Postoperative pain experience and barriers to pain management in Chinese adult patients undergoing thoracic surgery

Yin, Hai Hui; Tse, Mun Yee Mimi; Wong, Frances Kam Yuet

doi:10.1111/j.1365-2702.2011.03886.x

Cited by 16 publications

(16 citation statements)

References 56 publications

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“…Their main concern seemed to be the harmful effects of pain medication in relation to surgery. In another study on pain experience and barriers to pain management, for Chinese patients undergoing thoracic surgery, even higher total barrier scores were reported, with the main concerns being pain medication tolerance, inhibition of wound healing, time intervals, and distraction [23]. The positive results from the current study indicate that our serious game can indeed be developed further to support more advanced health-related outcomes and address in more detail the misconceptions and attitudes that may hinder optimal pain management.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients do not always follow the instructions they receive about pain management, and many avoid taking pain medications despite being in severe pain [21]. Patient-related barriers to effective pain management, such as their reluctance to report pain and use available analgesics, are well known, both within the population of patients with cancer [22] and patients undergoing surgery [23]. Improved patient education is vital to improve pain management and address such barriers, but providing patients with information alone is not sufficient [21,24,25].…”

Section: Introductionmentioning

confidence: 99%

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Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study

Ingadóttir¹,

Blöndal²,

Thue³

et al. 2017

JMIR Serious Games

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BackgroundPostoperative pain is a persistent problem after surgery and can delay recovery and develop into chronic pain. Better patient education has been proposed to improve pain management of patients. Serious games have not been previously developed to help patients to learn how to manage their postoperative pain.ObjectiveThe aim of this study was to describe the development of a computer-based game for surgical patients to learn about postoperative pain management and to evaluate the usability, user experience, and efficacy of the game.MethodsA computer game was developed by an interdisciplinary team following a structured approach. The usability, user experience, and efficacy of the game were evaluated using self-reported questionnaires (AttrakDiff2, Postoperative Pain Management Game Survey, Patient Knowledge About Postoperative Pain Management questionnaire), semi-structured interviews, and direct observation in one session with 20 participants recruited from the general public via Facebook (mean age 48 [SD 14]; 11 women). Adjusted Barriers Questionnaire II and 3 questions on health literacy were used to collect background information.ResultsTheories of self-care and adult learning, evidence for the educational needs of patients about pain management, and principles of gamification were used to develop the computer game. Ease of use and usefulness received a median score between 2.00 (IQR 1.00) and 5.00 (IQR 2.00) (possible scores 0-5; IQR, interquartile range), and ease of use was further confirmed by observation. Participants expressed satisfaction with this novel method of learning, despite some technological challenges. The attributes of the game, measured with AttrakDiff2, received a median score above 0 in all dimensions; highest for attraction (median 1.43, IQR 0.93) followed by pragmatic quality (median 1.31, IQR 1.04), hedonic quality interaction (median 1.00, IQR 1.04), and hedonic quality stimulation (median 0.57, IQR 0.68). Knowledge of pain medication and pain management strategies improved after playing the game (P=.001).ConclusionsA computer game can be an efficient method of learning about pain management; it has the potential to improve knowledge and is appreciated by users. To assess the game’s usability and efficacy in the context of preparation for surgery, an evaluation with a larger sample, including surgical patients and older people, is required.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study

Ingadóttir¹,

Blöndal²,

Thue³

et al. 2017

JMIR Serious Games

View full text Add to dashboard Cite

show abstract

“…Despite advocacy in the international literature regarding aggressive pain management protocols to prevent CPSP (Ballantyne et al., ; Macrae, ; Perkins & Kehlet, ; Visser, ), inadequate pain management after surgery is a global problem for health professionals (Chou et al., ). Due to cultural influences in China, patients, nurses and physicians tend towards more conservative pain management approaches even when patients are in severe pain (Liu, Luo, & Liu, ; Shen, Sherwood, McNeill, & Li, ; Yin, Tse, & Wong, ). In a cross‐sectional study ( n = 97), Yin et al.…”

Section: Introductionmentioning

confidence: 99%

Postoperative pain experiences in Chinese adult patients after thoracotomy and video‐assisted thoracic surgery

Wang

Liang

et al. 2017

Journal of Clinical Nursing

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Aims and objectives:To investigate the developing course of postoperative pain in a Chinese sample of patients following thoracic surgery.Background: Chronic postoperative pain following thoracic surgery including both thoracotomy and video-assisted thoracic surgery is often reported. However, research on pain trends concerning this topic is scarce with a notable lack of culturally focused studies by nurses.Design: A prospective observational study. Methods:The sample included patients undergoing thoracotomy (n = 137) and video-assisted thoracic surgery (n = 143). Pain intensity and interference of pain with function were assessed during hospitalisation (day 1 to day 7 postoperatively) and followed up by telephone at 2 weeks and then at 1, 2, 3 and 6 months after surgery.Results: Moderate-to-severe pain when coughing and moving was reported in over 85% during hospitalisation, and a significant difference in pain was found between those undergoing a thoracotomy (61%) and those having video-assisted surgery (34%). Many patients whose immediate postoperative pain was poorly managed tended to report high pain levels after discharge and continued to have clinically important chronic pain 6 months after surgery. The pain intensity mean score during movement in the first five postoperative days was an important predictor of clinically important chronic pain, and those experiencing severe acute pain during hospitalisation had a higher probability of developing chronic pain.Conclusions: Postoperative pain after thoracic surgery warrants greater attention because those experiencing severe acute pain during hospitalisation have a higher probability of developing chronic pain. Aggressive pain management and multimodal analgesia are recommended to prevent long-term suffering in patients. Relevance to clinical practice: Chronic pain after thoracic surgery remains a challenge in clinical nursing. To improve pain management quality and to prevent the transition of acute postoperative pain to chronic pain, standardised practice protocols and comprehensive physician and nurse education are highly recommended. K E Y W O R D S chronic postsurgical pain, thoracic surgery, thoracotomy, time course, video-assisted thoracotomy

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“…We used the BPI to assess pain intensity and the extent to which that pain interferes with daily activities. It is a widely used pain assessment tool that has been translated into Chinese and validated in the Chinese population 29,30 . In the original Chinese version, Cronbach's α values for the internal reliability for pain severity and pain interference items were 0.81 and 0.89, respectively.…”

Section: Methodsmentioning

confidence: 99%

Postoperative Pain Self‐Management Behavior in Patients Who Underwent Total Knee or Hip Arthroplasty

Zhu¹,

Pei-pei²,

Lei³

et al. 2017

AORN Journal

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The self-management of acute postoperative pain is not well researched. This cross-sectional study investigates postoperative pain and pain self-management behavior. We recruited 127 patients who underwent total knee or total hip arthroplasty in an acute care hospital. We measured postoperative pain intensity and pain self-management behavior for three postoperative days. The results showed that the participants experienced mild and moderate pain intensity and perceived moderate to severe pain interference, which influenced their mood, sleep patterns, ability to walk, and performance of general activities and rehabilitation exercises. Female participants reported significantly higher pain intensity and lower pain self-management behavior; highly educated participants reported significantly lower pain intensity and higher self-management behavior. Pain intensity scores had a significant negative correlation with the total self-management behavior score (r = -0.719, P < .01). Health care professionals must consider patients' demographic characteristics when providing education and support regarding pain self-management for postoperative pain control.

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Postoperative pain experience and barriers to pain management in Chinese adult patients undergoing thoracic surgery

Abstract: Education approach for patients is inadequate to improve the status of unrelieved postoperative pain. Appropriate pain management regime together with attentive nursing care should be provided to achieve better pain relief for Chinese patients.

Cited by 16 publications

References 56 publications

Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study

Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study

Postoperative pain experiences in Chinese adult patients after thoracotomy and video‐assisted thoracic surgery

Postoperative Pain Self‐Management Behavior in Patients Who Underwent Total Knee or Hip Arthroplasty

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