Article

Women's perspectives of pain following day surgery in Australia.

Department of Health and Community Services, Northern Territory, Australia.
The Australian journal of advanced nursing: a quarterly publication of the Royal Australian Nursing Federation (Impact Factor: 0.24). 24(4):19-23.
Source: PubMed

ABSTRACT To investigate the incidence of pain following discharge from reproductive day surgery.
Cross-sectional descriptive study.
A public hospital for women in Melbourne.
315 women participated in phone interviews and 10 in face-to-face interviews.
Self-reports of pain were assessed in relation to age, English and non-English speaking background, prior experience of day surgery, type of surgery, time in recovery, information provision prior to surgery, and access to significant others at home.
Older women were less likely to report having pain immediately following discharge (regression coefficient = -0.72, 95% CI, 0.58 to 0.88, p < or = 0.01), or within 48 hours following discharge (regression coefficient = - 0.71, 95% CI, 0.57 to 0.88, p < or = 0.05). Women with a prior experience of day surgery were 1.9 times more likely to be in pain within 48 hours following surgery (regression co-efficient 1.88, 95% CI, 1.134 to 3.10, p < or = 0.05). Women who understood information were less likely to report that they experienced pain within 48 hours of discharge (regression co-efficient -0.74, 95% CI, 0.24 - 0.95, p < or = 0.05).
Younger patients, those who have had prior experience of day surgery and those who received inadequate information prior to surgery were most likely to report pain. Adequate individual patient assessment will ensure that patients' experience of pain following day surgery is minimised.

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    ABSTRACT: Aim: To evaluate the experiences of patients and caregivers in the early transition phase of recovery at home following day surgery. Background: A global increase in elective day surgery has taken place over the last two decades. This has arisen from enhanced surgical and anaesthetic techniques, healthcare cost containment and patient preference. Minimal hospital stay ensures meticulously managed medical practices are uppermost leaving nursing-based knowledge limited room for expression. However, patients may require much help once discharged hence providing nurse-led involvement in this area with much potential. Data Sources: Five databases from 2000 – 2011 were searched including MEDLINE, CINAHL, British Nursing Index, PsychINFO and Cochrane Database of Systematic Reviews. Reference and citation tracking was performed on included publications. Review Methods: One reviewer screened titles and abstracts for possible inclusion over a 10 month period. Data synthesis involved thematic analysis informed by the findings of the included literature. Results: Twenty-five studies were included in the review. Common themes were pain, information provision and anxiety. Pain management was a concern exacerbated by reduced information. Much information had been forgotten due to latent effects of anaesthesia, limited opportunity on the day of surgery or information booklets lacking a problem-solving approach. Anxiety was associated with inadequate information, unexpected events or by carers striving to supervise a successful recovery. Conclusions: Recovery at home with limited access to healthcare professionals presented a number of challenges mostly relating to inadequate knowledge/ information. Future research should explore continued nurse/ patient contact, nurse-led support services and patient and carer information booklet content.

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Jun 5, 2014