Postoperative Patients in Jordan: Pain Prevalence, Characteristics, Beliefs, and Satisfaction

doi:10.1016/j.pmn.2018.12.004

Pain Management Nursing

Volume 20, Issue 3, June 2019, Pages 239-244

https://doi.org/10.1016/j.pmn.2018.12.004 Get rights and content

Abstract

Background

Unrelieved postoperative pain contributes to soaring medical costs and poor quality of life. Whilst much has been written about postoperative pain prevalence in the literature, few empirical studies have explored pain care in Middle Eastern countries.

Aims

This study aimed to determine pain prevalence, its characteristics, beliefs and satisfaction among postoperative patients in Jordan.

Design

This is a descriptive survey design.

Settings

This study was conducted in a 200-bed Jordanian public hospital located in the southern province of Jordan.

Participants

A convenient sample of 143 surgical patients was selected.

Methods

Data were collected by the American Pain Society Patient Outcomes questionnaire, Brief Pain Inventory scale and beliefs towards pain scale. Data were analyzed using SPSS version 21.

Results

Pain prevalence following surgery during the first 24 hours was 87%. The overall Mean of satisfaction of all participants was moderate (66.6%). The analysis found that the greatest interference of pain was with activity (Mean ± SD = 6.27 ± 3.30). The belief “people get addicted to pain medicine easily” was the most common misunderstanding (Mean ± SD = 3.48 ± 1.71). Male participants had worse average pain experience but were more satisfied with pain management than females (ps = .012, .017, respectively). Participants aged 30 or more had better pain management experience and satisfaction than those aged under 30 (p = .021).

Conclusions

The study revealed high pain prevalence among surgical patients that remains undertreated. If patients’ postoperative environment is to be a “Pain Free Zone”, nurses’ training programs and the application of various screening tools in the postoperative context taking into account the role of gender and culture are urgently needed.

Section snippets

Design and Sample

This study was part of a 3-year funded project focusing on the pain management from the perspective of hospital patients and nurses using triangulation methodology. Although the qualitative data were published elsewhere (Shoqirat, 2014, Shoqirat, 2015), in this article a descriptive survey design was used to identify the prevalence, satisfaction, and beliefs regarding pain management among postoperative patients in Jordan. A convenient sample of 143 surgical patients was used. Inclusion

Participant Characteristics

A total of 150 questionnaires were distributed over a three-month period, and 143 questionnaires were returned (a response rate of 95%). The majority of participants were female (n = 82, 57.3%). Slightly more than half were aged ≥30 years (51%, n = 73). The majority were educated to the highest secondary school certificate (Tawjihi) (n = 111, 78%), and only 32 participants (22%) were educated to the bachelor's degree level.

Pain Characteristics and Satisfaction

The analysis revealed that pain was prevalent among surgical patients.

Discussion

This study aimed to determine pain prevalence, characteristics, beliefs, and satisfaction among postoperative patients in Jordan. The results revealed that pain was prevalent among 87% (n = 125) of all surgical patients (n = 143). The mean score of worst pain over the last 24 hours was 6.18 (SD = 3.41) out of 10. It is alarming that the pain prevalence in this study was the highest (87%) compared with many earlier cultural studies where pain prevalence was found to vary from 14% to 84.17% (

Conclusions

This study offers valuable insights into the world of surgical patient satisfaction and beliefs relating to pain and its prevalence and management. Although effective postoperative pain management is vital for the provision of humane patient care, this was not the case in this study, where the prevalence of pain among surgical patients was high. What was surprising in this study was the satisfaction with pain management received by postoperative patients despite the prevalence of pain and its

Acknowledgments

The authors are grateful to all participants who took part in this study. The project was funded by Abdul Hameed Shoman Foundation. The funder was not involved in the conduct of the study or development of the submission. The authors declare no conflicts of interest.

