{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:08:08Z","timestamp":1792786088702,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Institute of Arthritis and Musculoskeletal and Skin Disease","award":["K24AR080786"],"award-info":[{"award-number":["K24AR080786"]}],"id":[{"id":"https:\/\/ror.org\/006zn3t30","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100005831","name":"Foundation for Anesthesia Education and Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005831","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescents are at increased risk of persistent postsurgical opioid use. Qualitative data may provide insight on protective experiences and guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Adolescents aged 11-21\u2009years who were enrolled in a larger longitudinal survey study participated in semi-structured interviews one and 3 months after surgery between September 2022 and March 2023. Experiences were examined among adolescents who used opioids in postoperative weeks 3 and 4, after severe pain resolved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty interviews with 46 adolescents undergoing common procedures associated with severe pain and\/or persistent opioid use (POU) revealed that preoperative clinic conversations set an important framework for recovery. Positive experiences included normalizing anxiety, awareness of physical changes signifying recovery, including resolution of severe pain and subsequent opioid cessation, and effective non-opioid and non-pharmacologic pain treatment options, including ice and stretching. Patients with prolonged opioid use, whose caregivers often directed pain management, described more profound fears, struggles with seeking out information, difficulties actively engaging in recovery, and the use of opioids and sleep to avert pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The preoperative visit and recovery framework provided by the surgical team played an important role in guiding the recovery experience. Factors that may offer protection against prolonged opioid use include realistic descriptions of the recovery process with common milestones, encouraging preparation and engagement in the work of recovery, and educating on the role of opioid, non-opioid, and non-pharmacologic pain management options, including when to stop using opioids.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnag068","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:47:58Z","timestamp":1780055278000},"page":"1091-1099","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative guidance and an adolescent\u2019s surgical recovery experience: a qualitative study"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-237X","authenticated-orcid":false,"given":"Tori N","family":"Sutherland","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Children\u2019s Hospital of Philadelphia (CHOP), University of Pennsylvania Perelman School of Medicine , Philadelphia, PA 19104,","place":["United States"]},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104, United States"},{"name":"Clinical Futures, Children\u2019s Hospital of Philadelphia (CHOP) , Philadelphia, PA 19146,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E","family":"Hadland","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Mass General for Children, Boston, MA 02114, United States"},{"name":"Department of Pediatrics, Harvard Medical School , Boston, MA 02115,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4800-1080","authenticated-orcid":false,"given":"Jennifer A","family":"Rabbitts","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwon","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Children\u2019s Hospital of Philadelphia (CHOP), University of Pennsylvania Perelman School of Medicine , Philadelphia, PA 19104,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Fardad","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Children\u2019s Hospital of Philadelphia (CHOP), University of Pennsylvania Perelman School of Medicine , Philadelphia, PA 19104,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Kellom","sequence":"additional","affiliation":[{"name":"Qualitative Research Core (QRC), Children\u2019s Hospital of Philadelphia (CHOP), Philadelphia, PA 19146, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin T","family":"Clapp","sequence":"additional","affiliation":[{"name":"Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"2026100509370594100_pnag068-B1","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1111\/pan.13993","article-title":"Epidemiology of pediatric surgery in the United States","volume":"30","author":"Rabbitts","year":"2020","journal-title":"Paediatr Anaesth"},{"key":"2026100509370594100_pnag068-B2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-2439","article-title":"Persistent opioid use among pediatric patients after surgery","volume":"141","author":"Harbaugh","year":"2018","journal-title":"Pediatrics"},{"key":"2026100509370594100_pnag068-B3","doi-asserted-by":"publisher","first-page":"e170504","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults","volume":"152","author":"Brummett","year":"2017","journal-title":"JAMA