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Methods:A descriptive, cross-sectional study was conducted in a medical center in northern Taiwan. Patients aged over 65 years and hospitalized in the surgical wards were eligible for inclusion. Convenience sampling method was adopted and 164 patients were enrolled. The data collection included patient basic information, clinical characterisitcs, treatments, the Brief Pain Inventory (Taiwan version), Pain Opioid Analgesics Belief Scale, Short Portable Mental Status Questionnaire (SPMSQ), and the dosage of analgesics. Data were assessed through descriptive analyses, independent-sample t-tests, one-way ANOVA, and Pearson correlations.
Results:There was about the same number of males and females included in our study with the mean age 73.08 years old. The patients had average three chronic illnesses. Most of patients were with primary level of education. The self-recognized disease severity was most frequently assessed to be moderate. The most common modality used for postoperative pain control was morphine PCA (86%). The severity of postoperative pain was reported to be mild to moderate during the postoperative 1-3 day, and declined gradually thereafter. The average pain opioid analgesics belief scale score was 21.31, which revealed a belief about the negative effect of analgesics. Self-recognized disease severity and the surgical site were the major predictive factors of postoperative pain. More severe postoperative pain was reported in the patients who were aware of higher severity (beta= .23, p＜ .01), whereas less pain was noted in the patients receiving lower gastro-intestinal surgery (beta= - .25, p ＜.01). Besides, males received higher dosage of analgesics than females during 8 to 16 hours after surgery, was also a crucial associated factor of postoperative pain (beta= .29, p＜ .01).
Conclusion:This study suggests that in order to optimize the management of postoperative pain for the elderly patients who receive abdominal surgery, the following factors such as the self-recognized disease severity of postoperative disease severity, surgery site, gender etc. should be assessed comprehensively. An appropriate pain control plan can be done accordingly. A pain-free postoperative care is not only for the right of human being, but also beneficial for the quality of care and patient recovery.