Postoperative pain management – the influence of surgical ward nurses

MSc, RN Kerstin Wickström Ene; Nordberg, Gunnar F.; Bergh, Ingrid; Johansson, RN Fannie Gaston; Sjöström, RN Björn

doi:10.1111/j.1365-2702.2008.02278.x

Cited by 59 publications

(44 citation statements)

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“…Some studies have revealed that nurses and doctors underestimate patients' pain or desire for analgesia and pain monitoring programmes, consisting of staff education and pain documentation with numeric pain scales, have been shown to improve the compliance with administration of analgesia. 6,11,15,[17][18][19][20] In Europe it is now becoming common practice to document pain scores as part of the routine postoperative observations. This could provide a way to make nursing staff more aware of the problem as patients tend to underreport their pain until it becomes unbearable.…”

Section: Morphine Administrationmentioning

confidence: 99%

Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Murray

Retief

2015

Southern African Journal of Anaesthesia and Analgesia

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Background: Postoperative pain is poorly studied in developing countries. At a Western Cape referral hospital, it was aimed to determine the incidence of acute postoperative pain, to identify populations associated with a higher risk thereof (in order to guide resource allocation) and to investigate whether inexpensive analgesic modalities are currently utilised maximally. Methods: Patients completed visual analogue scales 24 h after surgery for pain immediately after surgery, maximum pain since surgery and current pain. The incidence of moderate or severe pain and median pain scores were calculated for each scale and for different patient populations. Post hoc logistic regression was performed. Morphine prescriptions were compared with the actual administration thereof. Results: Of 1 231 patients, 62% indicated their maximum pain as moderate or severe. Procedures with the highest incidences were caesarean section and lower limb orthopaedic surgery (> 80%). Younger age, female gender, emergency surgery, and surgery to the abdomen and lower limbs were associated with higher incidences. Patients experiencing moderate or severe pain received 46% of their prescribed morphine. Conclusion: In this institution, the incidence of postoperative pain is high as expected. Associations with postoperative pain are identified, which may guide resource allocation. At least one low-cost analgesic modality is currently underutilised.

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Section: Morphine Administrationmentioning

confidence: 99%

Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Murray

Retief

2015

Southern African Journal of Anaesthesia and Analgesia

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“…der fant man at et knapt flertall av nyopererte ikke opioidavhengige pasienter var blitt spurt om å angi sin smerteintensitet på en smerteskala. sjelden bruk av kartleggingsverktøy kan henge sammen med manglende rutiner, men det kan også knyttes til stigmatiserende, moralistiske og negative holdninger som helsepersonell kan ha til opioidavhengige (8,12,42).…”

Section: Introduksjonunclassified

Smertebehandling av rusmisbrukere innlagt i sykehus

Andenæs

Undall³

et al. 2012

Sykepleien

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“…[4][5][6] Therefore, the patient's verbal report of pain is essential and should be accepted as the single most reliable indicator of pain. [4,[7][8][9] Nurses are the health care professionals who spent most of time with the patients [10][11][12] and their role in pain management is essential. In addition; to ensure an effective pain management, there should be an effective pain assessment.…”

Section: ıNtroductionmentioning

confidence: 99%

“…[14] Except these factors; there is another important factor in postoperative pain management which is patients' and also nurses' acceptance of postoperative pain as a normal result of surgery. [11] On the other hand, the pain rating scale used takes an important role on underestimation of pain. Usage of Verbal Rating Scales which the patient verbally describes the level of his pain is not sensitive enough to expose the change in pain level.…”

Section: ıNtroductionmentioning

confidence: 99%

“…[12] Previous studies show that nurses have tendency to underestimate their patients' pain. [8,11,[16][17][18][19][20][21][22][23][24][25] Underestimation of pain may result with inadequate nursing care and treatment, certain physical and psychological problems and also brings greater annual economic costs. [6,19,26,27] There are many reasons behind the underestimation of pain by nurses.…”

