Monday, November 3, 2003

This presentation is part of : Pain Management

Assisting Older Adults to Communicate Their Pain After Surgery

Deborah Dillon McDonald, RN, PhD1, Glenda Thomas, APRN, ONC2, Karen Livingston, ONP, MS3, and Judith Severson, RN, BS1. (1) School of Nursing, University of Connecticut, Storrs, CT, USA, (2) Nursing, Saint Francis Hospital and Medical Center, Hartford, CT, USA, (3) Orthopedics, University of Connecticut Health Center, Farmington, CT, USA
Learning Objective #1: Identify communication skills that patients might use to communicate their pain
Learning Objective #2: Describe the effect on pain outcomes of a preoperative intervention teaching elders how to communicate their postoperative pain

Objective: To assess the pain relief effect of an intervention assisting elders' to communicate their pain.

Sample, Design & Setting: A posttest-only two-group experiment was used with repeated measures on postoperative day one and two, and one and seven days after hospital discharge. Forty preoperative elders were randomly assigned to either a control group where elders watched a 10-minute videotape on managing postoperative pain or a treatment group where elders watched a 15-minute videotape on managing postoperative pain and communicating pain management needs.

Methods: A research assistant measured elders' pain using the Brief Pain Inventory. Measures included pain intensity; pain interference with walking, mood and sleep; and pain relief.

Findings: Both groups reported moderate pain intensity during postoperative day one and two. Treatment group elders reported less pain interference with sleep postoperative day one, M = 3.6 (SD = 2.64) compared to control group elders M = 6.4 (SD = 3.46), F(1,38) = 8.39, p < .006, Eta2 = .18. Treatment group elders reported greater pain relief with treatments on postoperative day one, M = 61.2% (SD = 20.24%) compared to control group elders, M = 50.0% (SD = 22.55%), but control group elders reported an improvement in their pain relief on postoperative day two, M = 65.3% (SD = 16.45%) while treatment group elders reported pain relief similar to the previous day, M = 56.2% (SD = 21.38%), F(1,38) = 5.28, p < .027, Eta2 = .12.

Conclusion: The pain communication intervention had modest, but significant effects on reducing pain interference with sleep during the early postoperative period.

Implications: More effective pain relief might be achieved by educating both patients and providers about pain management and pain communication.

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