Application effects analysis of a nurse-led and family-involved pain management program for children with limb fractures

Purpose This study aimed to assess the effectiveness of a nurse-led, family-involved pain management program in children with limb fractures. Methods A total of 120 children undergoing limb fracture surgery at Fujian Children's Hospital from January 1, 2024 to May 31, 2025 were enrolled. A controlled before-after quasi-experimental design was adopted, and the children were divided into groups according to the order of admission: the control group received routine nursing care, whereas the intervention group received a nurse-led, family-involved pain management program for children with limb fractures. The primary outcomes, pain scores at 6 and 24 h postoperatively, were compared between the two groups. Secondary outcomes included length of hospital stay, complications, fear of movement, family anxiety, and functional exercises compliance. Results A total of 120 children were enrolled (60 in the control group and 60 in the intervention group). Primary outcome showed postoperative pain scores at 6 h and 24 h were both significantly lower in the intervention group (6h: U = 1,073.5, P < 0.001, r = 0.367, median difference = 0.99994, 95% CI:0.00005–1.00000; 24h: U = 402, P < 0.001, r = 0.685, median difference = 2.00, 95% CI: 2.00–2.00). Secondary outcomes showed shorter hospital stays [3 (IQR: 2, 3) vs. 4 (IQR: 2, 5); U = 1,224, P = 0.002], lower TSK scores (24.65 ± 2.43 vs. 37.10 ± 2.71; MD = 12.45, 95% CI: 11.520–13.380, P < 0.001), and a higher compliance rate with functional exercises (86.7% vs. 58.3%; χ 2 = 12.079, P = 0.001). Preoperative SAS scores were comparable between groups, while postoperative SAS scores were significantly lower in the intervention group [42 (IQR: 40, 44) vs. 63.5 (IQR: 63, 63.75); U = 12, P < 0.001]. No complications were reported. Conclusion The nurse-led, family-involved pain management program for children with limb fractures was associated with meaningful improvements in postoperative pain, reduced fear of movement, better exercise compliance, and decreased family anxiety compared with routine nursing care. These findings suggest that the program may be a promising approach for postoperative management in children with limb fractures.