title: Patient participation in quality pain management during an acute care admission.
abstract: OBJECTIVE
  The objective of the study was to explore patient participation in the context of pain management during a hospital admission for a cardiac surgical intervention of patients with cardiovascular disease.
  
  
  METHODS
  This is a single-institution study, with a case-study design. The unit of analysis was a cardiothoracic ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia. Multiple methods of data collection were used including preadmission and predischarge patient interviews (n=98), naturalistic observations (n=48), and focus group interviews (n=2).
  
  
  RESULTS
  Patients' preference for participation in pain management was not always commensurate with their involvement in pain management. Patients displayed a greater understanding of their role in pain management in terms of reporting pain and the use of multimodal analgesics after surgery. The majority of patients, however, did not understand the importance of reporting pain to avoid complications. Patients had limited opportunity to participate in their pain management. On occasions in which clinicians did involve patients, the involvement appeared to be focused on reporting pain rather than treatment of pain.
  
  
  CONCLUSIONS
  Patient participation in pain management during hospitalization is not optimal. This has implications for the quality of pain management patients receive. Higher engagement of patients in their pain management during hospitalization is required to ensure comfort, reduce potential for complications, and adequately prepare the patients to manage their pain following discharge from hospital.
authors.affiliation: *School of Nursing and Midwifery, Deakin University †Alfred/Deakin Nursing Research Centre, Alfred Health ‡Epworth/Deakin Centre for Nursing Research, Melbourne, Vic., Australia.
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: McTier
authors.forename: Mari
authors.initials: M
authors.lastname: Botti
authors.forename: Maxine
authors.initials: M
authors.lastname: Duke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000601:surgery; D005260:Female; D017144:Focus Groups; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement; D010351:Patient Discharge; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference; D011183:Postoperative Complications / Q000503:physiopathology; D013997:Time Factors