Presurgical psychosocial predictors of acute postsurgical pain and quality of life in children undergoing major surgery
Open accessAbstract
Unlabelled Limited research has examined presurgical risk factors for poor outcomes in children after major surgery. This longitudinal study examined presurgical psychosocial and behavioral factors as predictors of acute postsurgical pain intensity and health-related quality of life (HRQOL) in children 2 weeks after major surgery. Sixty children aged 10 to 18 years, 66.7% female, and their parent/guardian participated in the study. Children underwent baseline assessment of pain (daily electronic diary), HRQOL, sleep (actigraphy), and psychosocial factors (anxiety, pain catastrophizing). Caregivers reported on parental pain catastrophizing. Longitudinal follow-up assessment of pain and HRQOL was conducted at home 2 weeks after surgery. Regression analyses adjusting for baseline pain revealed that presurgery sleep duration (β = -.26, P < .05) and parental pain catastrophizing (β = .28, P < .05) were significantly associated with mean pain intensity reported by children 2 weeks after surgery, with shorter presurgery sleep duration and greater parental catastrophizing about child pain predicting greater pain intensity. Adjusting for baseline HRQOL, presurgery child state anxiety (β = -.29, P < .05) was significantly associated with HRQOL at 2 weeks, with greater anxiety predicting poorer HRQOL after surgery. In conclusion, child anxiety, parental pain catastrophizing, and sleep patterns are potentially modifiable factors that predict poor outcomes in children after major surgery.Perspective This study addresses an important gap in literature, examining presurgical risk factors for poorer acute postsurgical outcomes in children undergoing major surgery. Knowledge of these factors will enable presurgical identification of children at risk for poorer outcomes and guide further research developing prevention and intervention strategies for these children.
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Higher levels of child pain catastrophizing predict increased acute postsurgical pain.
“Nonetheless, higher levels of child PC predict increased acute postsurgical pain, 24”
From Virtual psychoeducation for improvement of pain catastrophizing in pediatric presurgical patients and caregivers: a proof-of-concept study (2023) · cites this paper as [24]
The Results section ('Baseline risk factors for pain 2 weeks after surgery') says child pain catastrophizing was not associated with child-reported pain two weeks after surgery. The Discussion likewise states that children's presurgery pain catastrophizing did not predict postsurgical pain; it was parental catastrophizing that predicted greater pain intensity. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredCatastrophizing affects the effectiveness of pain-relieving interventions, including surgery.
“Catastrophizing also impacts treatment effectiveness for pain-relieving interventions 300, 301, 309, including surgery310–312.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [301]
In patients with musculoskeletal pain, catastrophizing is the single most important pre-treatment risk factor that reduces the effectiveness of pain-relieving interventions.
“Studies in patients with musculoskeletal pain have indicated that catastrophizing is the single most important pre-treatment risk factor that impairs the effectiveness of pain-relieving interventions 300, 301”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [301]
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- Authors
- Rabbitts, J. A., Groenewald, C. B., Tai, G. G., & Palermo, T. M.
- Affiliations
- University of Washington (US)
- Seattle Children's Research Institute (US)
- Corresponding author
- Rabbitts, Jennifer A.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 16
- Issue
- 3
- Pages
- 226-234
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC5137504
- OpenAlex
- W1974801913
- Cited by
- 114
- References
- 53
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 9 · 2023: 5 · 2022: 12 · 2021: 17 · 2020: 21 · 2019: 6 · 2018: 6 · 2017: 9 · 2016: 3 · 2015: 10
- FWCI
- 6.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of General Medical Sciences (T32GM086270)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD078239)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- health-related quality of life, psychosocial predictors, state anxiety, sleep duration, children
- MeSH terms
- Adolescent, Anxiety, Child, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Pain Measurement, Postoperative Pain, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Risk Factors, Sleep, Socioeconomic Factors, Linear Models, Caregivers, Catastrophization
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