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Perceptions of health professionals for postoperative pain
Agron Bytyqi, BSc, Ma, Teacher of Nursing at R.H. Prizren
Acute pain is a significant problem in the postoperative
setting. Patients report a lack of information about
pain-control measures and ineffective pain control. Health
professionals continue to rely on
pharmacologic measures and tend to under-administer analgesics.
Postoperative pain encompasses a
complex phenomenon that involves physical, psychologic, social,
cultural, and environmental factors thatinterconnect and affect how
the pain is perceived, managed, and evaluated (IASP, 2003). Pain is
a
personal experience for patients and health professionals and is
influenced by the context in which it
occurs. After surgery, pain is a common experience for patients
in the surgical ward due to tissues trauma.
It is unethical to let the patient to suffer from pain without
adequate efforts to provide high qualitytreatment. Health
professionals always should believe in assessing the patient for
his pain. Pain is treated
in best way before it reach severe levels.
The ethical responsibility for pain management, which health
professionals must have, is a crucial part in
handling the patient suffering from pain. Postoperative pain
management should be based on a system of
well-organized health care which emphasizes that continuing
professional education is consistent with the
proper techniques of pain management.
The aims of this study are: Assessment of the health
professionals perceptions about postoperative pain
management; Recognition and analysis of interventions for
postoperative pain management; Comparisonof results of the
perception of health professionals and the outcome of interventions
for postoperative pain
management; Creating opportunities for improving health
education and continuing medical care to
patients with pain; To investigate their routine work, to
describe the level of their knowledge and improve
old ways of working for better quality care to patients with
pain.
The research method was quantitative, was made statistical
analysis of data from assessments, opinions
and attitudes of participants and their generation in the
numerical value provided by their observation
based on prepared questionnare. The target group were doctors
and nurses of surgical branches with
different experience in the Regional Hospital of Prizren.
First was noted deficiency in the source of information that
health professionals have received, in thecurricula of the faculty
of medicine was not put special emphasis to pain management, and
less that in
secondary schools, while most nurses (95%) were with secondary
school. In this institution. Liked in
others in the country level there is no accreditation program
for postoperative pain management.
Results showed that pain assessment most of professionals do it
through objective data and that through
oral reporting (65%) than from the subjective data (35%) and
documentation of postoperative pain using
assessment tools have reported that only 20% of participants do
it, while according to literature these
forms of evaluation should be routin for each patient, according
to American Pain Society, the pain
should be considered as the fifth vital sign and according to
Bonica et al., 2000 scales of assessment with
numbers and analog should be used as common tools and
standards.
By non-pharmacological treatment, other techniques that are used
to manage postoperative pain mostly
was reported appropriate position 60% while the other as
cooling/heating, massage/relaxation, recreationand the environment
are least techniques used (3%), while according to Lewis et al,
2005 such strategies
should be included among working with postoperative patients
because helps in managing postoperative
pain, increase comfort, promote sleep and improve quality of
life. While pharmacological treatment
compared to non-pharmacological treatment is dominant in routine
activities of health professionals in the
management of postoperative pain, in 70% of cases was given
analgesia while less than 25% was used
other techniques. Schedule of analgesics use for initial
postoperative period was according to statutory
schedule at 70% of participants, and 30% have administer the
drug when the patient has asked for it, this
practice is consistent with literature where according to Mac
Lellan, 1997 and Manias, 2003 description
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and administration of analgesics in the initial postoperative
stage should be done in a routine manner and
not as required. Documentation of postoperative pain, in
addition to general medical and nursing
documentation is a problem in itself, since in the plan of
health care lacks adequate documentation for
assessing and evidentation of pain and lack of pain assessment
tools. 80% of participants have point out
that they dond do documentation of postoperative pain. This is
contrary to studies of Merboth &Barnason, 2000 and Chanvej et
al, 2004 where the documentation of postoperative pain should be
part of
the chart for recording vital signs, and by American Pain
Society documentation should include allassessments and measures of
management axcept patient answers.
To improve the quality of health services related to
postoperative pain management we recommend:
- To complete health documentation (medical and nurse
documentation) for each patient with anadministrative directive
from the Ministry of Health,
- To undertake professional continuing education for medical and
nursing staff includingpostoperative pain management with relevant
specification of assessment, treatment and
documentation,
- To prepare and issued guidelines and protocols for pain care
at postoperative patients,
- Strengthening of continuing education programs, increasing the
volume and quality of curriculum
for specific training in the management of postoperative
pain,
- Development and implementation of educational programs within
the stationary healthcare
institutions with special emphasis on effective management of
postoperative pain.
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