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Postoperative pain management has always been a significant challenge for both hospital staff and surgical patients. Determination of pain management outcomes among surgically treated patients may help develop pain management strategies, improve health services that would yield better outcomes, and increase patient satisfaction. This study aimed to assess the outcomes of pain management among postoperative patients.
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This study showed that the overall mean for pain severity and the worst pain experienced by patients after 24 hours was slightly higher than medium. Examination of interference of the pain with functions demonstrated that patients experienced problems with physical activities and sleeping. The most experienced side effects were nausea and drowsiness, and the most common emotions were anxiety and helplessness during the postsurgery period. The satisfaction rate of the patients with postoperative pain management was relatively high.
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In the first 24 h after surgery, it is necessary to evaluate the patient responses to pain, analgesia and patient satisfaction to prevent complications related to the pain management process.
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The study sample was comprised of 700 patients, who were surgically treated at the surgical clinics of a university hospital and completed the first postoperative 24 h. The data was collected through the “Patient Information Form” and the “Turkish version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)”.
The medians of the lowest and the worst postoperative pain severity level were 3.0 and 7.0, respectively. Patients experienced severe pain in 60 % of the first postoperative 24 h and reported that 70 % of their pain eventually decreased. A positive and significant correlation was found between pain interference, pain-affected mood/emotions, the severity of pain-related side effects, the least and worst pain severity levels and severe pain, and the percentage of time experienced with severe pain.
Most of the patients experienced severe pain, which restricted their daily life activities and led to negative emotions. Acute postoperative pain may negatively affect patient outcomes and delay postoperative recovery during the early period. Therefore, pain should be managed in the early period to prevent physical and psychological side effects.
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Inclusion criteria in the study were being over the age 18 and completing the 24th hour after surgery. A questionnaire prepared by the researchers according to the literature was used in the study.20-24 The questionnaire consisted of two parts.
This study was conducted to determine the prevalence and severity of postoperative pain in the first 24 hours after surgery and to emphasize the importance of postoperative pain assessment.
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This study was carried out on May 21, 2019 with 898 patients who had completed the postoperative 24th hour in the surgical clinics of 10 training and research hospitals in Istanbul, the capital of Turkey. Point prevalence was used in the study. Data were collected using a questionnaire developed by the researchers and the Revised American Pain Society Patient Outcome Questionnaire. Descriptive statistics were presented as frequency, percentage, mean, and standard deviation. Nonparametric tests were used for data without normal distribution (Kolmogorov-Smirnov Test, P < .05). Two-group comparisons were performed using the Mann-Whitney U test. The Kruskal Wallis-H test was used for the comparison of three or more groups. Statistical significance was set as P < .05.
The three main types of surgery were general surgery with 31.8%, gynecologic surgery with 12.9%, and orthopedic surgery with 12.7%. The mean lowest level of pain felt by the patients included in the study in the first 24 hours was 3.90 ± 2.94, and the mean highest level of pain was 6.38 ± 4.45.
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Satisfaction with pain management was high in the study, nonetheless, 27.8% of patients experienced more postoperative pain than they expected. In other studies, in the literature with different patient groups, patients’ high level of satisfaction with nursing care despite high pain scores is congruent with the findings of our study.37,38 Further research is suggested on the subject to investigate the driving force behind satisfaction with pain management despite the severity of it.
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Original ArticlePostoperative Patients in Jordan: Pain Prevalence, Characteristics, Beliefs, and Satisfaction

Abstract

Background

Aims

Design

Settings

Participants

Methods

Results

Conclusions

Section snippets

Design and Sample

Participant Characteristics

Pain Characteristics and Satisfaction

Discussion

Conclusions

Acknowledgments

Burns

Journal of Emergency Nursing

Pain

The Journal of Pain

Journal of Pain and Symptom Management

Pain Management Nursing

Pain Management Nursing

The Journal of Pain

Pain

Patient satisfaction survey as a tool towards quality improvement

Oman Medical Journal

Nurses' knowledge and attitudes regarding pain assessment and intervention

Medsurg Nursing

Gender role affects experimental pain responses: a systematic review with meta-analysis

European Journal of Pain

Saudi Arabian nurses’ knowledge and attitudes regarding pain management: survey results using the KASRP

International Journal of Health Sciences and Research

Pain assessment intensity and pain relief in patients post-operative orthopedic surgery

Escola Anna Nery

Pain management barriers in Jordanian critical care units

International Journal of Advanced Nursing Studies

Pain barriers: psychometrics of a 13-item questionnaire

Nursing Research

Pain-related knowledge and barriers among Jordanian nurses: a national study

Health

Are we controlling postoperative pain?

Colombian Journal of Anesthesiology/Revista Colombiana de Anestesiología

Barriers to pain management: Focus on opioid therapy

Clinical Drug Investigation

Cultural Competence in Pain and Palliative Care

Effective pain management and improvements in patients’ outcomes and satisfaction

Critical Care Nurse

American Pain Society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force

Archives of Internal Medicine

The prevalence and characteristics of pain in critically ill cancer patients: a prospective nonrandomized observational study

Indian Journal of Palliative Care

Does pain severity guide selection to multimodal pain rehabilitation across gender?

European Journal of Pain

A study of knowledge and attitudes of registered nurses towards pain management in an urban hospital

La Clinica Terapeutica

Opioids and older adults: An article review

Indian Journal of Gerontology

Managing pain medications in long-term care: nurses' views

British Journal of Nursing

Original Article
Postoperative Patients in Jordan: Pain Prevalence, Characteristics, Beliefs, and Satisfaction