The association of patients' daily summarized self‐rated “real‐time” pain scores with physical recovery after major surgery – A repeated measurement design

Wikström, Lotta; Nilsson, Mats; Eriksson, Kerstin

doi:10.1002/nop2.392

Cited by 7 publications

(3 citation statements)

References 44 publications

(60 reference statements)

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“…Our study demonstrated that inadequate pain control occurred in 39.49% of the patients after abdominal surgery, which is less than other studies. Wikström et al (2020) revealed that 82% of patients reported ≥4 NRS scores at rest on post-operative day one. Zhang et al (2023) reported that moderate to severe pain was experienced by 58.7% of patients within 24 h following surgery.…”

Section: Status Of Post-operative Inadequate Pain Control In Patients...mentioning

confidence: 99%

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Wang,

Qin,

Zhen

et al. 2024

Journal of Clinical Nursing

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AimsTo develop a nomogram to provide a screening tool for recognising patients at risk of post‐operative pain undergoing abdominal operations.BackgroundRisk prediction models for acute post‐operative pain can allow initiating prevention strategies, which are valuable for post‐operative pain management and recovery. Despite the increasing number of studies on risk factors, there were inconsistent findings across different studies. In addition, few studies have comprehensively explored predictors of post‐operative acute pain and built prediction models.DesignA prospective observational study.MethodsA total of 352 patients undergoing abdominal operations from June 2022 to December 2022 participated in this investigation. A nomogram was developed for predicting the probability of acute pain after abdominal surgery according to the results of binary logistic regression. The nomogram's predictive performance was assessed by discrimination and calibration. Internal validation was performed via Bootstrap with 1000 re‐samplings.ResultsA total of 139 patients experienced acute post‐operative pain following abdominal surgery, with an incidence of 39.49%. Age <60, marital status (unmarried, divorced, or widowed), consumption of intraoperative remifentanil >2 mg, indwelling of drainage tubes, poor quality sleep, high pain catastrophizing, low pain self‐efficacy, and PCIA not used were predictors of inadequate pain control in patients after abdominal surgery. Using these variables, we developed a nomogram model. All tested indicators showed that the model has reliable discrimination and calibration.ConclusionsThis study established an online dynamic predictive model that can offer an individualised risk assessment of acute pain after abdominal surgery. Our model had good differentiation and calibration and was verified internally as a useful tool for risk assessment.Relevance to Clinical PracticeThe constructed nomogram model could be a practical tool for predicting the risk of experiencing acute post‐operative pain in patients undergoing abdominal operations, which would be helpful to realise personalised management and prevention strategies for post‐operative pain.Reporting MethodThe Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.Patient or Public ContributionBefore the surgery, research group members visited the patients who met the inclusion criteria and explained the purpose and scope of the study to them. After informed consent, they completed the questionnaire. The patients' pain scores (VAS) were regularly assessed and documented by the bedside nurse for the first 3 days following surgery. Other information was obtained from medical records.

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Section: Status Of Post-operative Inadequate Pain Control In Patients...mentioning

confidence: 99%

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Wang,

Qin,

Zhen

et al. 2024

Journal of Clinical Nursing

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“…Orthopaedic surgery is commonly known to be very painful (Gerbershagen et al., 2014). Poorly controlled postoperative pain has a negative impact on the patient's well‐being and can impede early mobilization, which delays recovery and increases the risk of complications (Dagyaran et al., 2022; Lo et al., 2021; Wikstrom et al., 2020). Opioid analgesics are highly effective in treating moderate to severe pain in the early postoperative phase (Hegmann et al., 2014).…”

Section: Introductionmentioning

confidence: 99%

Long‐term postoperative opioid use in orthopaedic patients

Melis,

Vriezekolk,

van der Laan

et al. 2023

European Journal of Pain

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BackgroundThe prevalence of long‐term opioid use after orthopaedic surgery varies from 1.4% to 24% and has mostly been studied with prescription data, making it difficult to estimate the size and impact of the problem. This study aims to assess the prevalence and predictors of long‐term postoperative opioid use in a high volume and tertiary orthopaedic centre by using online patient reported measures.MethodsThis Dutch prospective cohort study was conducted among adult patients who underwent any type of orthopaedic surgery from June to August 2021. Six months after surgery patients were invited to complete an online survey on current opioid use and patients' willingness to taper opioids. The demographics, clinical factors and preoperative opioid use were extracted from the patient file.ResultsIn total, 607 patients (mean age 61.2 years, 63.4% female) completed the survey. Seventy‐six patients (12.5%) used opioids 6 months after surgery of which 20 (3.3%) did not use opioids before surgery. The median (Q1–Q3) postoperative daily dose after 6 months was 29.9 mg (10.0–76.1) morphine equivalents. Most of them (88.2%) wanted to taper opioids. Affected body region (OR's: 6.84–12.75) and pre‐operative opioid use (OR = 35.33) were significant predictors of long‐term opioid use.ConclusionThe prevalence of long‐term postoperative opioid use was 12.5%; one in thirty patients became a new long‐term opioid user. Pre‐operative opioid use and affected body region were predictive for long‐term opioid use. These findings, together with the observation that long‐term opioid users want to taper opioids, emphasize the relevance of prevention, recognition and tapering support in the perioperative setting.Level of EvidenceLevel II.SignificanceShort‐term opioid use can unintentionally progress to long‐term opioid use. The prevalence of long‐term opioid use after orthopaedic surgery varies widely and is mostly prescription‐based, making it difficult to estimate the magnitude of the problem. This study assessed long‐term postoperative opioid use in a full breadth orthopaedic population using patient reported measures, making conclusions much more robust. The prevalence of long‐term postoperative opioid use in this study was 12.5%.

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“…One PROM that has increased in use within nursing research during recent years is the postoperative recovery profle (PRP) by Allvin et al [11]. Te instrument has been used for patients recovering from general and orthopedic surgery [12][13][14][15], heart and lung transplantation [16,17], upper abdominal cancer surgery [18], gastric bypass [19], colorectal cancer surgery [20][21][22], trauma [23], and coronary artery bypass grafting [24]. Te PRP was developed in Sweden, but the instrument has also been translated and used in the United States [25].…”

Section: Introductionmentioning

confidence: 99%

Psychometric Evaluation of the Postoperative Recovery Profile

Jakobsson

2023

Nursing Research and Practice

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Aim. To further evaluate the postoperative recovery profile regarding its psychometric properties. Background. The postoperative recovery profile is an instrument for the self-assessment of general postoperative recovery that has received increased attention within nursing research. However, psychometric evaluation during development was sparse. Design. Psychometric evaluation was done using classical test theory. Method. Data quality, targeting, reliability, and scaling assumptions were measured. In addition, confirmatory factor analysis was used to evaluate construct validity. Data collection was made during 2011–2013. Result. Data derived from this study showed acceptable quality; however, item distribution was skewed, with ceiling effects in the majority of items. Cronbach’s alpha showed high internal consistency. Item-total correlations indicated unidimensionality, whereas six items demonstrated high correlations pointing at redundancy. The confirmatory factor analysis confirmed problems related to dimensionality as the five proposed dimensions were highly correlated with each other. Furthermore, items were largely uncorrelated with the designated dimensions. Conclusion. This study shows that the postoperative recovery profile needs to be further developed to serve as a robust instrument within nursing as well as medical research. Arguably, values from the instrument should not be calculated at a dimensional level for the time being because of discriminant validity issues.

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The association of patients' daily summarized self‐rated “real‐time” pain scores with physical recovery after major surgery – A repeated measurement design

Cited by 7 publications

References 44 publications

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Long‐term postoperative opioid use in orthopaedic patients

Psychometric Evaluation of the Postoperative Recovery Profile

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