Surg"},{"key":"2026100509370594100_pnag068-B4","doi-asserted-by":"publisher","first-page":"e2420370","DOI":"10.1001\/jamanetworkopen.2024.20370","article-title":"Preoperative vs postoperative opioid prescriptions and prolonged opioid refills among US youths","volume":"7","author":"Sutherland","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026100509370594100_pnag068-B5","doi-asserted-by":"publisher","first-page":"2790","DOI":"10.1111\/add.15487","article-title":"Opioid use disorder and overdose among youth following an initial opioid prescription","volume":"116","author":"Hadland","year":"2021","journal-title":"Addiction"},{"key":"2026100509370594100_pnag068-B6","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1136\/rapm-2023-104944","article-title":"Perioperative opioid prescribing and iatrogenic opioid use disorder and overdose: a state-of-the-art narrative review","volume":"49","author":"Larach","year":"2024","journal-title":"Reg Anesth Pain Med"},{"key":"2026100509370594100_pnag068-B7","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1111\/j.1526-4637.2005.00072.x","article-title":"Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the opioid risk tool","volume":"6","author":"Webster","year":"2005","journal-title":"Pain Med"},{"key":"2026100509370594100_pnag068-B8","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1213\/ANE.0000000000004823","article-title":"Incidence of and factors associated with prolonged and persistent postoperative opioid use in children 0-18 years of age","volume":"131","author":"Ward","year":"2020","journal-title":"Anesth Analg"},{"key":"2026100509370594100_pnag068-B9","doi-asserted-by":"publisher","first-page":"686414","DOI":"10.3389\/fpsyg.2021.686414","article-title":"Social-ecological predictors of opioid use among adolescents with histories of substance use disorders","volume":"12","author":"Nichols","year":"2021","journal-title":"Front Psychol"},{"key":"2026100509370594100_pnag068-B10","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaa201","article-title":"Associations between adolescent sleep deficiency and prescription opioid misuse in adulthood","volume":"44","author":"Groenewald","year":"2021","journal-title":"Sleep. Mar"},{"key":"2026100509370594100_pnag068-B11","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1097\/SLA.0000000000005802","article-title":"Safety and distribution of opioid prescribing by U.S. surgeons","volume":"277","author":"Waljee","year":"2023","journal-title":"Ann Surg"},{"key":"2026100509370594100_pnag068-B12","doi-asserted-by":"publisher","first-page":"j5790","DOI":"10.1136\/bmj.j5790","article-title":"Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study","volume":"360","author":"Brat","year":"2018","journal-title":"BMJ"},{"key":"2026100509370594100_pnag068-B13","doi-asserted-by":"publisher","first-page":"e207367","DOI":"10.1001\/jamanetworkopen.2020.7367","article-title":"Rate and risk factors associated with prolonged opioid use after surgery: a systematic review and meta-analysis","volume":"3","author":"Lawal","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2026100509370594100_pnag068-B14","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3150","article-title":"Unique needs of the adolescent","volume":"144","author":"Alderman","year":"2019","journal-title":"Pediatrics"},{"key":"2026100509370594100_pnag068-B15","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1016\/j.jpain.2017.03.007","article-title":"Prevalence and predictors of chronic postsurgical pain in children: a systematic review and meta-analysis","volume":"18","author":"Rabbitts","year":"2017","journal-title":"J Pain"},{"key":"2026100509370594100_pnag068-B16","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1186\/s12887-023-04183-y","article-title":"The experience of living with adolescent idiopathic scoliosis: a qualitative evidence synthesis using meta-ethnography","volume":"23","author":"Hannink","year":"2023","journal-title":"BMC Pediatr"},{"key":"2026100509370594100_pnag068-B17","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.pmn.2020.04.003","article-title":"Adolescent patients\u2019 management of postoperative pain after discharge: a qualitative study","volume":"21","author":"Dagg","year":"2020","journal-title":"Pain Manag Nurs"},{"key":"2026100509370594100_pnag068-B18","doi-asserted-by":"publisher","first-page":"100496","DOI":"10.1016\/j.bjao.2025.100496","article-title":"The Adolescent Surgery Experience (ASE): a survey-based prospective cohort study to measure risk factors for persistent opioid use","volume":"16","author":"Sutherland","year":"2025","journal-title":"BJA Open"},{"key":"2026100509370594100_pnag068-B19","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"O\u2019Brien","year":"2014","journal-title":"Acad Med"},{"key":"2026100509370594100_pnag068-B20","doi-asserted-by":"publisher","first-page":"359.e1-359","DOI":"10.1016\/j.jpain.2016.11.004","article-title":"The