{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:49:08Z","timestamp":1792133348040,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Moderate\u2010to\u2010severe pain remains a clinically relevant concern after paediatric laparoscopic pyeloplasty and may interfere with early recovery. Identifying children at increased risk may support more timely and individualized perioperative pain management.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n To investigate factors associated with moderate\u2010to\u2010severe pain after laparoscopic pyeloplasty in children and to inform targeted nursing and perioperative management strategies.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single\u2010centre retrospective observational study included children undergoing laparoscopic pyeloplasty. Postoperative pain was assessed at 2, 6, 12 and 24\u2009h using either a Faces Pain Scale or the Face, Legs, Activity, Cry and Consolability (FLACC) scale according to age and communication ability. Moderate\u2010to\u2010severe pain was defined as a score \u2265\u20094 at any assessment within 24\u2009h. Demographic, disease\u2010related, surgical and perioperative variables were analysed. Multivariable binary logistic regression was used to identify factors independently associated with moderate\u2010to\u2010severe pain, and repeated\u2010measures analysis of variance was used to assess changes in pain scores over time. This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 258 children, 65 developed moderate\u2010to\u2010severe postoperative pain, corresponding to an incidence of 25.2%. Multivariable analysis showed that age <\u20093\u2009years, significant preoperative anxiety, operative time\u2009\u2265\u2009120\u2009min and the absence of a regional block were independently associated with moderate\u2010to\u2010severe pain. Sex, severe hydronephrosis and postoperative drainage tube placement were not independently associated with the outcome. Pain scores were highest at approximately 6\u2009h after surgery, with significant group, time and group\u2010by\u2010time interaction effects.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Moderate\u2010to\u2010severe pain is relatively common during the early postoperative period after paediatric laparoscopic pyeloplasty. Early risk identification, preoperative psychological support, appropriate regional analgesia and intensified pain assessment during the first 6\u201312\u2009h may improve perioperative pain management. Prospective multicentre studies are warranted to validate these findings and develop clinically applicable risk\u2010stratification strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jocn.70583","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:29:32Z","timestamp":1792132172000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Moderate\u2010to\u2010Severe Pain After Paediatric Laparoscopic Pyeloplasty: Implications for Nursing Care"],"prefix":"10.1111","author":[{"given":"Yueqin","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Nursing Children's Hospital of Nanjing Medical University Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxia","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Nursing Children's Hospital of Nanjing Medical University Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianlian","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Nursing Children's Hospital of Nanjing Medical University Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3333-7053","authenticated-orcid":false,"given":"Lanzheng","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Nursing Children's Hospital of Nanjing Medical University Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"5","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.5005\/jp-journals-10005-3463","article-title":"Comparative Evaluation of Pain Perception and Postoperative Pain in Children With Precooled Injection Sites Using Popsicles for Local Anesthesia: A Randomized Controlled Trial","volume":"19","author":"Baldawa H. 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Part A"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"e244","DOI":"10.1016\/j.pedn.2024.07.012","article-title":"The Effects of Preoperative Therapeutic Play on Anxiety and Fear Levels in Preschool Children","volume":"78","author":"Celik B.","year":"2024","journal-title":"Journal of Pediatric Nursing"},{"issue":"4","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1111\/jocn.17582","article-title":"Non\u2010Pharmacological Interventions for Preoperative Anxiety in Children: A Systematic Review and Network Meta\u2010Analysis","volume":"34","author":"Chen H.","year":"2025","journal-title":"Journal of Clinical Nursing"},{"issue":"10","key":"e_1_2_13_9_1","first-page":"723","article-title":"Risk and Protective Factors in Predicting Pediatric Acute Postsurgical Pain: A Systematic Review and Meta\u2010Analysis","volume":"42","author":"Chow C. H. 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