Section: ıNtroductionmentioning

confidence: 99%

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Pain Levels of Orthopedic Surgery Patients and Pain Perceptions of Their Relatives and Nurses

Yildirim¹

2015

Agri

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ÖzetAmaç: Bu tanımlayıcı araştırma, ortopedik cerrahi hastalarında ağrının hasta yakını ile hemşire tarafından algılanışının incelenmesi amacıyla gerçekleştirildi. Gereç ve Yöntem: Araştırmanın örneklemini ortopedi kliniğinde yatan 150 hasta, hastaların yanındaki 150 hasta yakını ve hastanın bakımından sorumlu 50 hemşire oluşturdu. Her hemşire araştırmaya yalnızca üç kere katıldı. Ağrı düzeyi, Görsel Analog Skala ile değerlendirildi. Hasta yakını ve hemşirenin, hastanın ağrı skalasını görmemesi sağlandı. Verilerin değerlendiril-mesinde; yüzdelik, ortalama, standart sapma, Mann-Whitney-U, Eşleştirilmiş Örneklem t-Testi, Lineer Regresyon ve Spearman Korelasyon Analizi kullanıldı. Bulgular: Hemşirelerin puan ortalamasının, hastaların puan ortalamasından istatistiksel olarak anlamlı düzeyde düşük olduğu (t=9.136, p<0.001); hasta yakını ile hastanın verdikleri puanlar arasında istatistiksel olarak anlamlı bir fark olmadığı saptandı. Regresyon analizinde; hasta yakınlarının, hastanın verdiği ağrı puanının yaklaşık %40'ını verirken, hemşirelerin %60 kadarını tahmin edebildiği saptandı. Sonuç: Hemşirelerin; ağrının hastadaki fiziksel ve emosyonel yansımalarını yorumlayabilmeleri için, ağrının fizyolojisi hakkın-da bilgilendirilmelerinin yanı sıra empatik becerilerinin geliştirilmesine yönelik eğitimlerin planlanması gereklidir. Bununla birlikte hastayla çokça vakit geçiren hasta yakınının da; cerrahi girişim sonrası hastanın gösterebileceği ağrı davranışları konusunda bilgilendirilmesi önerilmektedir.Anahtar sözcükler: Hemşire; ortopedik cerrahi; ağrı şiddeti; ağrı algısı; hasta yakını. SummaryObjectives: This descriptive study investigated pain levels of orthopedic surgery patients, and how this pain is perceived by their relatives and nurses. Methods: The study was carried out with 150 patients, 150 relatives and 50 nurses to determine pain intensity levels of orthopedic surgery patients and perceptions of this among their relatives and nurses. Intensity of pain was measured on a 0 to 10 visual analogue scale. Relatives and nurses were not allowed to see the patient's pain intensity score, and each nurse was allowed to participate in pain measurement three times. The data were analyzed by descriptive statistics, the Mann Whitney-U test, Paired Sample t-Test, Linear Regression and Spearman Correlation Analysis. results: The pain intensity scores given by nurses (t=9.136, p<0.001) were significantly lower than patients' own scores. There was no significant difference between relatives' and patients' pain scores. In the regression analysis, pain intensity scores given by relatives were approximately 40% lower than those given by patients, while nurses' scores were approximately 60% lower. conclusion: Education on pain management and the physical and emotional reactions of patients to pain should be provided for nurses working in surgical clinics. Meanwhile, as those who spend most time with the patient, relatives should be informed about possible pain behaviors in the postoperative period in order to prepare them for the...

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Postoperative pain management – the influence of surgical ward nurses

Abstract: The study shows a need for more accurate pain assessment, since the patient experiences and suffers pain and the nurse determines upon treatment.

Cited by 59 publications

References 47 publications

Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Smertebehandling av rusmisbrukere innlagt i sykehus

Pain Levels of Orthopedic Surgery Patients and Pain Perceptions of Their Relatives and Nurses

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