title: Pain in adults post surgical repair of congenital heart defects.
abstract: The purpose of this study was to describe pain in adults post surgical repair for congenital heart defects. What is the intensity, sensory, and affective dimensions of pain experienced post-operatively? What is the trend in pain experienced post-operatively over time? What is the effectiveness of post-operative pain management strategies? What factors influence the dimensions of post-operative pain experienced? A descriptive prospective repeated measures design was used with 30 adult congenital heart (ACH) post-operative patients. Pain assessments using the McGill Short Form Questionnaire (MSFQ), a visual analogue pain scale (VAP), and recordings of other variables (analgesic, anxiety, activity level, non-pharmacologic intervention) were performed three times daily until hospital discharge. Mean pain intensity scores ranged from 2.44 +/- 1.31 following extubation to 1.30 +/- 0.66 on post-operative day (POD) five (scale, 0-5). Mean MSFQ scores ranged from 9.26 +/- 7.21 following extubation to 4.40 +/- 5.22 on POD five (scale, 0-45). Mean VAP scores ranged from 50.77 +/- 25.79 following extubation to 18.76 +/- 18.50 on POD five (scale, 0-100). Mean number of narcotic doses per day ranged from 4.61 +/- 2.01 to 1.88 +/- 1.98 on PODs one and five, respectively. Anxiety predicted VAP and MSFQ scores on PODs one and two; anxiety and analgesia doses predicted VAP and MSFQ scores on POD three; analgesia doses predicted MSFQ scores, analgesia and anxiety predicted VAP scores on POD four; analgesia doses and anxiety predicted VAP and MSFQ scores on POD five. No relationships were found among pain and other demographic, treatment, or clinical variables. Overall, pain was reported as mild to moderate intensity, variable in sensations, decreased over time, and adequately managed.
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G 2G3. louise.jensen@ualberta.ca
authors.forename: Louise
authors.initials: L
authors.lastname: Jensen
authors.forename: Darlene
authors.initials: D
authors.lastname: Rebeyka
authors.forename: Gayle
authors.initials: G
authors.lastname: Urquhart
authors.forename: Sylvia
authors.initials: S
authors.lastname: Roschkov
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000416:Alberta; D000698:Analgesia / Q000523:psychology; D001294:Attitude to Health; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012648:Self Care / Q000379:methods / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors