Public perceptions of postoperative pain and its relief

Abstract

SummaryIn order to evaluate the general public's knowledge of postoperative pain and its management, a simple questionnaire was devised and sent out to five general practices in Scotland and Yorkshire. Questionnaires were completed voluntarily by 529 people attending their general practitioner for reasons not related to surgery. Five hundred and fifteen completed questionnaires were analysed. Two hundred and thirty-nine (46.4%) responders had undergone previous major surgery whereas 267 (51.8%) had not. Attitudes to pain varied greatly and confirm the findings of other surveys that amongst the general public there is little or no understanding of the nature of postoperative pain or of the methods available to treat it. Despite the published literature, the public have a high degree of confidence in the ability of doctors and nurses to treat such pain. Widespread public and professional education is required before further improvements can be made to such a universal and basic clinical problem. Pain following surgery is a universal and potentially dangerous problem which until the last decade received little attention from the medical profession. The publication in 1990 of the report of the working party of the Royal Colleges of Surgeons and Anaesthetists has led to some organisational improvements in the provision of pain relief after surgery [1] and, to meet the report recommendations, many hospitals have established pain teams which can achieve significant reductions in pain scores [2]. However, other surveys have highlighted the lack of improvement in some hospitals in staff attitudes to pain and the poor knowledge amongst patients in hospital awaiting surgery [3][4][5][6]. No data are available regarding the perceptions and knowledge that the general public have of postoperative pain or on the importance it places in the topic. This was the purpose of the study. MethodsA simple questionnaire was designed to assess the knowledge and attitudes of the general public towards postoperative pain and the methods currently available for its treatment. An initial 30 questionnaires were sent out to nonclinical staff and to hotel staff within the HCI hospital complex to determine the ease with which the questions were understood and completed. Following this, questionnaires were sent to four general practices in Scotland (two in Aberdeen, one in Edinburgh, one in Dumfries) and one practice in Keighley, Yorkshire. Over a 6-month period, patients attending the general practices for reasons unrelated to surgery were invited to complete the questionnaires voluntarily. It was not necessary for patients to have undergone previous surgery. If blanks were left, the answers were counted as a 'don't know' or in the case of questions on sex or age 'not answered'. The differences in responses between males and females, different age groups and previous surgery and no surgery groups were examined using the Chi-squared test. A probability of less than 0.05 was taken to be significant. ResultsFive hundred and twenty-nine questionnair...

Evaluation of Quality in Patient-Controlled Analgesia Provided by an Acute Pain Service

“…Similar to previous studies, our results indicate that patients having moderate to severe pain are satisfied with the management [3,6,[11][12][13]. Even patients saying they never had good pain relief were 83% satisfied (or very satisfied).…”

“…Interestingly, high satisfaction scores are reported regardless of pain intensities in a small number of studies performed on quality assessment of postoperative pain therapy. The fact that undertreatment of acute postoperative pain has been a source of fear of patients may partially explain the high incidence of satisfaction in these studies [1,5,8,12]. Besides, the immediate accessibility of analgesic agents, the more uniform level of analgesia inherent with PCA and the ability to titrate analgesia have been proposed as other possible explanations for the enhanced satisfaction associated with this technique.…”

“…Patient satisfaction is defined as a personal evaluation of the health service and it does not reflect what really happened but rather patients' subjective evaluation of their satisfaction with what happened [9,12]. With this definition, it is reasonable to anticipate lower pain intensities to correlate with higher satisfaction scores, and among other factors which influence satisfaction pain intensity seems to have a primary role [9].…”

Patient satisfaction following day surgery

“…Postoperative pain intensity was a decisive factor in patient satisfaction following day surgery in several studies [5,9,11,13,[23][24][25]. Both at discharge and 30 days after surgery, patients with lower postoperative pain scores were also the ones who reported higher satisfaction levels.…”

Interference of Postoperative Pain on Women's Daily Life after Early Discharge from Cardiac Surgery

“…A British study of the impact of postoperative pain on women's experience and recovery following major gynecological surgery reported that patients have low expectations and inadequate coping strategies and knowledge of pain after discharge from hospital (Carr, 2001). Research exploring expectations of postoperative pain and its relief indicate that most people have little or no understanding of the nature of postoperative pain or of the methods available to treat it by themselves (Scott & Hodson, 1997). In our study, the women were advised by the hospital to take analgesics both regularly and PRN upon returning home.…”