Postoperative pain is an expected result of a surgical procedure, and is an undesirable sensory and affective experience related to tissue trauma or disease processes (International Association for the Study of Pain, 1986). Postoperative pain is a primary consideration because of its confirmed effects on an individual's recovery.
This study examined the individual and combined effects of age, education, state anxiety, attitudes and beliefs about pain, and prior pain experiences on postoperative pain ratings and on the amount of analgesia administered to adult female surgical patients. A sample of 85 Caucasian women gave consent to participate in this study on the second day after their abdominal hysterectomy. All women were in good preoperative health, had a preoperative diagnosis other than cancer, received a general anesthesia, and pain medication per patient-controlled analgesia pump.
Data were collected per interview, three visual analogue scales measuring incisional pain (present pain, pain on awakening from anesthesia, and worst pain), state-anxiety (Spielberger, 1978), and agreement or disagreement with statements about attitudes and beliefs related to pain. Chart review provided data about all analgesia received pre-, intra- and postoperatively which were converted to morphine equivalents and totaled.
Two research questions were answered using univariate, bivariate, and multivariate analysis of data. These questions are: (a) How much variance in postoperative pain intensity is explained by education, postoperative anxiety, prior pain experience, and attitudes and beliefs about pain? (b) How much variance in the amount of analgesia received is explained by age, education, postoperative anxiety, prior pain experience, attitudes and beliefs about pain?
Using hierarchical multiple regression, state anxiety accounted for 18% of the variance in postoperative pain and years of education explained another 8%. Total postoperative morphine equivalents was explained by age, with older women receiving less analgesia.
Results suggest that postoperative state anxiety should be assessed as well as the women's present pain. In addition to analgesia administration, adjunctive therapy such as relaxation, distraction, and music may be useful to decrease postoperative state anxiety and assist in managing postoperative pain. Older women self-administered analgesia less than younger women. These findings suggest the need for more frequent assessment of verbal and nonverbal indicators of postoperative pain, and reassurance to older adults that using analgesia postoperatively will assist in their recovery.
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