpatient surgery.   Parents report wanting to receive detailed information regarding children's preoperative care; however, variables such as parent ethnicity and language spoken have not been accounted for in understanding desire for information.   One hundred and eighty-one mothers of children undergoing outpatient surgery, elective surgery, and general anesthesia were recruited and categorized into one of three groups: English-speaking White (ESW, n=79), English-speaking Hispanic (ESH, n = 63), and Spanish-speaking Hispanic (SSH, n = 39). In addition to providing demographic questionnaire, mothers completed the Parental Desire for Information (PDI) questionnaire, a 14-item measure of surgery and anesthesia-related statements.   Overall, mothers desired receiving information about the majority of the items on the PDI. As compared to ESW mothers, SSH mothers and ESH mothers were overrepresented in the 'have a right to know' response option, with significant differences existing in items concerning alternative methods of anesthesia, details of needles used, and location of PACU and OR.   Anesthesiologists should tailor the provision of preoperative information based on ethnicity and language of mothers involved. Ethnic and language differences shown in this study may exist in other populations as well.

Martin SR ，Fortier MA ，Kain DI ，Tan ET ，Huszti H ，Wahi A ... -  《-》