Abstract
Purpose
This qualitative analysis of interviews with surgical patients who received a brief
perioperative psychological intervention, in conjunction with standard medical perioperative
care, elucidates patient perspectives on the use of pain self-management skills in
relation to postoperative analgesics.
Design
This study is a secondary analysis of qualitative data from a randomized controlled
trial.
Methods
Participants (N = 21) were rural-dwelling United States Military Veterans from a mixed
surgical sample who were randomized to receive a manual-based, telephone-based Perioperative
Pain Self-management intervention consisting of a total of four pre- and postoperative
contacts. Semi-structured qualitative interviews elicited participant feedback on
the cognitive-behavioral intervention. Data was analyzed by two qualitative experts
using MAXQDA software. Key word analyses focused on mention of analgesics in interviews.
Findings
Interviews revealed a dominant theme of ambivalence towards postoperative use of opioids.
An additional theme concerned the varied ways acquiring pain self-management skills
impacted postoperative opioid (and non-opioid analgesic) consumption. Participants
reported that employment of pain self-management strategies reduced reliance on pharmacology
for pain relief, prolonged the time between doses, took the “edge off” pain, and increased
pain management self-efficacy.
Conclusions
Perioperative patient education may benefit from inclusion of teaching non-pharmacologic
pain self-management skills and collaborative planning with patients regarding how
to use these skills in conjunction with opioid and non-opioid analgesics. Perianesthesia
nurses may be in a critical position to provide interdisciplinary postoperative patient
education that may optimize postoperative pain management while minimizing risks associated
with prolonged opioid use.
Keywords
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Article info
Publication history
Published online: January 10, 2023
Publication stage
In Press Corrected ProofFootnotes
Conflict of Interest: None to report.
Funding: The Veterans Health Administration VA Office of Rural Health, Veterans Rural Health Resource Center- Iowa City (Award # 10712). Visit www.ruralhealth.va.gov to learn more. Funding was also provided by the VA Health Services Research and Development's (HSR&D) Small aWard Initiative For impacT (SWIFT) pilot program. The work reported here was also supported by the US Department of Veterans Affairs Health Services Research and Development (HSR&D) Service through the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center (CIN 13-412).
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the US Department of Veterans Affairs, or the United States Government.
Data Availablity Statement: Telephone Cognitive Behavioral Therapy for Veterans Undergoing Surgery.
ClinicalTrials.gov Identifier: NCT03351309. Link: https://clinicaltrials.gov/ct2/show/NCT03351309.
Identification
Copyright
Published by Elsevier Inc. on behalf of American Society of PeriAnesthesia Nurses.
