Attitudes, Norms, Perceived Behavioral Control, and Intention to Practice for Postoperative Recovery Among Caregivers of Children
Early and proper practice of postoperative care of hospitalized children by caregivers speeds up recovery and prevents complications. The purpose of this correlational descriptive research study was to study the attitudes, norms, perceived behavioral control, and intention-to-practice related to postoperative recovery care, and their relationship among caregivers of children. The Theory of Planned Behavior by Ajzen (1991), along with the reviewed literature, was used as the framework for this study. The participants, recruited according to inclusion criteria, were 106 caregivers of 3-12 year old children who received postoperative recovery care at 3 tertiary level hospitals. Data were collected from August to December 2014. The study instruments included: (1) demographic information of caregivers and children who had received major surgery (2) the modified parents’ beliefs questionnaire by Tourigny et al. (2005) including the intention-to-practice questionnaire, scoring a content validity index of .87 and a reliability of .87; and the caregivers’ beliefs questionnaire about attitudes, norms, and perceived behavioral control with the reliability of .84 (attitudes = .85, norms = .86 and perceived behavioral control = .72). Data were analyzed using descriptive statistics and Pearson product-moment statistical correlation.
The study findings showed that
- All participants had a high overall score of practicing postoperative recovery care. 60.38% had a moderate level of l attitude towards practicing postoperative recovery care. All of the participants recorded a high level of norms to practice for postoperative recovery care. 72.64% had a moderate level of perceived behavioral control to practice postoperative recovery care.
- Attitudes were statistically significantly and positively correlated at a moderate level with intention-to-practice (r = .41, p < 0.1). Norms were statistically significantly and positively correlated with intention-to-practice (r = .50, p < 0.1)
The results of this study provide an understanding of attitudes, norms, perceived behavioral control, and intention-to-practice regarding postoperative recovery among caregivers. Health personnel may use this information to help caregivers’ care and do further research.
Processes, 50, 179-211.
Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior.
Englewood Cliffs. NJ : Prentice-Hall.
Allvin, R., Berg, K., Idvall, E., & Nilsson, U. (2007). Postoperative recovery: A concept analysis.
Journal of Advance Nursing, 57(5), 552-558.
Bonica, J. J., & Loeser, J. D. (2001). History of pain concepts and therapies. In J. D. Loeser (Ed.),
Bonica’s management of pain (3rded.) (pp. 3-16). Philadelphia: Lippincott.
Browning, L., Denehy, L., & Scholes, R. L. (2007). The quantity of early upright mobilization
performed following upper abdominal surgery is low: and observational study.
Australian Journal of Physiotherapy, 53, 47-53.
Callery, P., Luker, K. (1996). The use of qualitative methods in the study of parents’ experiences
of care on a children’s surgical ward. Journal of Advanced Nursing, 23 (2), 338–345.
Chae, F. H., & Stiegmann, G. V. (2006). Ambulation and early postoperative performance
criteria. New York: Springer.
Chapados, C., Pineault, R., Tourigny, J., & Vandal, S. (2002). Perceptions of parent’s
participation in the care of their child undergoing day surgery: Pilot – Study. Issues in Comprehensive Pediatric Nursing, 25, 59–70.
Chatterjee, S., Rudra, A., & Sengupta, S. (2011). Current concepts in the management of
postoperative nausea and vomiting. Anesthesiology Research and Practice, 1-10.
Chieng, S. Y. J., Chan, S. W. C., Liam, W. J. L., Klainin-Yobas, P., Wang, W., & He, H. G.
(2013). Exploring influencing factors of postoperative pain in school-age children undergoing elective surgery. Journal for Specialists in Pediatric Nursing, 18, 243–252.
Craven, R. F., & Hirnle, C. J. (2003). Fandamental of nursing: Humen health and function
(4thed.) .Philadelphia: Lippincott Williiams & Wilkins.
Department of Medical Services. (2011). Disease statistic 2011. Retrieved from
http://www.dms.moph.go.th/dmsweb/dmsweb_v2_2/index.php (In Thai)
Godin, G., & Kok, G. (1996). The theory of planned behavior: A review of its application to
health-related behaviors. American Journal of Health Promotion, 11(2), 87–98.
He, H. G., Pölkki, T., Vehvilainen-Julkunen, K. A., & Pietilä, A. M. (2005). Chinese nurse’s use
of non-pharmacologocal methods in children’s postoperative pain relief. Journal of
Advanced Nursing, 51(4), 335-342.
Johnston , C. C., Rennick, E. J., Filion, F., Campbell-Yeo, M., Goulet, C., Bell, L., Tucci, M., & Ranger, M. (2012). Maternal Touch and Talk for Invasive Procedures in Infants and Toddlers in the Pediatric Intensive Care Unit1. Journal of Pediatric Nursing, 27,
Saiwaree , J. (2013). Development of nursing standard for children undergoing open heart surgery at the pediatric intensive care unit, Songklanagarind hospital. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Nursing Science (Pediatric Nursing). Prince of Songkla University. (In Thai)
Kristensson-Hallstrom, I. (2000). Parental participation in the pediatric surgery care.
Association of Perioperative Registered Nurses journal, 71, 1021-1003.
Lam, L. W., Chang, A. M., & Morrissey, J. (2006). Parents’ experiences of participation in the
care of hospitalized children: a qualitative study. International Journal of Nursing Studies 43, 535–545. doi:10.1016/j.ijnurstu.2005.07.009
Maxwel, L. G. (2004). Age-associated issue in peroperative evaluation, testing and planning:
pediatrics. Anesthesiology Clinics of North America, 22(1), 27-43.
Ministry of Public Health. (2009-2010). Statistic of pediatric patients underwent surgery and procedures. Information and Communication Technology Center. (In Thai)
Pawar, D. (2012). Common post-operative complications in children. Indian Journal of Anaesthesia, 56(5), 496-501. doi: 10.4103/0019-5049.103970
Pai, M. S., Bhaduri, M., Jain, A, G., Kumar, V., & Sethi, S. (2008). The experiences of mothers
of pediatric surgery children-a qualitative analysis. Journal of Pediatric Nursing, 23(6), 479-489.
Pölkki, T., Pietilä., A-M., Vehviläinen-Julkunen., K ., Laukkala, H., & Ryhänen, P. (2002).
Parental views on participation in their child pain relief measures and recommendations to health care providers. Journal of Pediatric Nursing, 17(4), 270-278.
Power, M. N., Howard, F. R., Wade, M. A., & Franck, S. L. (2012). Pain and behaviour changes in children following surgery. Original article, 97, 879–884.
Reismann, M., Dingemann, J., Wolters, M., Laupichler, B., Suempelmann, R., & Ure, B. M. (2009).
Fast-track concepts in routine pediatric surgery: a prospective study in 436 infants and children. Langenbecks Arch Surg, 394, 529–533. doi: 10.1007/s00423-008-0440-1
Stull, M.K., & Deatrick, J.A. (1986). Measuring parental participation in the care of the
hospitalized child: part 1. Issues in Comprehensive Pediatric Nursing, 9(3), 157–165.
Tourigny, J., Chapados, C., & Pineault, R. (2005). Determinants of parental behaviour when children undergo day-care surgery. Journal of Advanced Nursing, 52(5), 490–497.
Zeitz, K., McCutcheon, H., & Albrecht, A. (2004). Postoperative complications in the first
24 hours: a general surgery audit. Journal of Advanced Nursing, 46(6), 633–640.