title: Impact of preoperative education on pain outcomes after coronary artery bypass graft surgery.
abstract: 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.
authors.affiliation: 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
authors.forename: Judy
authors.initials: J
authors.lastname: Watt-Watson
authors.forename: Bonnie
authors.initials: B
authors.lastname: Stevens
authors.forename: Joel
authors.initials: J
authors.lastname: Katz
authors.forename: Judy
authors.initials: J
authors.lastname: Costello
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Reid
authors.forename: Tirone
authors.initials: T
authors.lastname: David
mesh_terms: 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