Impact of preoperative education on pain outcomes after coronary artery bypass graft surgery.
Cardiovascular diseases cause more disability and economic loss in industrialized nations than any other group of diseases. In previous work [Nurs Res 49 (2000a) 1], most coronary artery bypass graft patients (CABG, N=225 ) reported unrelieved pain and received inadequate analgesics. This study proposed to evaluate a preadmission education intervention to reduce pain and related activity interference after CABG surgery. Patients (N=406) were randomly assigned to (a) standard care or (b) standard care+pain booklet group. Data were examined at the preadmission clinic and across days 1-5 after surgery. Outcomes were pain-related interference (BPI-I), pain (MPQ-SF), analgesics (chart), concerns about taking analgesics (BQ-SF), and satisfaction (American Pain Society-POQ). The impact of sex was explored related to primary and secondary outcomes. The intervention group did not have better overall pain management although they had some reduction in pain-related interference in activities ( t(355)=2.54, P<0.01) and fewer concerns about taking analgesics ( F(1,313)=2.7, P<0.05) on day 5. Despite moderate 24-h pain intensity across 5 days, patients in both groups received inadequate analgesics (i.e. 33% prescribed dose). Women reported more pain and pain-related interference in activities than men. The booklet was rated as helpful, particularly by women. In conclusion, the intervention did not result in a clinically significant improvement in pain management outcomes. In future, an intervention that considers sex-specific needs and also involves educating the health professionals caring for these patients may influence these results.
Watt-Watson
Judy
J
Faculty of Nursing and Centre for the Study of Pain, University of Toronto, 50 St George Street, Toronto, Ont., Canada M5S 3H4. j.watt.watson@utoronto.ca
Stevens
Bonnie
B
Katz
Joel
J
Costello
Judy
J
Reid
Graham J
GJ
David
Tirone
T
D000368:Aged; D000704:Analysis of Variance; D001026:Coronary Artery Bypass / Q000451:nursing*; D003327:Coronary Disease / Q000451:nursing* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000451:nursing* / Q000628:therapy; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000379:methods*; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome