title: Perspectives, perceptions and experiences in postoperative pain management in developing countries: A focus group study conducted in Rwanda.
abstract: BACKGROUND
  Access to postoperative acute pain treatment is an important component of perioperative care and is frequently managed by a multidisciplinary team of anesthesiologists, surgeons, pharmacists, technicians and nurses. In some developing countries, treatment modalities are often not performed due to scarce health care resources, knowledge deficiencies and cultural attitudes.
  
  
  OBJECTIVE
  In advance of a comprehensive knowledge translation initiative, the present study aimed to determine the perspectives, perceptions and experiences of anesthesia residents regarding postoperative pain management strategies.
  
  
  METHODS
  The present study was conducted using a qualitative assessment strategy in a large teaching hospital in Rwanda. During two sessions separated by seven days, a 10-participant semistructured focus group needs analysis was conducted with anesthesia residents at the Centre Hospitalier Universitaire de Kigali (Kigali, Rwanda). Field notes were analyzed using interpretative and descriptive phenomenological approaches. Participants were questioned regarding their perspectives, perceptions and experiences in pain management.
  
  
  RESULTS
  The responses from the focus groups were related to five general areas: general patient and medical practice management; knowledge base regarding postoperative pain management; pain evaluation; institutional/system issues related to protocol implementation; and perceptions about resource allocation. Within these areas, challenges (eg, communication among stakeholders and with patients) and opportunities (eg, on-the-job training, use of protocols, routine pain assessment, participation in resource allocation decisions) were identified.
  
  
  CONCLUSIONS
  The present study revealed the prevalent challenges residents perceive in implementing postoperative pain management strategies, and offers practical suggestions to overcoming them, primarily through training and the implementation of practice recommendations.
authors.forename: Ana P
authors.initials: AP
authors.lastname: Johnson
authors.forename: Ryan
authors.initials: R
authors.lastname: Mahaffey
authors.forename: Rylan
authors.initials: R
authors.lastname: Egan
authors.forename: Theogene
authors.initials: T
authors.lastname: Twagirumugabe
authors.forename: Joel L
authors.initials: JL
authors.lastname: Parlow
mesh_terms: D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods* / Q000523:psychology*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000628:therapy*; D010465:Perception; D012432:Rwanda / Q000453:epidemiology