Despite technological advances and AHCPR guidelines, unmanaged pediatric pain prevails with alarming frequency and children suffer needless pain. This experimental study will investigate the effectiveness of guided imagery, in combination with routine analgesics in reducing postoperative pain in 7-10 year old children during hospitalization and at home. Children from a Short Stay Unit (SSU) in a children's hospital, scheduled for a tonsillectomy or tonsillectomy and adenoidectomy will be recruited. Sixty children randomly assigned to the experimental group will watch a videotape on the use of guided imagery and then listen to a 20-30 minute audio tape of guided imagery one time prior to surgery, 2-4 hours after surgery, and at 22- 24 hours after discharge from the SSU. The 60 children in the comparison group will receive standard care. Pain will be measured prior to surgery, 2-4 hours after surgery, and in the home at 22- 24 hours after discharge from the SSU in both groups. Measures of sensory pain will be the Oucher and frequency and amount analgesics used in the hospital and home, and measures of affective pain will be the Palmar Sweat Test and State-Trait Anxiety Inventory for Children. Parents will be asked to keep records of analgesia use when the child is at home. Data will be analyzed by comparing groups in pain measures with analysis of covariance (ANCOVA). Frequency distribution and measures of central tendency deviation will be examined. This study is designed to provide insight into the link between pharmacologic and nonpharmacologic interventions with children having postoperative pain while in the hospital and at home. It is essential for the comfort of children that nursing enhances its knowledge, research base, and clinical management of pain.
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