Pain assessments in day surgery patients

• Aim This study aimed to examine whether seven items on pain are motivated to aggregate in a modified, less comprehensive, instrument to assess the quality of recovery (QoR) after day surgery.Background A modified version of the instrument quality of recovery – 40 (QoR-40) was developed to assess QoR in a Swedish group of day surgery patients (Idvall et al. 2009). The relevance of the original 40 items for day surgery patients in a Swedish context was assessed and modified to 27 items in four dimensions and one general question about pain. After psychometric tests, three-dimensions in the instrument showed initial support according to Cronbach’s coefficient alpha and item-to-total dimension correlation coefficients viz, ‘emotional state’, ‘physical comfort’ and ‘physical independence’, altogether 23 items (Idvall et al. 2009). The original version of QoR-40 (Myles et al. 1999, 2000) contained several items (n = 7) to assess a pain dimension. Our modified version reduced the pain dimension to one general item to address minor surgery and avoid focusing on so many different pain symptoms (Idvall et al. 2009). We now want to scrutinise whether that rationale was well motivated.Design A descriptive prospective design with a patient questionnaire was used.Method A consecutive sample of 201 day surgery patients in a university hospital in Sweden answered a pain questionnaire prior to being discharged. The inclusion criteria were as follows: received a day surgery procedure, aged over 18 years and had adequate command of the Swedish language. The study followed common ethical principles in clinical research and was approved by the head of the Day Surgery Department. We collected the data during the spring of 2009. The questionnaire included six items concerning pain: wound pain, headache, muscle pains, backache, sore throat and sore mouth. Respondents assessed the items on a 5-point scale from ‘none of the time’ to ‘all of the time’. In the original QoR-40, there were seven items but we aggregated two items on wound pain to one and a breast pain item was deleted because it was found irrelevant. We added a question on having a sore mouth which seemed relevant for day surgery patients because there are manipulations of the airways during anaesthesia. Further, one question was asked about pain ‘right now’ on an 11-point scale, with the endpoints being ‘no pain’ and ‘worst possible pain’. Descriptive statistics are presented as median (range) and mean (SD), number and per cent. We used a Mann-Whitney U-test to assess differences between those receiving general and local anaesthesia. Statistical significance was established with p < 0Æ05.Results The respondents’ mean (SD) age was 50 (16) years, and 48% (n = 97) were male. They had undergone general

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Keyword

day surgery

postoperative pain

quality of recovery

MEDICINE

MEDICIN

Vårdvetenskap

Nursing Science

Publication and Content Type

ref (subject category)

art (subject category)