Title: Realities of post-operative pain management in Ghana: Evidence from method and participant triangulation
Introduction: Post-operative pain has been a problem over the years for many countries including Ghana. Thus patients continue to experience moderate to severe post-operative pain.
Aim: The study aimed to understand the factors that contribute to ineffective post-operative pain management at two hospitals in Accra, Ghana.
Method: A focused ethnography was employed using multiple data collection methods such as individual interviews, observation, and documentary review. The participants included patients (13), nurses (11), surgeons (3), pharmacists (1), and anaesthetists (1). Sixteen participant observations with partial immersion were conducted and 44 nurses’ documentation of care was reviewed. Purposive sampling was used to recruit participants and the sample size was determined by data saturation. Content analysis was used to analyse the data generated and the NVivo 9 software was used to manage the data.
Findings: It was realized that multiple factors contributed to ineffective post-operative pain management. These factors were related to the individual, the health system and national policies. The individual factors included socio-cultural, psychological, and inadequate knowledge. Health system factors were negative attitude, poor supervision and team work. National factors included lack of policies and unavailability of opioids.
Conclusion: The study concluded that a multidisciplinary and multi-sectorial approach is required to enhance post-operative pain management in a resource-limited clinical context such as Ghana. The need for a context appropriate clinical guideline was highlighted.