transition of acute postoperative pain to chronic pain: an integrative overview of research on mechanisms","volume":"18","author":"Chapman","year":"2017","journal-title":"J Pain"},{"key":"2026100509370594100_pnag068-B21","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual Health Res"},{"key":"2026100509370594100_pnag068-B22","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1177\/1077800410383121","article-title":"Qualitative quality: eight \u201cBig-Tent\u201d criteria for excellent qualitative research","volume":"16","author":"Tracy","year":"2010","journal-title":"Qual Inquiry"},{"key":"2026100509370594100_pnag068-B23","doi-asserted-by":"publisher","first-page":"547","DOI":"10.2147\/JPR.S36614","article-title":"Pain-related psychological correlates of pediatric acute post-surgical pain","volume":"5","author":"Page","year":"2012","journal-title":"J Pain Res"},{"key":"2026100509370594100_pnag068-B24","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3150","article-title":"Supporting the health care transition from adolescence to adulthood in the medical home","volume":"142","author":"White","year":"2018","journal-title":"Pediatrics"},{"key":"2026100509370594100_pnag068-B25","doi-asserted-by":"publisher","first-page":"2266751","DOI":"10.1080\/24740527.2023.2266751","article-title":"The impact of preoperative patient education on postoperative pain, opioid use, and psychological outcomes: a narrative review","volume":"7","author":"Darville-Beneby","year":"2023","journal-title":"Can J Pain"},{"key":"2026100509370594100_pnag068-B26","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1136\/rapm-2024-105601","article-title":"Upskilling pain relief after surgery: a scoping review of perioperative behavioral intervention efficacy and practical considerations for implementation","volume":"50","author":"Darnall","year":"2025","journal-title":"Reg Anesth Pain Med"},{"key":"2026100509370594100_pnag068-B27","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1097\/j.pain.0000000000002521","article-title":"Can perioperative psychological interventions decrease the risk of postsurgical pain and disability? A systematic review and meta-analysis of randomized controlled trials","volume":"163","author":"Nadinda","year":"2022","journal-title":"Pain"},{"key":"2026100509370594100_pnag068-B28","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/scs.13046","article-title":"Adolescents\u2019 perioperative experiences in relation to inpatient and outpatient elective surgery\u2014a qualitative study","volume":"36","author":"Pestana-Santos","year":"2022","journal-title":"Scand J Caring Sci"},{"key":"2026100509370594100_pnag068-B29","doi-asserted-by":"publisher","first-page":"zpae039","DOI":"10.1093\/sleepadvances\/zpae039","article-title":"Ecological momentary assessment of sleep, pain, and opioid use among adolescents following surgery","volume":"5","author":"Rogers","year":"2024","journal-title":"Sleep Adv"},{"key":"2026100509370594100_pnag068-B30","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1016\/j.jhsa.2017.07.003","article-title":"A prospective randomized study analyzing preoperative opioid counseling in pain management after carpal tunnel release surgery","volume":"42","author":"Alter","year":"2017","journal-title":"J Hand Surg Am"},{"key":"2026100509370594100_pnag068-B31","first-page":"169","article-title":"Perioperative opioid counseling reduces opioid use following primary total joint arthroplasty","volume":"42","author":"Carender","year":"2022","journal-title":"Iowa Orthop J"},{"key":"2026100509370594100_pnag068-B32","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1177\/1558944720919936","article-title":"Prospective randomized study examining preoperative opioid counseling on postoperative opioid consumption after upper extremity surgery","volume":"17","author":"Vincent","year":"2022","journal-title":"Hand (N Y)"},{"key":"2026100509370594100_pnag068-B33","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1097\/AJP.0000000000001205","article-title":"Prescription opioid decision-making and use behaviors in adolescents with acute pain: a qualitative study","volume":"40","author":"Kapos","year":"2024","journal-title":"Clin J Pain"}],"container-title":["Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/painmedicine\/advance-article-pdf\/doi\/10.1093\/pm\/pnag068\/68432872\/pnag068.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/painmedicine\/article-pdf\/27\/10\/1091\/68432872\/pnag068.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/painmedicine\/article-pdf\/27\/10\/1091\/68432872\/pnag068.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:37:17Z","timestamp":1791207437000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/painmedicine\/article\/27\/10\/1091\/8698140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/pm\/pnag068","relation":{},"ISSN":["1526-2375","1526-4637"],"issn-type":[{"value":"1526-2375","type":"print"},{"value":"1526-4637","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,5,29]]}}}