Focus on comfort: the effect of focus language on postoperative hospital stay compared to the Numeric Rating Scale in children receiving postoperative care—a pre-post study

This study evaluates the effect of a comfort assessment using focus language compared with pain assessment using the Numeric Rating Scale (NRS) on postoperative length of stay (LOS), analgesic use and patient and parental satisfaction. Prospective pre-post study was conducted on a general pediatric ward. During the pre-intervention period, pain was assessed using the NRS. Post-intervention, comfort was assessed by focus language using comfort scores; an approach that shifts the conversation from the reduction of pain to the improvement of comfort. Eligible participants were children ≥ 6 years receiving postoperative care for > 24 h, able to report a NRS. Primary outcome was LOS (hours). Secondary outcomes were analgesic use (hours) and patient and parental satisfaction. Multivariable linear regression was used to adjust for baseline differences, potential confounding and effect modification. Pre-intervention 93 patients were included and post-intervention 99. The adjusted mean LOS in the post-intervention group: 94 h, was higher than in the pre-intervention group: 74 h (p < 0.01). The estimated LOS was significantly higher post-intervention, suggesting more complex surgeries during that period; no statistically significant difference was found between estimated and actual LOS. Analgesic use and patient and parental satisfaction were comparable. CONCLUSION: A focus on comfort during pediatric postoperative care did not statistically significantly impact the LOS, the analgesic use, and patients and parents' satisfaction. Shifting from pain-focused to comfort-focused communication appears to be a safe, feasible, and promising approach. Future research requires more homogeneous patient groups to determine the impact of using comfort-focused language. WHAT IS KNOWN: • The NRS is commonly used to assess pain in children ≥ 6 years. • Pain-related communication may influence the perception of pain. WHAT IS NEW: • Comfort assessment instead of NRS did not change analgesic use or patient/parent satisfaction. • Comfort-focused communication appears safe and feasible in pediatric postoperative care.