Postoperative pain assessment and impact of pain on early physical recovery, from the patients' perspective

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Eriksson, KerstinJönköping University,Hälsohögskolan,Länssjukhuset Ryhov i Jönköping (author)

Postoperative pain assessment and impact of pain on early physical recovery, from the patients' perspective

BookEnglish2017

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Jönköping :Jönköping University, School of Health and Welfare,2017
77 s.
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:hj-35346
ISBN:9789185835799
https://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-35346URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:vet swepub-contenttype
Subject category:dok swepub-publicationtype

Series

Dissertation Series. School of Health and Welfare,1654-3602 ;080

Notes

Background: Pain is a common postoperative experience. Guidelines recommend performing regular pain assessments, which include self-rated pain and additional communication to capture patients' experiences. During hospitalisation, pain intensity is found to be a vital factor influencing other aspects of an early physical recovery, and is consequently an important item in questionnaires for recovery. These tools consist of extensive questionnaires which are difficult to use in everyday clinical work. A simplified method of monitoring postoperative recovery would benefit both patients and healthcare professionals.Aim: The overall aim of this thesis was twofold: (A) to determine the ability of extending the use of pain ratings to reflect and predict early physical postoperative recovery and (B) to describe patients’ perspectives on pain assessments.Methods: The studies were carried out at one (I), three (IV) and four hospitals (II, III) involving general surgical and orthopaedic inpatients. Two quantitative methods were used based on data from questionnaires and medical records. They consisted of one cross-sectional study (I) and one study with repeated measures (IV). An association was sought between pain intensity and postoperative recovery on days 1 and 2 (I, IV), and prehospital data (IV). Two qualitative methods were used involving a phenomenographic (III) approach and Critical Incident Technique (IV), where semi-structured interviews were performed postoperatively and analysed inductively in accordance with the approach.Results: An association was found between moderate/severe average pain intensity compiled from monitoring records and impact on early physical postoperative recovery on day 1 (I). Retrospective average pain intensity at rest and during activity reflected impact on recovery on postoperative day 1 (IV). Severe pain intensity at rest and during activity on postoperative day 1 predicted impact on physical recovery items on day 2 (IV). The use of the Numeric Rating Scale (NRS 0-10) was considered to facilitate communication about pain, but to involve difficulties of interpretation and place demand on healthcare professionals and care routines (II). Patients’ descriptions of their experiences when in need of describing pain indicated two main areas: patients’ resources when needing to describe pain and ward resources for performing pain assessments (III). Descriptions of their actions when they were in pain indicated two main areas: patients used active strategies when needing to describe pain or patients used passive strategies when needing to describe pain (III).Conclusions: This thesis contributes to knowledge about the possibility of using patients' self-rated average pain intensity to reflect early physical postoperative recovery on day 1 and to predict recovery on the following day. The pain scale gave patients and healthcare professionals a shared vocabulary, which facilitated communication. Furthermore, dialogue during pain assessments was described as critical in ascertaining whether pain intensity had an impact on different aspects of physical recovery. Environmental factors such as the attitude of healthcare professionals, workload and staffing influenced how pain assessments were performed.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Omvårdnad hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Nursing hsv//eng
pain assessment
pain intensity
pain scale
physichal recovery
postoperative care

Added entries (persons, corporate bodies, meetings, titles ...)

Broström, Anders,ProfessorJönköping University,HHJ, Avdelningen för omvårdnad(Swepub:hj)BAnd (thesis advisor)
Fridlund, Bengt,ProfessorJönköping University,HHJ, Avdelningen för omvårdnad(Swepub:hj)FrBe (thesis advisor)
Årestedt, Kristofer,Biträdande universitetslektorLinköpings universitet (thesis advisor)
Brink, Eva,ProfessorDepartment of Health Sciences, University West, Trollhättan (opponent)
Jönköping UniversityHälsohögskolan (creator_code:org_t)

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