title: Acceptability of a web-based and tailored intervention for the self-management of pain after cardiac surgery: the perception of women and men.
abstract: BACKGROUND
  Approximately two thirds of adults undergoing cardiac surgery suffer from moderate to severe postoperative pain. Assisting patients with pain management is therefore critical to prevent its negative consequences. Information technologies have become part of our lifestyle and can facilitate the implementation of interventions to manage pain in a busy care setting. A computer-tailored and Web-based intervention-referred to as SOUtien à L'AutoGEstion-Traitement-Assistance Virtuelle Infirmière-Enseignement (SOULAGE-TAVIE)-for the self-management of pain was developed. Findings from a previous pilot randomized controlled trial (RCT) provided some evidence of the feasibility and preliminary effectiveness of this intervention in decreasing pain interference with a few postoperative activities and by modulating pain beliefs and analgesic intake. However, its acceptability from the patient's perspective remains unclear. Moreover, the proportion of women is much lower in the cardiac surgical population, making it difficult to detect differences in experiences between men and women.
  
  
  OBJECTIVE
  The objectives were (1) to describe SOULAGE-TAVIE's acceptability from the perspective of adults experiencing pain after cardiac surgery and (2) to compare the perceptions of men and women.
  
  
  METHODS
  A mixed-method approach was used to capture the various attributes of patients' perceptions of the intervention's acceptability and to compare the perceptions of men and women. Quota samples of men (n=10; mean age 62.5 years, SD 7.3) and women (n=10; mean age 64.3 years, SD 10.7) who had cardiac surgery in the past month were invited to view the intervention, complete a brief questionnaire rating its acceptability, and then to discuss each component in a 60-minute, semistructured interview. Mann-Whitney U tests were used to compare groups. The transcripts were content analyzed to generate themes based on patients' experiences with the intervention and reports of acceptability. The content of each category and subcategory were compared between men and women. Frequency counts were also done to validate the emergence of a difference between the 2 subgroups.
  
  
  RESULTS
  Participants perceived the intervention to be very acceptable in terms of content and format, and tended to describe awareness-raising and convenient support experiences. Women scored higher than men in terms of the intervention's appropriateness (U=13.5, P=.008). They were willing to adhere to the intervention based on the importance and relevance of the advice provided, whereas men were more focused on the delivery mode and its flexibility.
  
  
  CONCLUSIONS
  This study underlined the acceptability of computer tailoring and persuasive communication to modulate pain beliefs and attitudes in an acute care context. Both men and women appreciated the Web-based interface and general self-guided approach of the intervention. The delivery of SOULAGE-TAVIE across the continuum of care seems to be an interesting avenue to influence the transition from acute to chronic postoperative pain.
authors.affiliation: Faculty of Nursing, University of Montreal, Montreal, QC, Canada. geraldine.martorella@umontreal.ca.
authors.forename: Geraldine
authors.identifier: http://orcid.org/0000-0001-9383-7114
authors.initials: G
authors.lastname: Martorella
authors.forename: Céline
authors.identifier: http://orcid.org/0000-0001-7948-5570
authors.initials: C
authors.lastname: Gélinas
authors.forename: Margaret
authors.identifier: http://orcid.org/0000-0001-6080-3495
authors.initials: M
authors.lastname: Purden
keywords: Internet; mixed method; pain, postoperative; patient education; surgery, cardiac